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[IP] Re: Lori needing advice


I have this problem too, and it's taken awhile to work it out. Try what
others have mentioned--I know working with kids is different than
adults--but one thing I do is a square wave bolus. Sometimes its 30
minutes, and other times an hour, depending on what I eat. I also do a
1:7 breakfast ratio, and a 1:10 for other meals. Pregnancy has
exacerbated the after-breakfast highs, so my endo just put me on a higher
basal rate from 8-10 am in addition to these changes. I've noticed that
different foods need different rates. For example, bagels (which I could
never eat on MDI without being 300 afterwards) need a large bolus (at
least 6 units) over 1 to 1.5 hours. Muffins need a 5 unit bolus over 1/2
hour. If I ate more protein and less carbos, I would use the lesser time,
like 30 minutes. Having Ryan eat the same breakfast for a week, and
checking hourly may help you see what works best. But I'm sure that's
impossible with school :) Try the best you can.

Also, as Michael pointed out, weekends can be different. Many times I
sleep in, and don't eat until 10 or later. Then I skip the square wave
bolus altogether and take a normal bolus with little or no problem. It's
an early morning phenom. 

I hope this helps--and made sense. Just woke up from a nap, and not too
clear-headed yet (or at least that's my excuse).

Maureen M. 

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