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[IPp] Re:pump question for the experts

Hi Stacey,
       My daughter started pumping at age 6, she is now 9 and is average 
 size. Her insulin to carb ratio has always been 1:15 for all meals and snacks,
except if she is eating right before exercise I use 1:20.  This means that we 
always use 1:20 for school lunches, and virtually never in the mornings.  
       If you are getting highs or lows after meals, sometimes its hard to 
 tell if it is the basal rate or the carb ratio, until you can do a fasting
 This can be hard to get with kids during the day, especially when they are 
going to school.  Can't really ask them to skip lunch and then go play on the 
playground, can you?    I only figured out that I needed to lower the school 
 lunchtime bolus amount (from 1:15 ratio, to a 1:20 ratio) after such persistent
afternoon lows at school, that even a zero basal rate wouldn't have 
 corrected. Lowering the basal rate just by .1 unit per hour and changing to a
carb ratio worked like a charm though.  
       Also, the endo thought that Claire needed a higher morning basal rate, 
because her lunchtime number was always higher than expected.  But this 
 turned out to be from the morning snack being too close to the lunchtime bg
(about 75 minutes).  This year Claire has insisted on not eating breakfast and 
 going off to school and some days the teacher does not give them a snack break,
so after almost 2 years of pumping we had a fasting basal test in the 
 mornings at school!! So I finally discovered that she did not need a higher
basal rate after all.  
       Sounds like you are doing great and things will gradually fall into 
place.....just in time for summer vacation, when it all may change again!!

Barbara, Mum of Claire 9


> seems to be high cosistently 2-3 hrs after
> breakfast and lunch. sooooo since he was level from
> midnight til 11:30, I guess that the bolus ratio is
> off ... At dinner(BG was 114) tonight he bolused 1:30
> and 2.5 hrs later he was 295 . How much do I change
> the bolus??? For breakfast do I try 1:20?? On MDI he
> was 1:15 at breakfast and 1:25 all other times
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