basal rate / carb ratio test

I successfully completed basal rate testing in my 5 year old. It needed to be done and we did it! Yeah! Only needed to make a few changes.

So today we decided to now check I:C ratio.

I carefully calculated the carbs of breakfast, used our I:C ratio of 1:14, and by the time the insulin was completely finished her BG was 310! According to my crappy math (which I'm bad at) this means I should change her breakfast I:C ratio to 1:7!!! She's 5. I'm thinking I'll do 1:12 tomorrow and 'just see what happens'. 1:7 does not seem right. I wish I were smarter. Then if 1:12 doesn't work I suppose I do need to keep dropping.

p.s. our ISF is 175.

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Replies to This Discussion

I:C ratios, unlike basal rates, can't really be "tested" or submitted to any formulas which are only approximations. It is all about trial and error. It's better to be conservative and do changes slowly as you suggested. Going to 1:12 and seeing how she does is, imho, the way to go. Then if a couple meals at 1:12 still leave her high, go to 1:10. You might also keep in mind, that she might have different ratios for different meals (Mine are 1:5, 1:10 and 1:19.

Are you sure about that 175? That is awfully high. If 1:14 is leaving her that high, she doesn't sound as insulin sensitive as the 1:175 ISF would suggest.

I think the safest way to make changes in insulin dosing is in small increments and allowing at least a few days at each change level. If you used an IC ratio of 1:14 today, perhaps you should use the same breakfast content and size and dose the same 1:14 IC ratio tomorrow. I know that it might seem like you're taking too small steps but there may be another factor that influenced today's breakfast dose that you're unaware of.

What type of insulin are you using? How long does this insulin last? I have found that my insulin last about 4 1/2 hours, a duration that I suspect is longer than many other diabetics.

The reason that I think you should take such small steps in adjusting your dose is because you're dealing with a diabetic that does not weigh much.

What was your daughter's BG before breakfast? How much time before breakfast was the insulin delivered?

She’s 5 she’s going to be active running around doing different things every day and she’s growing. Keep track of her schedule just because you did basal testing today doesn’t mean its going to be the same for tomorrow and for a school day when she’s running around with her friends. Also is her honeymoon phase over? that will play with all your results.

Take little steps..and don’t worry

Thanks, we definately have different ratios and ISF throughout the day.

I'm putting this carb ratio test on hold until tomorrow. I changed the pump site. She was high all day and night and it wouldn't budge, unusually high, 300-400. We went to a birthday party and a bbq yesterday, so lots of fat involved, but even still, I think the site was bad bc those numbers were not our normal. Fixing the site and then will resume the carb test tomorrow. Will keep you posted.

oh dear not a good day, i would have changed the site too, hope things are better! amy

hello, breakfast can be a tough meal to bolus, because it is often carb loaded, and they have a good spike up after the carbs, alot of people suggest they can handle heavier carbs later in the day but not so much in the am ? different sensitivity? what did she have for breakfast, cereal seems to be the biggest offender, my son loves cereal so i let him have it but make sure we include some protein or at least a glass of milk on the side, he hadn't had cereal for a while and had it today, big spike, i think i miss the spike when if goes off to school because he doesnt test again until lunch 5 hours later and is usually pretty good number wise by then, i still think balancing protein and fat at meals helps with spikes, best wishes, as others have suggested there are so many variables and unfortunately numbers will never be always perfect, we just try to use the numbers to figure out what better to do next time, best wishes! amy

Cereal is the one food we never eat! She had plain yogurt and apple, eggs and sausage. That's what she has almost every morning. I think it was just the site. BG is finally going down. I would not mind diabetes so much if it would stay constant. It seems every few months I'm tweaking something, then a few months later tweaking it back. Ugh.

do i ever hear you! good job keeping her diet so healthy that sounds like a very healthy start to her day, my son eats lots of carbs lately he is 13 and growing, someday he may need to consider the low carb thing but for now i try to let him decide within reason, ( he just made himself a banana smoothie and then went for who knew cookies!, 72 carbs just for snack yikes!) i keep mostly healthy food in the house, in my opinion restaurant and too fatty foods are the real D enemy .. one day at a time i guess. how long has your daughter been on the pump, jacob has been on the omnipod for 1 year we have worked out some issues but somedays if seems like it was much easier on MDI when we rarely thought about DKA or even used many ketone strips, but the freedom from shots and the ease of treatment and tweeking can't be denied.. so pump we will, hope things get better amy

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