My 9 year just started using the Omnipod this past August after using a traditional pump for 4 years. He is frequently high (200-250) at the same times every day because his insulin to carb ratio changes so much throughout the day and I have only been able to set 4 different ratios with the Pod. Using his old pump I could set as many different IC ratios as I wanted.

Is this correct? That the Pod only allows 4 different ratios per day? Does anyone else have this problem? Ideally, we need 6 different ratios - 1:15 at breakfast, 1:25 at snack, 1:35 at lunch, 1:45 at dinner, and 1:50 overnight. The overnight ratio technically counts as 2 because the times start at 12am, so six ratios total that I have to make work with only the four allowed. We are having problems with the morning snack because it is now merged with the lunch ratio and he gets dosed at 1:35. I know I can just up the snack dose manually, but he is at school during this time and in order to up the dose the nurse has to call me every time. Anyone know why the Pod doesn't allow more ratios?

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I just looked at my manual, and the limit is definitely only 4....not sure why they limited it to just that. Could you eliminate the overnight one? That way you could add the snack one.

Just to make sure we're all talking about the same thing, you're asking about insulin to carbohydrate ratios used for bolusing purposes when food is consumed right? Not sensitivity factors for correcting high BGs?

If you really do mean bolus-related insulin to carb ratio, then I agree w/ putertech. For the purposes of getting that crucial snack time ratio into play, I'd try eliminating the overnight ratio and just maybe use dinner time one?. If you did that, you'd have to decrease whatever insulin you were going to give throughout the night time hours if you were going to eat something...but I guess that brings me to the question, why is your son eating and bolusing at 2 in the morning? There shouldn't necessarily need to be a nighttime one used that often, so it would be okay to eliminate it (remembering of course that he'd need a little less if he did bolus).
At what point during the night/waking hours does it circulate back from 1:50 to 1:15?

Yes, I could eliminate the overnight by making the ratio 1:15 starting at midnight. We did do this for a while, but it made me a little nervous. He does wake up low in the middle of the night, not often, once or twice a month, usually after a day filled with excercise. It's hard to remember to lower the dose in the middle of the night. It's doable, but it seems like the risk/reward might be too great. We will probably have to go back to that method.

Perhaps your basal rate needs adjusting. You can change the basal rate numerous time during the day and also have several basal rate programs.

That's what I was thinking. How many basal rates do you have?

i have 9 basal rates set up in mine cause there r only the 4 settings in carb ratio. my endo and i set it up to compensate my needs due to various activities. i can always use the carb ratio or suspend for a short time if to low.
hope this helps, this is what works for me.

Instead of making the breakfast ratio your overnight ratio... why not make you dinner ratio your overnight ratio. A ratio of 1:45 is much closer to 1:50 than 1:15 is. Cause I understand about night time lows. I live in fear of my son going too low.

I too had to go check the manual about the #4 limit on IC rations and you are correct about the limit. I too would try working with the basal rates. Also, when I take my pre-bed BG, if I'm at or below 120 and 150, I use a temporary basal rate -10-25% set for 8 hours depending on how much exercise I've had to head off night time lows.

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