I think things have strayed slightly away from the original poster's question, which wasn't about different mealtime ratios, but different ratios according to what was actually eaten at breakfast (say, toast and jam, cereal, porridge?). I'm wondering if it's not the ratio, but the time tests are being taken. If taken at the same time to try and determine peak this may seem to indicate that cereal, for example, is much higher than porridge. Here, the problem is more likely with timing of insulin dose, and getting the insulin peak to coincide with the food peak. Time of day affects ratios, but the same ratio should apply to all food at the same time of day - but digestion of the food may vary depending on what was eaten.
Ah right sorry, I must have read the post wrong. Sorry.
The problem with breakfasts is that you have the insulin resistance but also it is the hardest meal. Cereals are a nightmare for lots of people. There are few on here who will argue that point but with the cwd group the majority have a problem with any cereal whether it be porridge, shreddies, coco pops etc, it makes no difference.
We find the oatsosimple sachets are ok and we do not spike.
In theory you shouldn't need a different ratio for different foods, you just have to learn what each food does and how it works in the body.
For example take the difference between mashed potato and pasta. So lets say they are both eaten at lunch time and the ratio that is set for that period of time is 1 : 10. So lets say it is calculated and they both need 3 units of insulin according to that ratio.
Now I think I can pretty much guarantee you that with the mashed potato the levels will go up very quickly and come back down so a normal bolus of insulin is just fine which is great when on injections.
However with the pasta even though 3 units is perfect for the amount eaten and the ratio, you may well find a hypo even after an hour or so but a huge spike about 4 to 6 hours later. This is purely due to how the pasta works in your body not to do with the ratio and amount of insulin.
The way to deal with that particular meal is easy on a pump as you can give the insulin in different ways. Some people on injections spilt the injection so give say 50% immediately and then about 2 hours later give the other 50%, so 1.5 units when eating (or 20 minutes beforehand) and the remaining 1.5 units two hours after eating which should combat the pasta spike.
I hope that helps.
At school, they should have a sliding scale or a calculation of how to work out a correction. They do not need to ring you. However they may feel nervous and may want to ring you, afterall a miscalculation of insulin could be a disaster. If this is a new thing then maybe you can allow them to call you for a few months and they will hopefully build up their confidence but no they do not have to call you but you have to have written down your guidance in a care plan on what to do and how to do it.
