Confused ratios

[bex123]

Hi all , i know i don't post here very often but i was hoping someone may have some advice regarding my insulin to crab ratios. i have got an appointment with dsn soon but in the meantime does any one have any ideas on this?
I had a pump break for a month as absorption was becoming an issue ( and D burnout saying i never wanted to use the pump again... lots of support later and my mind quickly changed ) and all seems better now. But i discovered a problem since and during the pump break.
I have a 0.5 to 10g ratio which has always worked , but while on pens i quickly realised the smaller of doses for example : if i only ate 10g the 0.5 bolus did nothing and i got high b.s readings 1 and 2 hours after( like as if i hadn't bolused at all ) , and the same with all small doses. So i upped the ratio to 1u to 10g which worked great for the smaller boluses. But , if i had a big meal for example 90g of carbs and used the 1 : 10g ratio i would go hypo. I have played around with this to try and see what is happening and the 0.5 ratio works for big meals but not small snacks. This is now happening on the pump with smaller doses and have done all the usual checks , bubbles , priming etc , and am totally confused as to where to go from here. I don't want to change my ratio to 0.7 because the 0.5 works for big meals and is spot on and i don't want problems with hypos.
any ideas?

 

[Copepod]

Welcome back, Bex123 - hope some pumpers will be along soon to help with your specific queries.

 

[HOBIE]

There is so many extra things to affect, Basal,what you are doing. It isnt a science. If i am thinking/worried about something bg drops. It is a minefield & after 47yrs you still learn ! Good luck sorting 🙂

 

[Redkite]

Hi Bex,

You can program several different ratios into your pump for different times of day. My son has 1:8 for breakfast (always needs more insulin at that time of day), then 9.30am the ratio goes down to 1:15 to be used for snacks, 12.30 he has a lunch ratio, currently 1:17. This suits him for afternoon snacks as well, and then he has another ratio starting from 5pm for evening meal.

However, we do get problems sometimes when his carb amounts are much lower or higher than usual. His meals would normally be 50-80g carb. If he eats less than 30g, his ratios don't work so well and he ends up hypo. If it's 100g or more, this can also lead to a hypo as you've described. What I tend to do for the large amounts is to do a dual wave bolus, with the portion of insulin relating to the excessive carbs going in as a square wave. Then he can check his levels after an hour or two, and if necessary cancel the rest of the bolus. For snacks between meals, if his levels are in range, he can have 10g carb with no bolus, and just gives insulin for anything over the 10g. But it's not an exact science! 🙂