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50-50 Rule.

Discussion in 'Parents of Children with Type 1' started by Rusty, Feb 10, 2010.

  1. Rusty

    Rusty Approved members

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    I have been thinking about this 50-50 rule lately and have even talked with CDE about it. I do understand that generally the TDD should be about 50 percent basal and 50 percent bolus. Now what i have been wondering about is if you have a day with more carbs requiring a higher bolus total for that day that is significantly higher that the basal given that day will it throw your numbers off, Specifically night time numbers. Like i said i have tried to talk to CDE about this and have not gotten any real straight answers.
     
  2. deafmack

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    Somewhere I read about the 50-50 rule on another diabetes website. Someone said they were using it and their numbers were really good. I asked them what it was and never got an answer. Maybe you will have better luck than me.
     
  3. Becky Stevens mom

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    We very rarely have a 50/50 day here. Usually more like 60/40 with more bolus insulin being given each day. If you find out about this Rusty Id be curious to hear what the CDE says or I can ask our endo next time. Im not sure if there is anything in the book "think like a pancreas" but I'll check
     
  4. joan

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    That 50/50 rule does not work for my son right now. He is a teen and eats a lot. He also plays varsity sports and is prone to lows at night. So his ratios are much greater bolus to basal. I think if his life was more predictable and sedentary that might work but his blood sugars guide us on his doses not a percentage ratio that doesn't consider his activity level and lifestyle. When he was younger and did not eat as much his basal was closer to the bolus amts and I did like that but for right now it isn't possible. I know your son is younger but that is how it is for us.
     
  5. Christopher

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    Hi Rusty,
    Danielle's endo also suggested that we try and get an equal balance between basal and bolus, but it just is not happening right now. She needs much more bolus than basal and the only way to equal the two out is either reduce her carb/food intake (no) or increase the basal (would cause her to go low).

    In my opinon, this is one of those "nice to have" type of things, but not at the expense of health or safety.
     
    Last edited: Feb 10, 2010
  6. ecs1516

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    We were never 50-50 , especially when my kids were younger. Their basal was more like 30%. Their endo said this is normal for for younger children.
     
  7. Charliesmom

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    Charlie is more basal than bolus. It's the only way I have figured out how to deal with his grazing throughout the day and not have the spikes. Probably not the best way but it's working for now.
     
  8. StillMamamia

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    Hmmm...I've never paid attention to this rule.:eek:
    Have to ask about this.
     
  9. Barbzzz

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    We're definitely like this... Alex is probably more like 65/35 basal/bolus, and it allows her to be her normal grazing little self without too much bolusing.
     
  10. Mom2Will

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    How interesting that you post this today. I was just telling my husband last night that it appears Will's basal and bolus are 50/50. No effort put into that it just seems to be how it's working lately. Tomorrow is another day, however...:cwds:
     
  11. Mouchakkaa

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    We also try to get 50/50. We did this about a year ago and it has worked great for us. Before we were about 30% basal. It took us about a week to get the correct split but once we got it we saw a different right away. Her BG became more stable. We took her TDD and split it in half and worked out the basal. We then adjusted the ratios so that we had the split. We then made adjustments throughout the week always trying to keep the 50/50 as close as possible. We of course can not get a 50/50 every day but my daughter is usually 45/55 and it could be basal as the more or the bolus. I figure this is pretty close to 50/50. In the last year the greatest different was 40/50. This accounts for more food eaten that day or a sick day. With growth spurts we have to increase the basal but then she is also eating more during those times so her boluses are also increased and we still maintain close to 50/50.
     
  12. tom_ethansdad

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    Our CDE tries to target 60% bolus - 40% basal, but it is just a general target. Actual needs change from day to day and are what they are.
     
  13. hawkeyegirl

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    This is something that I honestly don't care about. I suppose I would stop and look closer if he suddenly went to 80/20 (or 20/80), but as it is, I simply don't pay any attention to his basal/bolus split. He needs what he needs.
     
  14. Toni

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    When younger she was more in the 36 to 40 percent basal, rest bolus; in last year she seems to need a lot of basal 60/40. Endo would prefer 50/50, but I can't artificially impose a lower basal. I mean I could but if she didn't eat at a certain time she would be high. Brought in Walsh's chart (he noticed teens often use 60 basal/40 bolus). But if we go over 60 percent basal (which we did for a few days, endo is on top of it and not okay with that). I am now watching the basal/bolus split daily on her pump. P.S. Joslyn did a study recently which states that a 38 to 40 percent basal/rest bolus is optimum. But the basal is what it is....... I get the basal and work around that.
     
  15. redmcgee

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    I have never even heard of the 50/50 rule so apparently we don't do that. I think it is more like 60/40.
     
  16. redmcgee

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    I agree about basal being what it is and then working around that. If the basal is wrong then everything is out of range.
     
  17. Gracie'sMom

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    Our endo said the 50/50 is just a ballpark, if the child's bg's are way off and the ratio is really far from that then they try to get it closer to the 50/50 to see if that stabilizes things. But he also said it will almost never be at 50/50.
     

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