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33% Basal 67% Bolus

Discussion in 'Parents of Children with Type 1' started by NomadIvy, May 8, 2011.

  1. NomadIvy

    NomadIvy Approved members

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    I've had three CDEs go :eek: on our basal/bolus ratios. Is this bad?
    I've read Pumping Insulin, Think Like a Pancreas, Type 1 Diabetes, and what have you... and I know what they say. But if I try to go closer to a 50/50 ... even just a 45 basal/ 55 bolus , she tends to drop. I'm trying for a 40/60 but it's so hard to do basal testing because she won't stop eating! :eek:
     
  2. Katie'sMom

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    We usually stay right around 60/40 bolus to basal which is whatr our CDE told us was good when my dd first started pumping.
     
  3. Lisa P.

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    If we go too high on basal (It's probably 40% or less right now, too lazy to go get the pump and look) here's what happens for us. We want her to be in range when she eats and then back in range four hours later when the insulin is tailing off and she eats again. If we have the basal too high, she'll go low every time by the four hour mark. So we wind up giving her less bolus insulin so that she won't go low. And so she spikes really high at two hours, then is back in range at four hours.

    To me, it makes sense that in little kids who are growing, they will have less basal. Isn't basal glucose pretty much what your body puts out perpetually to keep a baseline on daily living functions? So extra activity or growth, that's going to come from extra carbs, isn't it? So doesn't it make sense that you would need more bolus insulin if you are eating to grow?

    I remember being confused when the doctor explained how my three year old needed more calories a day than, say, a four year old would (I forget the exact ages, but the point is that a younger, smaller kid needed more carbs than a bigger, older kid would). This was because the food was fueling faster proportionate growth.
     
  4. rutgers1

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    I haven't have anyone be able to explain why my son only needs 5 units of Levemir, which is less than 30% of his total daily insulin. If we go any higher on a day when he is active, he goes low like crazy in the night.
     
  5. PatriciaMidwest

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    Ours looks similar. I can't add any more basal, she runs low right now (unless eating). Yet she needs a ton of insulin for carbs, and sometimes we have to dose for protein and fat too. There is no way we could go 50/50 right now. I know what you mean about those shocked looks though:eek:
     
  6. Flutterby

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    If it works for you, then don't worry about what the books say.. K is usually 70/30-60/40 BASAL/bolus.. we've never been 50/50. :)
     
  7. NomadIvy

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    Yes, this happens to us too. But the way the CDE was looking at our charts (we finally have a downloadable pump!) you'd think we were doing something insane and messing her up big time.:rolleyes:
     
  8. wilf

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    My motto has always been "Never mind what standard practice is - go with what works!" :)

    You are doing just that. Kudos! :cwds:
     
  9. Heather(CA)

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    I say if it's not broke...Don't fix it. If its not working, then try what their saying... I honestly don't pay any attention to what the balance "should" be, I just do what works :)
     
  10. Heather(CA)

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    I hadn't read this...But, what he said! :D
     
  11. selketine

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    How old is your child (I can't tell from the sig - 3 yrs or 6?).

    Anyway when William was younger his basal was about 25-30% of TDD. That has risen somewhat as he gets older (maybe up to 30-35%) but sometimes that is what works.
     
  12. joan

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    I really have a tough time understanding how your CDE's think that 50/50 is the way for you to go if your daughter's blood sugars are in a good range. I just don't get it. Did they say why they think this is what you should be aiming for?

    For my son 50/50 would be great if he was sedentary. He would need much more basal and would not eat as much because he would not be burning as many calories. With exercise 50/50 is impossible.
     
  13. frizzyrazzy

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    when my son was younger we tended closer to 70% bolus, 30% basal. Not that he's getting older and heavier we are nearer to 50/50 but still stray towards 60/40 basal/bolus rather than 40/60.

    If it's working, keep it up.
     
  14. Christopher

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    People with diabetes need what they need in terms of insulin. Why attempt to force an artificial bolus/basal percentage? Danielle has never been 50/50, has always used more bolus than basal, and when I did try and even it out she had bad lows. Unless the endo can give you a solid reason why 50/50 is important, I say keep doing what you are doing.
     
  15. emm142

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    I used to be on 20/80, and at that time had some of my lowest a1Cs ever. I never really honeymooned, but I believe that at that time my pancreas was helping out a bit with basal insulin..
     
    Last edited: May 9, 2011
  16. mom2two

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    Exactly!! We are usually around 80/20, 70/30. It works for us and our A1C is below the Target where he should be so we are staying with what works for us.
     
  17. slpmom2

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    Our ratio looks much the same - 70-80% bolus, 20-30% basal. We've tried to change it, and it absolutely doesn't work, so we keep it as is. If it's working for you, it's fine!
     
  18. NomadIvy

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    Thanks! Maybe our Diabetes Teams should have meetings with PoCWDs once in a while so they could also "get it"! :p
     
  19. NomadIvy

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    I shouild write "darling daughter # 3 ...:D She was diagnosed when she was 6 years, 3 months over a year ago, so she is now 7 years old.
     

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