Yesterday, we were preparing to go to our homeschool dissection class, leaving the house. I noticed the Dexcom said he was 231 three hours post lunch and no insulin on board. (He's set at 4 hours, so that was the first clue.) He had eaten spaghetti, which does sometimes spike him, but I then checked his BG and yes it was high, and then...the PDM said no insulin bolus was made at lunch! It has happened once before and probably will happen again. We try to have fail-safe check systems, and I won't bore you with all that was going on that morning, but lots of activity at home. He thought I'd done the bolus, frankly, I thought I had, too. So, to make it worse, we gave him the recommended correction bolus (3.75) but son reasoned that he likely still had "food working" and so we added 3.0 on top of that. My initial reaction was to wait to see what 3.75 did and correct more later. That was the correct response (which I didn't follow) because his BG began falling into normal range, but right after the class (which also included some play time) he was 95 with 4 IOB! This was treated with a McChicken sandwich, a sacrifice my 12 year old willingly made. ("You mean I get this for "free"?? Wow, I feel normal!" (Mom sobs inside.)) My questions: 1. His BG was 153 before lunch. 75 carbs for lunch only brought him to 231? He is 8 mos. post dx and on all other days, doesn't seem to be in honeymoon. Can that come and go? 2. Obviously, I should have stuck with 3.75 bolus, but I've actually seen him with IOB and a lower BG that rides smooth and I think that particular food is "balanced" with the insulin. Doesn't happen often but sometimes. Shouldn't he have needed 7 or so units to process 75 carbs? Why only 3.75? I guess the answer lies in question #1. Once before this happened and he went over 300 and going straight up. He is about to grow, starting to need deodorant, etc. but now I know, based on basal needs, that growth does start and stop right now and isn't full on. We have been raising basal levels and perhaps it was a bit high for his needs for that day? I love how one can read and study and work about this disease and just one off moment can throw me into a spin. Please let me know if you have any thoughts on this. Thanks!!