Insulin/carb ratios

[Tamagno]

I have the worst time managing this along with basal rates.

Last night, for example, dinner had 12 carbs and I bolused .55 units as suggested by my pump. My basal rate was .70/hr. that is about the usual for me that time of day and glucose was 176 when I bolused. Within two hours my CGM read 246 with its alarming double arrows pointing straight up and dry mouth signaling impending DKA.

The day before, I was over 400 after a lunch of 32 carbs, basal at 2.00/hr. having bolused 2.25 to cover lunch and by dinner glucose was 35 and headed down. I must have eaten hundreds of carbs plus a glucagon shot and couldn't get glucose up until nearly midnight.

Anybody else dealing with this mess? The only constant seems to be that eating causes problems!

[Grammabear]

I also deal with situations such as you've described.  It seems to happen more often with me during the Spring and Fall months when the seasons change.  It is then that I have to change my basal rates and carb to insulin ratios.  I start by changing the problematic basal rates at whatever time of the day they happen.  Then I move on to changing the carb/ratios.  I do this little by little and eventually I get to where I want to be (most of the time).  It is important (at least for me) to make a carb ratio change and then wait two or three days to test it out and be sure it is working for me.  If I sound like I have it altogether - I don't.  Some days I'm lucky, other days I'm not.  Hope this helps you a little.

[Tamagno]

Thank you so much!

Actually, I hadn't thought of seasonal changes as a contributing factor - I'll have to see if I can remember, but it certainly seems reasonable.

Your scheme of testing a new I/C ratio for 2-3 days is excellent and I'll definitely try it. It's so much easier to be able to rely on suggested boluses, plus you have a baseline for comparison.

How do you like the T-Slim?

[starsign]

Don't know much about the subject, but reading this opens new doors of knowledge for us newcomers. Grateful for all the info here.

[Grammabear]

Thank you so much!

Actually, I hadn't thought of seasonal changes as a contributing factor - I'll have to see if I can remember, but it certainly seems reasonable.

Your scheme of testing a new I/C ratio for 2-3 days is excellent and I'll definitely try it. It's so much easier to be able to rely on suggested boluses, plus you have a baseline for comparison.

How do you like the T-Slim?

One of the reasons I chose to switch pump companies from Medtronic to Tandem is the colored screen on the Tslim.  I have nothing bad to say about Medtronic because I had their pump for 5-1/2 yrs and their customer service always treated me very well.  However the Medtronic pump screen was hard for me to see as it is black and white or black and gray.  I also like the Tslim because you can use basal rates that are more detailed.  For example if your basal rate was .70 per hr and you felt like you needed a bit more, with the Medtronic pump you are limited to the next number which would have been .75.  On the Tandem you can put in any number in-between .70 and .75 and use that as your basal rate.
Sometimes this feature is really useful, especially at night when dealing with the Dawn Phenomenon.