I:C ratio and bread

Is it normal to have one I:C ratio for most foods, but a different one for other foods, like say we are having a problem with breads. It seems like our I:C ratio should be different for bread. Is this common and how do you deal with the math? The I:C ratio is programmed into the pump, so when we eat things like bread we have to remember to “add x units on top of that”.

We don’t eat breads often because they are a problem, but for when we do…should I treat them sort of in the way we treat pizza? (which we’ve mastered the pizza bolus).

That’s pretty much what I do, sweettooth; I’ll be interested to see if anyone has a different solution. I’ve mostly stopped eating certain foods because their results are too out of range of my I:C and too unpredictable. But others I’ve learned are ok now and then if I do a combo bolus and perhaps also a bit extra. Like last night I had a vegie burger on a double fiber muffin. So I did a 40/60 combo bolus for 3 hours and added in 25% above what my wizard suggested for the carbs and it worked well. In general I do the settings in my pump for what works most of the time, but sometimes don’t listen to them (like if I’m lower than my target it tells me to do less insulin and I’ve found that I will go high if I don’t bolus for all the carbs). I think it helps to have done your own math and seen what works on MDI’s for awhile before going on the pump because then you don’t just blindly follow the bolus wizard. I also think people who have an endo, cde or trainer program in their settings for them, aren’t as aware of what they are or when they need to be changed. Just my opinion. It’s easy to start thinking of the pump as “the boss” instead of remembering “garbage in, garbage out”.

how did you come up with the 25% above the wizard suggestion? Just trial and error? That’s what I’m doing. Trialling and Erroring. The 40/60 for 3hrs with 25% above suggestion for carbs sounds like that would work for our bread problem. I will try it.

Hi sweettooth!

We definitely have foods that need different insulin dosing. For a while I tracked things and maintained a chart - pasta, bagels, oatmeal, etc. Over time I’ve become used to it but I do still have some notes on things we only eat every once in a while.

Yes, just trial and error. After having one of my weekend breakfasts this morning I decided I have to put potatoes on a similar plan. I was doing ok with that meal until I went on Symlin which means I cut my insulin use in half. That works with other meals but not the potatoes and omelette. It hasn’t been working for awhile but since I only eat it every two weeks I wasn’t seeing it as a pattern until today.

Seems like we are “more diabetic” so to speak than we were in the beginning of diagnosis. It’s confusing me because our problem foods now weren’t a problem in the beginning (of course, honeymooning contributed to that) and now they are, so we are changing our dosing plan, and everyone is confused.
“Do this if eating fruit…do that if eating fatty meat…do this plus that if having a sandwich…ISF different in summer”…dizzying.

There will be a day when it all works out every time and we are all perfectly level, right?

How long ago was diagnosis? What you are describing sounds very similar to what Caleb went through four years ago. Carbs seemed relatively equal after diagnosis and while on shots. Then he started pumping and it seemed he became more sensitive to different foods. That actually seemed to compound as he took what I considered “steps” out of the honeymoon. Foods that hadn’t been a problem, became a problem. And then another and then another.

I can’t say that it works out for us perfectly every time, but with time, we have been able to understand and simplify dosing enough that we hit the mark more than we do not.

"There will be a day when it all works out every time and we are all perfectly level, right?"

I can’t tell from online what tone you said the above in, but unfortunately I think the answer is “don’t hold your breath”…lol. I do agree with Lorraine that most of us are not aiming for or expecting perfection but “we hit the mark more than we do not” sounds like how I approach it. I did a survey of my numbers one time and found I hover somewhere around 75% and I’m good with that.

As for dietary things changing: I’m LADA and was misdiagnosed Type 2 and put on oral meds and did fine that way for about 15 months before my numbers started to climb and I needed insulin. During my time on oral meds I made no changes at all in my diet and though I didn’t eat any sugar, as a vegetarian I ate lots of pasta and rice, and cereal or granola for breakfast. So in some ways my experience is different from “regular” type 1’s, but I definitely was able to eat things during that honeymoon period I can’t touch now like rice, and cereal and pasta I eat rarely.

Yeah, some things are actually not worth the trouble and many of us decide to give up those things or eat them only occasionally because the results take special approaches and still are a crap shoot.

Diagnosed about a year ago. Same thing for us. Once we started pumping, certain foods became a problem - but we started pumping exactly when the honeymoon was ending, so I contributed these food problems to the lack of honeymoon, not the pump. But I sometimes start to wonder if we would have been better off on the shot and maybe the pump is the problem? I know once we nail these problem foods on the head we will be fine. I don’t want to completely eliminate foods - I want to make the pump work for them, and I know I can do it with the pumps advanced features. I’m back to record keeping again. :slight_smile: Just seems like things like doses and basals and foods keep slowly changing and changing. I’m anxious for stability.

For a while the I:C was 1:22…then 1:20…then 1:18…now trying 1:17. Things will be fine for a few weeks, then we’ll have a few weeks of highs so we decide to change rates and doses…then the cycle continues.

Few weeks of fine - few weeks of highs - change dose - repeat. Stop already! Please tell me this is normal for a growing kid.

No, I’m sure you are right that the food problems came due to end of honeymoon - not the pump. If anything the pump allows you do both basal and bolus much more exactly to meet your needs.

I tend ot have some swings as well, but they are starting to seem less frequent and not as extreme (4 years in/LADA). I figured my pancreas was on empty by now but maybe not. I should get a c-peptide. Whever people talk about treatment to “preserve beta function longer” I feel tempted to say “why?” It’s going to stop so I’d just as soon it got it over with.

As for flux in children, I’ve heard that is common due to growth with another phase of it in puberty. Sorry!