QUOTE(Evona @ Mar 9 2012, 06:57 AM)
I've recently tried to begin a low carb diet and add much more exercise to my lifestyle. My TDD is usually around 50-55 units. However in trying to watch how much I eat, my TDD balance has now switched from 50/50 to 70/30. That is - 70% of my TDD is basal, and 30% is bolus. Is this considered a bad thing to have as a pumper? In the book by John Walsh called "Pumping Insulin" it mentions a desirable level is 50/50 or up to 60/40 - but I couldn't find out why he feels this way. I need help?
Actually only some people have a 50/50 ratio. When they developed the clinical rules for the first pumps they just chose 50/50 there was no scientific data.
My TDD is 40/60 and I would have to starve myself to achieve a 50/50 ratio...whatever works is the right setting if your BG control is OK. If you are having trouble with
BG control, your ratio could point you to the problem.Example:
30/70...and 20% of your bolus insulin is correction insulin, could be poor diet or carb counting, basal set to low, incorrect I:C and or correction factor
and this is just some and not all of the reasons.
As many of us get older we can also suffer from insulin resistance...I used 30u TDD for 15 years and then it slowly moved up to 50u TDD during about a two year period then stabilized and it has been 50u for 6-7 years. If I changed my high target to 180 mg/dL I could probably get close to a 50/50 ratio but there are many days I use a little extra basal insulin to chase my BG back down below 140 mg/dL.
"Pumping Insulin" by John Walsh is a very good book but most settings, charts, and graphs are...YMMV.