It's been awhile since I have posted . It's been alittle over a year since my daughter was dio type 1 and it's been a rough road . She does well not on a pump has a dex 5 witch helps a lot she's Gona be 14 in nov and the teen years are in full force to say the least she's a 4.0 student smart as can be.not sports active or anything but does spend time with her close friends a lot giggling and acting like teen girls .. she hates her dexcom sensor insertions with a passion . A few weeks ago we findly had a melt down . Iv been waiting for it . And she's right it's not fair and I understand through her tears saying I don't want this anymore . I'd take it from her if I could in heart beat . She blood augers are very hard to manage she eats very well even before she was dio she wasn't a sweets person she's not over weight in fact she's finly back to a healthy weight after all she lost before her dio . She's on a 1 unit to 10 ratio . And we adjust up and down that depending on her activity and is on 35 units long . And again adjusted up or down depending on her activity weekends we ussuly go up since she isn't as active . The biggest issue is it takes a long time for her insulin to go active after she takes it making after meal spikes way to common . We try are best to premeal he doses but lunch at school is impossible to get 20 mins before and mornings sometimes are just as hard . But re onset of her insulin is so delayed she would have to dose 1 + hours before to stop her spikes . I can watch her cgm graph say she's 90 premeal she's Gona have 30 carbs we dose 10 to 15 mins before I see a slight drop at the 20 min mark then she skyrockets to the mid 200s within the next hour and will stay there till 2 hours after the drop back down to close to premeal levels. If we up the units ratio she will go hypo at 3 hours to 4 after meal it's very frustrating for all of us . If she's under 80 premeal and we dose 10 or more mins before she eats she will drop to the low 60s or 50s . We have tried to stretch out to 30 mins plus premeal but with the same results , she still spikes . The worst is if she comes in hi premeals .. if she's over 150 she will top out 300 or more regardless of how long we wait . And going to a higher unit ratio will only make her hypo after 3 to 4 hours ... of course the docs only sugustions are eat even less carbs or go on the pump . Iv been less then impressed with his lack of intrest in any other type of management he is not a ped endro . I'm going to get a refural for one . Her a1c is not great 8.5 to 8.7 but it has been coming down . But with these aftermeal spikes I'm afraid we can't get it down more . I'm looking for any advice anyone would have thank you and sorry for the long winded read