Test Pumpkin PM Hours. Staying up.

He's surprising me with unusually low numbers (normal numbers very early in the cycle). This is why I am so reluctant to test in the PM. It's past midnight and I have very, very bad, horrible anxiety that's easily triggered. He seems to be his highest AMPS, so guessing it goes up overnight? I guess I will stay up to monitor numbers because he just got his shot +3 ago. I don't want anything happening overnight. I work so hard + OT! No, it isn't feasible to test an earlier AMPS or adjust the times! I am worked to the hilt. I need rest, I am so tired .

Update - Snacked and numbers headed down even lower +4. This is terribly awful. I am not going to sleep now. 1:00 AM. I need sleep. I work and I have an appointment tomorrow. IE I need to be alert to drive.

Update - Increased by 1 point almost +5. 2:00 AM. I can't stay up all night. I have major responsibilities and an urgent dental appointment tomorrow. Meaning as I said, I need to drive. It's dangerous to drive on no sleep so I am going to have to try to sleep for health reasons!

What when a person has to sleep??

 

It looks like he’s levelling out at +5.
Did you give him snacks during this cycle?

 

Yes, I gave him snacks. Because it was a highly unusual progression of normal numbers for him. So, any possibility of hypoglycemia is extremely concerning to me. Especially when I will be asleep.

Even this morning at the end of the cycle, the AMPS number was lower than usual. So, there is something occurring and I don't know what.

Based on his curve I did yesterday, I am pretty sure I was supposed to increase the dosage. If I am supposed to increase the dosage, I'm not doing it until Monday when I can be more available to monitor. I don't even know if I should increase it now.

 

It's not unusual for cats to have lower numbers during the evening and then the numbers come up by AMPS. Cats are typically nocturnal and activity/exercise can lower BG numbers. The higher AM numbers are due to what's called, "dawn phenomenon." As the body prepares for the stresses of the coming day, stress hormones are produced. These will cause a normal rise in BG numbers.

With diabetes management, ostensibly your goal is to lower Pumpkins overall numbers. In other words, you want to see the pre-shot numbers drop and then the rest of the cycle drop. You've recently been seeing yellow PMPS numbers and even some blues last month.

I don't view the AMPS number today as being out of the ordinary. The number was rising after a flat blue PM cycle. That PM cycle looked great!

I think the hardest thing for caregivers to accomplish is to get used to seeing lower numbers. Regardless of whether your goal is tight regulation or remission, you want to get your kitty into numbers that are close to normal or at the very least, under renal threshold. The latter means you want to see Pumpkin spending time in blue numbers. The more time your cat is in lower numbers, there's a good chance the cycles will be flatter.

 

Helpful information. I expect that he may have blue numbers. I was considering cancelling my emergency dental appointment to watch, but I don't even know if that's necessary. Or, good for him to feel like he's being monitored. But, I have a lot of stress about not being here for a few hours.

However, learning that if/when he falls into blue numbers, the flatter the cycle will be makes me feel better about having to leave for a bit. And reduced stress for the caretaker is also great.

He is resting quite nicely now, so I think he'll sleep most of the day. Which means, he probably won't eat either.

Thank you for letting me know about the "dawn phenomenon" too.

One question please? What is the renal threshold? That sounds kidney related?

 

You're correct - renal threshold is kidney related. Diabetes is a disorder that is very hard on the kidneys. A less preferred way of assessing glucose levels is to test for glucose in the urine. When diabetes is unregulated, glucose 'spills' from the kidneys and into the urine. This can cause kidney damage. Even with a cat that may not get into remission, you want to make every effort to keep glucose levels at a place where there isn't glucose getting into the urine. As a general rule, this means keeping blood glucose levels under 200. That is, however a very general statement since the level is unique to each cat. You can always get urine tests if you than things to be more specific but as a general point, lower is better.