The Dosing Ultramarathon

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Hey Kris, how is darling Teasel doing? I just looked at his spreadsheet and here's what I was thinking... I think that sliding scale is not really working for Teasel. He is steady in numbers for now I see, but I find him still high... Looking at when you first started out, he was getting almost 1 unit more than what he's on now.. I know you can't go there in 1 day because then he will bounce like crazy, but don't you think it's better to start working that dose up and keeping it steady for a few cycles in a row (if those PS numbers will let you of course) ?
So for example, stick with 2.50 now for 3 days, and after that you can go up to 2.75U, and then after 3 days go up to 3U. Does this make sense? You can monitor every day right? so if his PS numbers are a little lower than you are used to than you may want to stick to that same dose (if you can monitor him). Do you know what I mean or do I sound really crazy right now? It's just a thought.
 
It's confusing alright! He just likes to keep you guessing Kris!
 
Ruby&Baco said:
Hey Kris, how is darling Teasel doing? I just looked at his spreadsheet and here's what I was thinking... I think that sliding scale is not really working for Teasel. He is steady in numbers for now I see, but I find him still high... Looking at when you first started out, he was getting almost 1 unit more than what he's on now.. I know you can't go there in 1 day because then he will bounce like crazy, but don't you think it's better to start working that dose up and keeping it steady for a few cycles in a row (if those PS numbers will let you of course) ?
So for example, stick with 2.50 now for 3 days, and after that you can go up to 2.75U, and then after 3 days go up to 3U. Does this make sense? You can monitor every day right? so if his PS numbers are a little lower than you are used to than you may want to stick to that same dose (if you can monitor him). Do you know what I mean or do I sound really crazy right now? It's just a thought.
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Hi Ruby,

I'm thinking what you're thinking - that Teasel needs a steady dose that is held for several cycles. He does need to go up and I agree that when I began he had some better cycles. With him it's hard to get AMPS and PMPS that are shootable AND a nadir number that's nice. A dose that gives a nice nadir usually means a low PMPS - eg. on 08/23. I've then given a lower PM dose (or a NS) and I get many cycles of pink and yellow afterward. This is the trend after 08/23, after 08/29, and probably again after yesterday. I've been increasing very slowly to avoid bouncing but he bounces anyway.

One quite decent cycle is way back on 08/03 from a glucose curve for my vet when I was dosing without doing preshots. He'd been on 3.6 u for a week by that time and I would've had no clue whether he'd been close to a hypo. I'd bumped him up that high to try and overcome insulin resistance that had set in. In those days, each dose that the vet recommended was held for a week and then I did a BG curve for her. I think that holding for a week was good when a dose was effective but bad when it was too low because he quickly became insulin resistant. When that happened, a dose that brought his numbers down previously didn't work anymore. I'd been through many months of that before joining FDMB. Now, at least, I'm not holding an ineffective dose as long so he responds better to small increases. That's a positive change, if nothing else. :confused:
 
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2.5 might have given you better levels for the 200 Pre shot, but it was overnight and a lower preshot than usual. I would have done the same thing.
 
Sue and Oliver (GA) said:
2.5 might have given you better levels for the 200 Pre shot, but it was overnight and a lower preshot than usual. I would have done the same thing.
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That's how I was thinking, Sue. The red AMPS today looked like a bounce though so the 2.3 u dose last night might have brought him down some overnight.
 
PMPS was 19.6. I'll give 2.5 u tonight and go to 2.6 u tomorrow morning. Here's my prediction: the slight dose increase tomorrow AM will likely give me some yellows and maybe even a blue; the PMPS might be a bit low tomorrow so I'll have to agonize over what dose to give; the cycles following will be full of pink and maybe red.
 
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