5/9 PMPS 179 +3 135 +4 145 bedtime consultation

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Elinor & Sibon

Elinor & Sibon

Member Since 2017
Previous post:
http://www.felinediabetes.com/FDMB/threads/9-3-sibon-amps-375-7-348-dosing-advice.183371

Hi all, I hope I could get a least one response before I'm off to bed (11:40PM GMT+3).
I got Sibon back on 1.50u and this evening I got my first blue 179. I didn't get anything close to this while he was on 1.25u during last week, and I'm unable to test mid-day if it's not the weekend.
I took my bravery pill and gave him the shot anyway. You guys really helped me in learning not to skip shots even if he's in the blue zone.
I'm wondering if I should set my alarm clock to any time in the middle of the night to check again before the AMPS.
Would anyone have any guess which time would be best to do this based on his spreadsheet for tonight? Should I wake up multiple times?

Thanks
 
Elinor & Sibon said:
I took my bravery pill and gave him the shot anyway.
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Well done!
Elinor & Sibon said:
I'm wondering if I should set my alarm clock to any time in the middle of the night to check again before the AMPS.
Would anyone have any guess which time would be best to do this based on his spreadsheet for tonight? Should I wake up multiple times?
Click to expand...
That would be perfect and is a best practice. We refer to it as "sleep testing" (I wish I had a dollar for every time I did it....) How soon tonight depends on your level of anxiety. You could start with a +6 and take it from there. Post if you need input on any of the test results.
 
When you shoot your lowest preshot yet to date, it's good practice to get a +1 and a +2. If the +2 is a lot lower than the preshot, then it's likely to be an active cycle that needs more testing. You use the numbers to decide if you need more testing. I tested more frequently if numbers were green. If he starts going up without influence of food (carbs), then it's fine to go to bed.
 
Elinor & Sibon said:
You mean every hour starting +6? :blackeye:
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No, I mean get +6 and based on what it is, relative to the numbers since PMPS, then decide if/when to next test. If you feel your kitty is past nadir and the numbers are rising you may be good until AMPS. If you see an unexpected low, you can intervene with food and guide the numbers up.
 
Elinor & Sibon said:
What if the +3 and +4 rising are just the previous dose wearing off, and he plummets again at +6 +7?
Is that possible?
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Yes on Levemir, not so much on Lantus. Usually the Lantus onset is between +2 and +3, that's when the insulin starts to take action to lower the numbers for that cycle. Knowing the Lantus onset, nadir and duration for your cat is key to knowing when to test. If he's still rising at +5 you know he's done dropping. +6 is OK too, but I like to maximize how long I sleep for. :)

Learn how YOUR kitty is responding to insulin:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
 
Here is important information regarding dealing with low numbers.
I recommend you print it out and keep it in a handy location, particularly since you are in GMT+3
The information below can be used as a guide:
Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.​
 
Thank you all so much. I have already familiarized myself with the new lingo and how a regulated curve should look like, but Sibon and I are still new at this and he keeps surprising me :) There were days when I tested curves and his lowest points were somewhere between +7 and +10.
I just tested his +5 and it's still rising, 153.
I'll wake up at +8 to test again go from there.

Good night :cat:
 
Good afternoon everyone,
Sibon's +8 last night was 397 and today's AMPS was 442.
Would you consider this a bounce because of the low numbers yesterday and/or is it possible that I didn't inject the insulin correctly in the evening?
Can the liver counteract the insulin when it releases stored sugar?
 
Elinor & Sibon said:
Good afternoon everyone,
Sibon's +8 last night was 397 and today's AMPS was 442.
Would you consider this a bounce because of the low numbers yesterday and/or is it possible that I didn't inject the insulin correctly in the evening?
Can the liver counteract the insulin when it releases stored sugar?
Click to expand...
Yes, this is likely a bounce from the blues yesterday. Restored sugar: regardless of cause the insulin has a bigger task getting BG down if it's high.
 
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