? The control is very difficult.

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Kaori &Utyun

Kaori &Utyun

Member Since 2017
Hello everyone.
I am sorry for broken English as I can not speak English.
Utyun is still out of control.
+2 suddenly falls this week. 11/21 pm sharply dropped to 80 from 311. What should I do in such a case?
And the bounce has always been ...
It is not quite a gentle curve.

Thank you for your advice.
 
I can understand your English.
I can not view your spreadsheet. Can you make it so that it is viewable to anyone with the link?
 
In the upper right corner of your SS, there should be a blue box "share". Open that up and copy & paste that link in your signature instead of the one you have in there now.
 
I can see it, did you switch to a human meter? I saw in your comments. Maybe you could put a whole row in a different color to mark it so it's obvious. Can't offer regulation advice, but I hope you get it sorted out soon :cat:
 
Stacy & Asia said:
I can see it, did you switch to a human meter? I saw in your comments. Maybe you could put a whole row in a different color to mark it so it's obvious. Can't offer regulation advice, but I hope you get it sorted out soon :cat:
Click to expand...
HI Stacy! Thank you

I became a difficult to see sheet because I could not edit the spreadsheet. I'm sorry···
 
If you're following the TR protocol and using a human meter, then I think you are doing fine. Hopefully, he will get used to the lower numbers soon and have less bouncing.
 
Dyana said:
If you're following the TR protocol and using a human meter, then I think you are doing fine. Hopefully, he will get used to the lower numbers soon and have less bouncing.
Click to expand...
Dyana said:
If you're following the TR protocol and using a human meter, then I think you are doing fine. Hopefully, he will get used to the lower numbers soon and have less bouncing.
Click to expand...
Yes changed to TR.
I will do my best to be a gentle curve now.
Thank you very much for your advice.
 
Hi Kauri, please see below the TR protocol rules for holding and reducing the dose. I don't believe he earned the last reduction from 0.5U to o.25U.


Phase 3: Holding the dose: aim to keep blood glucose concentration within 2.8–11.1 mmol/L (50–200 mg/dL) throughout the day
If blood glucose is <2.8 mmol/L (<50 mg/dL) - Reduce dose by 0.25–0.5 IU depending on if cat is on low or high dose of insulin
If nadir or peak blood glucose concentration is >11.1 mmol/L (>200 mg/dL) - Increase dose by 0.25–0.5 IU depending on if cat is on low or high dose of insulin and the degree of hyperglycemia

Phase 4: Reducing the dose: phase out insulin slowly by 0.25–0.5 IU depending on dose:
When the cat regularly (every day for at least 1 wk), has its lowest blood glucose concentration in the normal range of a healthy cat and stays less than 5.5 mmol/L (100 mg/dL) overall - Reduce dose by 0.25–0.5 IU depending on if cat is on low or high dose of insulin
If the nadir glucose concentration is 2.2–<2.8 mmol/L (40–<50 mg/dL) at least 3 times on separate days - Reduce dose by 0.25–0.5 IU depending on if cat is on low or high dose of insulin
If the cat decreases <2.2 mmol/L (<40 mg/dL) once - Reduce dose immediately by 0.25–0.5 IU depending on if cat is on low or high dose of insulin
 
Welcome back!

I think it will be easier if you use the instructions for following TR that are in the sticky note: TR Protocol. Frankly, I find the language that Toro & Ovi's caregiver posted that's from the German Lantus group to be a bit difficult and I'm a native English speaker. The text in the link I provided is more straightforward.

I think there are a few things going on. First, Utyun's numbers are "bouncing." It's very common to see numbers jump into high ranges after they drop into a lower range than your cat is used to experiencing. So, dropping from 292 to 78 by +4 is what caused the bounce to 391. Utyun's body hasn't gotten comfortable with lower numbers yet. It can take time for this to happen.

Another reason for the higher numbers is that you have been holding doses for too long. For example, early in November, you held the 0.25u dose from Nov.1 to Nov. 11. If you hold a dose too long, your cat's body gets used to being in those numbers and treats the higher range as the new "normal." Even if not using TR, you need to evaluate the dose based on whether the lowest point in the cycle is bringing your cat's numbers into the normal blood glucose range (50 - 120) on a regular basis.
 
Toro & Ovi said:
Hi Kauri, please see below the TR protocol rules for holding and reducing the dose. I don't believe he earned the last reduction from 0.5U to o.25U.


Phase 3: Holding the dose: aim to keep blood glucose concentration within 2.8–11.1 mmol/L (50–200 mg/dL) throughout the day
If blood glucose is <2.8 mmol/L (<50 mg/dL) - Reduce dose by 0.25–0.5 IU depending on if cat is on low or high dose of insulin
If nadir or peak blood glucose concentration is >11.1 mmol/L (>200 mg/dL) - Increase dose by 0.25–0.5 IU depending on if cat is on low or high dose of insulin and the degree of hyperglycemia

Phase 4: Reducing the dose: phase out insulin slowly by 0.25–0.5 IU depending on dose:
When the cat regularly (every day for at least 1 wk), has its lowest blood glucose concentration in the normal range of a healthy cat and stays less than 5.5 mmol/L (100 mg/dL) overall - Reduce dose by 0.25–0.5 IU depending on if cat is on low or high dose of insulin
If the nadir glucose concentration is 2.2–<2.8 mmol/L (40–<50 mg/dL) at least 3 times on separate days - Reduce dose by 0.25–0.5 IU depending on if cat is on low or high dose of insulin
If the cat decreases <2.2 mmol/L (<40 mg/dL) once - Reduce dose immediately by 0.25–0.5 IU depending on if cat is on low or high dose of insulin
Click to expand...
Hi Ovi
Thanks for your advice!

What was not faithful to the protocol of TR
As the day when +2 dropped too much continued, I became scared and so it fell to 0.25.
 
Sienne and Gabby (GA) said:
Welcome back!

I think it will be easier if you use the instructions for following TR that are in the sticky note: TR Protocol. Frankly, I find the language that Toro & Ovi's caregiver posted that's from the German Lantus group to be a bit difficult and I'm a native English speaker. The text in the link I provided is more straightforward.

I think there are a few things going on. First, Utyun's numbers are "bouncing." It's very common to see numbers jump into high ranges after they drop into a lower range than your cat is used to experiencing. So, dropping from 292 to 78 by +4 is what caused the bounce to 391. Utyun's body hasn't gotten comfortable with lower numbers yet. It can take time for this to happen.

Another reason for the higher numbers is that you have been holding doses for too long. For example, early in November, you held the 0.25u dose from Nov.1 to Nov. 11. If you hold a dose too long, your cat's body gets used to being in those numbers and treats the higher range as the new "normal." Even if not using TR, you need to evaluate the dose based on whether the lowest point in the cycle is bringing your cat's numbers into the normal blood glucose range (50 - 120) on a regular basis.
Click to expand...
Hi Sienne
Thanks for your advice!

I think I will review the TR protocol again.
Utyun is not used to a much lower number
I hope that it will be around 100 more than 50.
 
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