High Flat Lantus Curve

[Sara & Cats]

Hi Everyone,

I'm just looking for your opinion. Thomas's curve is usually flat and in the pink and red zone. His best readings are usually right before I give insulin.

Could this mean his nadir is at 12 hours?

My spreadsheet is a bit hard to understand because I'm convinced I flew right past the right dose for him before finding this group.

I'm wondering if I can turn back time and start low, go slow. Does anyone have the same experience as me? Am I crazy to want to start right back at 0.5 units and work my way up?

 

[Wendy&Neko]

High and flat can mean "needs more insulin". Occasionally it means "too much insulin" but with enough testing, you would catch some lows in there. But the lowest I've seen lately is mid 200's, so I'd lean to the "needs an increase" side of things. Have you decided if you'd like to follow Tight Regulation or Start Low, Go Slow method for dosing? The suggestions we give on dosing depend on which method you'd like to use. TR would allow you to increase quicker and by larger amounts, but has a higher testing requirements, so those increases are done safely.

His best readings are usually right before I give insulin.
Could this mean his nadir is at 12 hours?

It's possible, Neko's nadir was occasionally that late. But until Thomas gets to a better dose where he's seeing more colours, it'll be really hard to see a nadir. Right now he's just mostly high and flat.

Please don't back up and go slow. Very seldom is it the right answer. Instead, I'd make sure to do enough testing to know how low this dose is taking Thomas, and follow one of the dosing methods to get him to a better dose ASAP safely. Are you testing for ketones daily while he is in these numbers?

 

[Sara & Cats]

I have to follow start low and go slow due to testing requirements. I have been testing for ketones every chance I get.

Through some reading today, I realized that I have been injecting into the scruff. I will be changing that tonight.

 

[Wendy&Neko]

I injected in the scruff/below the shoulders for 5 years. No appreciable difference on the few times I shot in the flank (which she did not like).

Glad you are testing for ketones when you can. If you are following SLGS, do you might putting that in your signature so we stop asking the question. Since you are following SLGS, you would hold this dose for 3 more days, then increase if you see nothing below 150.

 

[Sara & Cats]

I may not be patient enough for the SLGS. I need to find a way to fit more testing in because I really want to start seeing lower numbers.

He acts very differently when he's above 20 or 360.

 

[Wendy&Neko]

Take a look at the Sticky Note on Doing TR with a Full Time Job. There may be some tips in there that can help. TR is the best way to get him out of those numbers. I'd really like to see you be able to accelerate those increases and help him feel better.