11/20 Blue AMPS 352 / 60 + 3.5

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Morning, Patty. :)

Your hard work gave your beautiful Bluebird a very good day yesterday. More of those, please! (You hearing this, Blue?) :cat:

On tenterhooks wondering what the +1 will be. :nailbiting:


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Patty and Blue said:
288 + 1 and I gave him LC but then thought again and put a little 12% on top. I thought that was a substantial drop.
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It was, Patty, and good call to up the carbs. Sorry I wasn't online at the time. For future reference, for a substantial drop like that so early in the cycle I'd really recommend rolling out the HC food and extra gravy. Indeed, the more I see of Blue's pattern of response, at the moment I think the food steering choice in the early hours of the cycle should be HC by default. (ETA: 20% HC food with some extra gravy, possibly with a little drop of honey for drops >50.)


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Also for future reference, Patty, after a drop like that you need to keep testing every 30 minutes and steering with food to slow/level out the drop. If you wait an hour before testing then because Blue can drop so fast so early you end up playing catch up and it's often too late to stop Blue going too low. Think management versus firefighting.


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Patty, when you post test results, it would help greatly for you to give the '+' times as well as the BG reading so that whoever's supporting you can quickly assess the situation and give you immediate suggestions on what actions to take. They may be working with more than one cat.


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Honey's not hit yet (or it's not doing much), but he's nearly at +4 and historically most of the time he doesn't drop much, if at all, after that but we don't want to take any chances so please give Blue some HC, some squeezed gravy and a drop of honey then test at +4.25.


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I'd suggest testing him in 45 minutes.

* If he's at 142 or higher then he should be OK till his scheduled feed.
* If he's dropped back and is between 100 and 142 give him a snack of the 12% with a small amount of gravy. Test in 30 minutes. (This is unlikely.)
* If he's under 100 give him another HC snack with a little gravy and test in 30 minutes. (This, I think, is very unlikely.)

Keep an eye on him and if in any doubt at any time test his BG and feed as BG level indicates.

My money's on a bounce, but this is Blue so who knows!


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Hope to catch you tomorrow but I'm not feeling so hectic so can't guarantee.

Here's my take and best suggestions:

1. When Blue drops, he drops early, and he drops fast and far, typically starting from +1, usually through to +4. He is very consistent in this respect. [Blue appears to metabolise insulin really quickly.]

2. It takes a lot of carbs to slow Blue down when he drops - and also to raise his numbers when he is running low.

3. FOR EVERY CYCLE (regardless of whether PS is low or high):

(a) Start testing at +1. If roughly the same or any way lower than PS (even if only, say, 10 or 20 points lower than PS), start feeding HC snacks (20%) straight away. The bigger the drop, the bigger and more gravyish the snack, with honey if indicated.

(b) Test every 30 minutes until at least +4 and be generous enough with the carby snacks to stay ahead of the drop (unless it's howlingly obvious he's having a significant bounce and is going to stay high enough for the rest of the cycle).

(c) Only give HC 20% during these hours. (The extra carbs to balance the insulin action early in the cycle are better than Blue spending more time in much higher numbers from a long/big bounce.)

(d) If Blue needs steering after +4 then if he's close to 50 keep with the HC 20% (with honey if indicated). If he's over 90, try the MC 12-15% gravy food instead. If numbers drop back down towards the 50 mark go straight back to the HC.​

(@tiffmaxee - When you have a moment, please can you review the above. I'd welcome your thoughts on the outlined strategy and any additional modifications/additions/corrections you can think of.)

What do you think about the above, Patty?


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I think the big drops caused the bounce. It could be the hc also but if he doesn’t get it he drops under 50. I would really like to prevent the quick big drops to see if I am right. Sorry but that means testing every 30 minutes starting with +1.
 
He's High tonight.
When did you want to do that. I think I need some sleep. It's been a long week with him and I'm getting emotional.
I'll be glad to test every 30 minutes. I actually did that a lot today. It's just crazy when he starts dropping nothing stops it. :(
 
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