Shooting more than One Hour Early after a Stall

[Kathy4Skipper]

Last night, Skipper's PMPS was 153, so I stalled for one hour, then shot a reduced dose of half of his normal dose. PM+10 was 381. Waiting two hours until the normal shot time this morning was going to be grueling because I knew he'd be even higher at shot time, so I shot one hour early.

I know that I'm not supposed to shoot more than one hour early. ProZinc stays in his system 12-14 hours, so if I shot two hours early, there'd be a chance of doubling up, right? That's the thought behind the one-hour rule? To me, though, it seems that going up into the reds and possibly black does more damage than doubling up a little.

Could I have given him another reduced dose at PM+10? I'm assuming the answer will be no, but what is the science behind this? It seems like I could keep doing reduced doses piggybacking on the previous cycle's remaining dose until I get him back up to the appropriate normal dose. We were doing so well, and now the damaging red is back.

Thanks for thinking outside the box and for your discussion.

 

[Shelley & Jess]

Hey Kathy - maybe @Marje and Gracie can help you with this one.

 

[Marje and Gracie]

Sorry, Kathy. I was on sometime today but just seeing the tag. Let me look at his SS. I’ll BRB.

 

[Marje and Gracie]

Last night, Skipper's PMPS was 153, so I stalled for one hour, then shot a reduced dose of half of his normal dose. PM+10 was 381. Waiting two hours until the normal shot time this morning was going to be grueling because I knew he'd be even higher at shot time, so I shot one hour early.

I know that I'm not supposed to shoot more than one hour early. ProZinc stays in his system 12-14 hours, so if I shot two hours early, there'd be a chance of doubling up, right? That's the thought behind the one-hour rule? To me, though, it seems that going up into the reds and possibly black does more damage than doubling up a little.

Could I have given him another reduced dose at PM+10? I'm assuming the answer will be no, but what is the science behind this? It seems like I could keep doing reduced doses piggybacking on the previous cycle's remaining dose until I get him back up to the appropriate normal dose. We were doing so well, and now the damaging red is back.

Thanks for thinking outside the box and for your discussion.

If you stall, you want to shoot the full dose. It’s ok that you short a reduced dose but normally, you don’t need to stall and shoot a reduced dose.

It used to be a common practice, even with Lantus and Levemir, to shoot early if the BG was headed up into a bounce. I have shot two hours early with Lantus to try and keep the bounce from getting too high but then the next shot needs to be 12 hours from the early shot.

The bigger issue is that what I described above is for those using the modified PZ method which is more aggressive. You are following SLGS which is a very conservative dosing method. OTOH, SLGS is a guideline and once you develop data, which you have, I don’t see the harm in doing what you did provided you are testing to be sure he doesn’t come back down. PZ is not like Lantus where a late shot is like a reduction and an early shot is like an increase because there is not a true depot. But, caution has to be exerted because PZ can get some long duration. With PZ, more so than Lantus or Levemir, you are shooting the PS with some consideration to the nadir whereas it is the opposite with the L insulins.


What you are suggesting about giving him another reduced dose at PM+10 is definitely not SLGS and not the normal modified PZ method. You are in between shooting a 12-hour schedule and shooting what is an 8-hour schedule with PZ. If you look on the dosing methods, I discuss this. This can be a pretty grueling schedule and should only be done with the expertise of an experienced member who has done it.

IMHO, your better option is to switch to modified PZ method as you test enough although you should get an earlier test in the pm cycle …like a +2 and/or before bed. You can increase his dose more often, safely, without chasing numbers.

Does that help?

 

[Kathy4Skipper]

If you stall, you want to shoot the full dose. It’s ok that you short a reduced dose but normally, you don’t need to stall and shoot a reduced dose.

It used to be a common practice, even with Lantus and Levemir, to shoot early if the BG was headed up into a bounce. I have shot two hours early with Lantus to try and keep the bounce from getting too high but then the next shot needs to be 12 hours from the early shot.

The bigger issue is that what I described above is for those using the modified PZ method which is more aggressive. You are following SLGS which is a very conservative dosing method. OTOH, SLGS is a guideline and once you develop data, which you have, I don’t see the harm in doing what you did provided you are testing to be sure he doesn’t come back down. PZ is not like Lantus where a late shot is like a reduction and an early shot is like an increase because there is not a true depot. But, caution has to be exerted because PZ can get some long duration. With PZ, more so than Lantus or Levemir, you are shooting the PS with some consideration to the nadir whereas it is the opposite with the L insulins.


What you are suggesting about giving him another reduced dose at PM+10 is definitely not SLGS and not the normal modified PZ method. You are in between shooting a 12-hour schedule and shooting what is an 8-hour schedule with PZ. If you look on the dosing methods, I discuss this. This can be a pretty grueling schedule and should only be done with the expertise of an experienced member who has done it.

IMHO, your better option is to switch to modified PZ method as you test enough although you should get an earlier test in the pm cycle …like a +2 and/or before bed. You can increase his dose more often, safely, without chasing numbers.

Does that help?

I apologize, I just now saw your message.

I'll read the modified PZ method as you suggested. It will be nice not to have to chase numbers, so I hope it will work for him.
Thanks!