8/4/2021 Milo AMPS 275 +2 230 +4 171 +6 184 +8 198 +10 216 PMPS 288 +4 198

[Mariaana and Milo]

Hello again,
Milo had a curve done on 8/4. His insulin dose was increased on August 29 to 1.75 Units, and held until his recent Curve was completed.(7 days)
Thinking i should do another increase to 2.0 Units? Advice appreciated ~ Thank You.

 

[Bandit's Mom]

Hi Mariaana,

You saw nadirs in the 90s on this dose but that was 5 days back - enough time for any bounce to clear and nadirs over 150 since. I think you are good for an increase to 2U.
But let me tag @Bron and Sheba (GA) and @tiffmaxee for comfirmation.

Sorry, if I've asked this before, but you test enough for TR. Is there a reason you are following SLGS?

Link to your previous post:
https://www.felinediabetes.com/FDMB/threads/7-28-2021-milo-amps-324-4-227-pmps-265-4-225.250496/

 

[Bron and Sheba (GA)]

Hi Mariaana,

You saw nadirs in the 90s on this dose but that was 5 days back - enough time for any bounce to clear and nadirs over 150 since. I think you are good for an increase to 2U.
But let me tag @Bron and Sheba (GA) and @tiffmaxee for comfirmation./

Yes, Milo can increase to 2 units. You hold the dose for 10 cycles when you first start seeing green BGs on a dose.

 

[Mariaana and Milo]

Hi Mariaana,

You saw nadirs in the 90s on this dose but that was 5 days back - enough time for any bounce to clear and nadirs over 150 since. I think you are good for an increase to 2U.
But let me tag @Bron and Sheba (GA) and @tiffmaxee for comfirmation.

Sorry, if I've asked this before, but you test enough for TR. Is there a reason you are following SLGS?

Link to your previous post:
https://www.felinediabetes.com/FDMB/threads/7-28-2021-milo-amps-324-4-227-pmps-265-4-225.250496/

Hi Bhooma,
Thank you once more for responding! I am still trying to figure out Milos nadirs and how to gauge when to increase
or decrease insulin dosing... I would surely be lost without you and your colleagues advice! I will increase his insulin
tomorrow morning to 2 Units, Thank You.
About changing to TR... to be honest i am a bit afraid to do it ~ if that makes sense..as you can dose on a lot lower BG numbers.

 

[Mariaana and Milo]

Yes, Milo can increase to 2 units. You hold the dose for 10 cycles when you first start seeing green BGs on a dose.

Hi Bron, Thanks for your response. I will increase Milos dose to 2 Units in the morning.
A few Questions: Is one cycle 12 hours? And then 10 cycles= 5 days right? I didn't realize that if there is Green BGs
i will add additional cycles/days even if i am at the end of the current dosing protocol? ( hold for 7 days~ do a curve and re evaluate)? You guys are simply the best! Thank You.

 

[Bron and Sheba (GA)]

Is one cycle 12 hours?

Yes. 1 cycle is 12 hours.

And then 10 cycles= 5 days right?

Correct1

I didn't realize that if there is Green BGs
i will add additional cycles/days even if i am at the end of the current dosing protocol? ( hold for 7 days~ do a curve and re evaluate)? .

When you first get green BGs on a particular dose, you hold that dose for 10 cycles.
If you got the greens on the first day of the increased dose (or decreased dose) you would still be holding the dose for the 7 days because you are doing SLGS. But if you got the first green BGs on the 6th day of the dose, for example, you would then have to hold the dose for 10 more cycles.
If you continue getting green BGs on that dose, you still just count the number of cycles from the first cycle. If you continued to get green cycles you would most likely not be needing to increase, but you would need to talk to an experienced person in that scenario.

 

[Bandit's Mom]

You are most welcome!

About changing to TR... to be honest i am a bit afraid to do it ~ if that makes sense..as you can dose on a lot lower BG numbers.

TR is definitely a more aggressive protocol than SLGS. Like you pointed out, you dose to have the numbers stay in the 50-100 range. If you are worried about Milo dropping too low, you have the option of following SLGS with a lower reduction point - say 70 rather than 90. That would enable you to keep Milo in the upper range of normal numbers (70-100).

@Bron and Sheba (GA) Bron, Marianna is following SLGS. I just wanted to recofirm that it still allows modification in terms of the reduction point?

 

[Bron and Sheba (GA)]

Bron, Marianna is following SLGS. I just wanted to recofirm that it still allows modification in terms of the reduction point?

You would need to take this up with one of the moderators as it is not normal practice to just chose your own reduction point. If everyone did that the SLGS method would be a mess and would simply not work. I will tag @Marje and Gracie for you

About changing to TR... to be honest i am a bit afraid to do it ~ if that makes sense..as you can dose on a lot lower BG numbers.

I was very nervous in the beginning at letting the BG drop under 50 to get a reduction, but I soon got used to it and used to love seeing Sheba in green numbers.
You test enough to do TR and would allow you to increase sooner than the 7 days. You might find you get Milo into better numbers sooner on TR.

 

[Marje and Gracie]

If you are worried about Milo dropping too low, you have the option of following SLGS with a lower reduction point - say 70 rather than 90. That would enable you to keep Milo in the upper range of normal numbers (70-100).

@Mariaana and Milo Just want to be sure you see this since it’s yesterday’s condo and I don’t see a new one today.

If members are dropping the reduction point, they are no longer following SLGS. That’s fine for experienced members with lots of data who don’t really need dosing advice any longer.

However, in this case, I would not suggest it as Milo is doing just fine following SLGS as it is written and it’s probably easier on Mariaana

I do agree it’s time for an increase to 2u. Good luck with that increase. You are doing really great with him, Mariaana!