2/16/22 Yoshi AMPS=352,+3=265,+6=202,+10=407, PMPS=435 -- need advice

[kd & yoshi]

Hi all,

It has been a minute since my last post. I had hoped that I may have gotten a hang of things by now, but I really feel like I'm going about things wrong and I'm unsure if I'm properly adjusting Yoshi's dose as needed. I had hoped that switching over to TR and then later finally getting him in for his dental surgery in January would see him have lower and more consistent numbers, but I feel like he is still a bit all over the place. There's especially a tendency for me to lower his dose after dropping below 50 only to see him immediately remain consistently high again, leaving me unsure if he's bouncing or if the reduced dose failed. Am I doing something wrong or not adjusting his dose properly? Any help or advice would be greatly appreciated. Really just desperate to get him seeing lower numbers more consistently!

Thank you so much!

 

[Bandit's Mom]

Hi Krystine, the dental does seem to have helped since Yoshi is seeing more green and is down in dose to 1.25U from 2.25U. He is bouncing from lows that he drops to at nights.

One thing you want to keep in mind is that the Lantus depot can take 4 cycles to adjust after a reduction, so back-to-back reductions invariably fail. On 2/6 you reduced to 1.75U and then again to 1.5U on 2/7. The 2U depot would have been at play till 2/7, so the drop you saw on 2/6 was thanks to the 2U depot and not the 1.75U dose. That's why you had to go up in dose briefly.

 

[kd & yoshi]

Hi Krystine, the dental does seem to have helped since Yoshi is seeing more green and is down in dose to 1.25U from 2.25U. He is bouncing from lows that he drops to at nights.

One thing you want to keep in mind is that the Lantus depot can take 4 cycles to adjust after a reduction, so back-to-back reductions invariably fail. On 2/6 you reduced to 1.75U and then again to 1.5U on 2/7. The 2U depot would have been at play till 2/7, so the drop you saw on 2/6 was thanks to the 2U depot and not the 1.75U dose. That's why you had to go up in dose briefly.

Thanks Bhooma. That makes sense. So was I right in dropping him down to 1.5 on 2/7 or should I have continued at 1.75? I know the guide mentions immediately returning to the last good dose. I guess I get confused as to when it's okay to return to that (ie how do I know a reduction has failed.) For example, should I return back to 1.5 given his last four cycles have all been high? Thanks for your help in understanding all of this!

 

[Bandit's Mom]

So was I right in dropping him down to 1.5 on 2/7 or should I have continued at 1.75?

You should have continued on 1.75U and not reduced back-to-back to 1.5U.

You would have to hold a reduced dose at least 6 cycles before deciding a reduction has failed. You want to make sure you give enough time for any bounce to clear and see what he does on the dose after that.

 

[kd & yoshi]

You should have continued on 1.75U and not reduced back-to-back to 1.5U.

You would have to hold a reduced dose at least 6 cycles before deciding a reduction has failed. You want to make sure you give enough time for any bounce to clear and see what he does on the dose after that.

Got it. So it's generally safe to say if he's falling below 50 after I've already reduced his dose that I can keep him at that original reduced dose (up to 4 cycles?) Given the 6 cycle holding period, I'll continue him at 1.25 for another 2 cycles and depending how his numbers look raise it back up to 1.5 on 2/18 if needed.

Thanks again for your help!

 

[Bandit's Mom]

So it's generally safe to say if he's falling below 50 after I've already reduced his dose that I can keep him at that original reduced dose (up to 4 cycles?)

Yes. If drops below 50 on the 4th cycle of the dose, it might be safe to reduce. When in doubt, post and ask.

Given the 6 cycle holding period, I'll continue him at 1.25 for another 2 cycles and depending how his numbers look raise it back up to 1.5 on 2/18 if needed.

I'd give him the full 6 cycles to clear the bounce and maybe even 1 more day and then call it a failed reduction if you don't see green.