4 Sept Minerva, curve (advice please), AMPS 270, +2 299, +4 281, +6 297, + 8 302, +10.5 299, PMPS

[Joy W]

I ran a partial curve yesterday, and a full curve today, and based on that it looks like she is going up to 2.25? I got some curve data last weekend but she'd only been on the increase for 3 days as I stressed about her last increase and delayed it out of worry, but wil get right on it this time.

I'm curious about the difference in values between yesterday and today, but have no idea why.

Also I've noticed that generally speaking, her curves aren't really curves, they're straight lines. I worry that I'm not administering insulin correctly, or that I'm doing something wrong. Or is that just a thing that happens?

Thank you to @Bandit's Mom for your reply to my last post, I totally never saw the email and thought there was no reply again, so I really appreciate your answer and my apologies for not acknolwedging it earlier. I'm trying to get pre-bed tests where I can (when I remember and am not basically dead on my feet).

And as usual, my apologies for the infrequent posting, life is giving me a whalloping at the moment, and posting is my weak link that gives way. I very much appreciate all the people who make themselves available to help here!

https://felinediabetes.com/FDMB/threads/25-aug-minerva-amps-292.267545/#post-2993140

 

[Bandit's Mom]

Hi Joy, sorry to hear that life is hard at the moment. Sending you hugs and hoping it gets better very soon. It's perfectly alright if you don't post often.

Minerva does look like she needs more insulin and you are good for an increase to 2.25U. I suggest that you evaluate her dose every weekend and increase her by 0.25U till you start seeing nadirs below 150. Don't hold a dose longer than a week.

There is not very much difference between the values of yesterday and today if you consider meter variance which can be as much as 20%. She is seeing glucose toxicity. Her numbers are flat and high because of that. Her body has gotten used to higher numbers and a temporary form of insulin resistance has set in. You want to keep increasing her dose till you break through the toxicity into better numbers.

 

[Joy W]

Thank you! Your info on glucose toxicity makes sense, thank you. I've always wondered if I was somehow not getting it in her system even though In know I am definitely pericing her skin.

I was a muppet not to increase fast enough the curve before last so that she had 1.5 weeks on each of the doses, but I won't do that again.

I was away a lot over June/July and have a lot of other obligations on weekends but I do try to get as many curves on weekends as I around for, and my travel is reducing so I should be able to do more and keep the curves and changes up faster - in trying to jam all my local obligations in to one day each weekend so I have a day at home each weekend, but after so many weekends away I also have a lot of errands and things to attend to. But I have done curves as many weekends /partial weekend days as I can and will continue to try for one every weekend.

Unfortunately I have 2 more events this year that I'm away for, and the next is this weekend coming, and the last is 3 weeks after that. I'll see if I can convince my partner to do a curve though. My partner will do preshot test and insulin but not curves. (The problem, horribly circular, is that he's not super confident that doing it and so testing and insulin takes him ages, he persists and succeeds but he gets stressed and it takes him a few attempts, and running a curve is just really stressful for him which is stressful for her. I get blood first time basically every time and it takes me only a minute to find her and test her. Of course the less often he does it the worse it stresses him out when he does do it!)

Thank you for being so kind and encouraging, it's really appreciated.

 

[Bandit's Mom]

If you can't do a curve next weekend, what might help is to get as many sport checks as you can during the week. Say a test before bed at night and a test during the day when you or your partner are at home.

Thank you for being so kind and encouraging, it's really appreciated.

 

[Joy W]

Thank you! Unfortunately there is no opportunity to get daytime checks other than weekends, we run a shop together and are out Monday to Friday from 8.40 until at least 6, often later if it goes badly. But I'm trying to make bedtime tests a habit every night! I've been so tired lately that I'm a zombie by bedtime but I know it will help her to get that habit in place so I'm working on that.

I will be able to get a late Sunday afternoon read but it will likely be after nadir (for all she has a nadir given its largely a straight line!) I might be able to get G to a +3, and then if I am home for +6 or +7, and then take it right through the night, that might work? I'll work on that!

Thank you!

 

[Bandit's Mom]

I don't suppose you can adjust shot time such that you can get a +1.5 or +2 before you leave for work? Just checking

 

[Joy W]

Brilliant idea, but we would never get home in time for her PM shot - we have deliberately set her AM shot for just before we leave to allow for our later nights. So we aim for testing at 8.10, shot at 8.20. We are usually home by 6.30 - 7.00 but if we need to stop at the store, or want to grab food on the way home, or we just have one of those days, we might not get home until 7.30, or 8, or even 8.30. It doesn't happen as often as it used to (small downside of covid drying up our business, for some gallows humour!) but still happens often enough that it would become a real challenge to get home to her on time.