01/18 Eddie AMPS 212 +4 292 PMPS 254 +7 304

Hi Jodey. So glad you have a guest who can watch Eddie! I hope he is feeling well.

Can I ask you about using Levemir? I’m considering a switch for Ivy from Lantus.
Why did you decide to use it? How do you like it? When does Eddie onset with it and nadir? Does it keep you up all night to monitor him with the later onset and nadirs? (I feed and shoot at 6 am/6 pm so trying to figure out if that could work for us, I have no helpers sadly. Just me who needs some sleep to be able to work etc).
Ivy seems to have issues with big time bouncing and duration issues, then she bounces up high.

Anything else you think I should know about its use to convince me one way or the other?
Thanks :bighug::bighug::bighug:
 
So your “box” is 4 cycles big, correct? Meaning your methodology is to increase after 4 consecutive cycles without a BG below 150?

1/15 - AM cycle had a BG of 124, which is within your “hold dose” range. PM cycle did not.
(Count = 1 cycle)

1/16 - 2 cycles with no BG below 150
(Count is 1 + 2 today = 3 cycles)

1/17 - AM cycle not below 150. PM cycle increased dose.
(Count is 3 + 1 today = 4 cycles before increase)
 
Staci & Ivy said:
Hi Jodey. So glad you have a guest who can watch Eddie! I hope he is feeling well.

Can I ask you about using Levemir? I’m considering a switch for Ivy from Lantus.
Why did you decide to use it? How do you like it? When does Eddie onset with it and nadir? Does it keep you up all night to monitor him with the later onset and nadirs? (I feed and shoot at 6 am/6 pm so trying to figure out if that could work for us, I have no helpers sadly. Just me who needs some sleep to be able to work etc).
Ivy seems to have issues with big time bouncing and duration issues, then she bounces up high.

Anything else you think I should know about its use to convince me one way or the other?
Thanks :bighug::bighug::bighug:
Click to expand...
Hi Staci, Yes, we've been using Levemir since August of 2022, the reason being that at high doses Lantus (acid-based) stings and Eddie was becoming reactive. TBH I prefer Levemir because it seems to have a later onset and nadir. It doesn't keep me up and I can be pretty confident that, normally speaking (if the word "normal" can be applied to any of this), Eddie is pretty stable until +7 or +8 either way, unless of course it's one of those dramatic events. When Eddie went for SRT in November of 2022, he was at 28u BiD Levemir. I don't really have any helpers either.. Just this time because a friend is visiting from out of town. I need to sleep, work and, well, just live. I generally give insulin at 9:00am/9:00 pm. That way, +8 is 5:00 am so I can set alarm, get up, test and get another two hours sleep, if I'm lucky. I get a bit tired now and then because my sleep is interrupted but it's not too bad. It's just that I am responsible for everything (the other cats, dog), my job, the shopping, the laundry, the, the, the... You know what I mean.

I should say though that I've learned Levemir is being discontinued in both the US and Canada. I am buying more than one penfill pack at a time... Don't really want to go back to Lantus.

I don't know what to say about Ivy, bouncing or duration. I know you, like me, are doing your best. :bighug::bighug::):):cat::cat:
 
JL and Chip said:
So your “box” is 4 cycles big, correct? Meaning your methodology is to increase after 4 consecutive cycles without a BG below 150?

1/15 - AM cycle had a BG of 124, which is within your “hold dose” range. PM cycle did not.
(Count = 1 cycle)

1/16 - 2 cycles with no BG below 150
(Count is 1 + 2 today = 3 cycles)

1/17 - AM cycle not below 150. PM cycle increased dose.
(Count is 3 + 1 today = 4 cycles before increase)
Click to expand...
I'm sorry, JL, I don't know what you are getting at.
 
Jodey&Eddie&Blue said:
I'm sorry, JL, I don't know what you are getting at.
Click to expand...
Sorry for any confusion—I’ve tried to ask this question a couple of times in different ways but am not clear on the answer. I’m just trying to clarify your criteria for increasing dose.

Per your signature:
- Reduce dose if BG goes below 90
- Hold dose if nadir is 90-149

Therefore it seems the criteria for increasing would be something like:
“Increase dose if all nadirs are over 150 in the prior x consecutive cycles”
or alternatively
“Increase dose is the lowest BG is > 150 in the previous x consecutive cycles”

My question is: What is the value of “x” ?

It appears that it’s “4” based on your most recent increase. Is that correct?
 
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