02/01 Eddie AMPS 473 +8.5 358 PMPS 410 +8 344

[Jodey&Eddie&Blue]

Good morning,
Here is yesterday.

When I tested at PM +5 I thought he was on his way down but, oh no:

https://felinediabetes.com/FDMB/threads/01-31-eddie-amps-277-5-212-8-5-290-pmps-6-371.273663/

I'm at a loss. One step forward two steps back. @Wendy&Neko can you translate from January 20th to today? All I see on the horizon is a long ride on 14u and an increase back to 15u. I test at various times of the day and obviously misread the pattern. Like last night's PM +6, 371, I thought he must be on the way down but he wasn't. Where is nadir?

Forest for the trees?

 

[Wendy&Neko]

Nadir is whenever the schedule the numbers are lowest. Nadirs can and do vary. On the AM 28th, the nadir was earlier, 1/25th it was later - but that was a bounce breaking cycle and those tend to be later nadirs.

can you translate from January 20th to today?

I don't know what you mean by that. Other than the 25th he showed that 15 units was too much. This dose he's shown some numbers in the low blues, which means hold the dose.

 

[Jodey&Eddie&Blue]

Nadir is whenever the schedule the numbers are lowest. Nadirs can and do vary. On the AM 28th, the nadir was earlier, 1/25th it was later - but that was a bounce breaking cycle and those tend to be later nadirs.
That is the hard part: varying nadirs. I guess it's Levemir because Lantus seems so much more predictable...

I don't know what you mean by that. Other than the 25th he showed that 15 units was too much. This dose he's shown some numbers in the low blues, which means hold the dose.

I meant there's a wave pattern I can only just discern and if I could read it, I might be better informed and less reactive. I know all the patience pants stuff but dealing with the variables of SRT leaves me holding the AT meter at times and looking at the spread sheet with uncertainty, which may well be appropriate.

 

[carfurby (GA)]

 

[Jodey&Eddie&Blue]

Nadir is whenever the schedule the numbers are lowest. Nadirs can and do vary. On the AM 28th, the nadir was earlier, 1/25th it was later - but that was a bounce breaking cycle and those tend to be later nadirs.


I don't know what you mean by that. Other than the 25th he showed that 15 units was too much. This dose he's shown some numbers in the low blues, which means hold the dose.

I do have a question about the low blues vs the too much insulin: when do we stop attributing changes in number to the draining or depletion of the depot? 'Cause right now, he's still high at AM +8.5 358.

 

[JL and Chip]

Eddie has seen some nice low blues on this dose, even blues that are in the “normal” range on an AT meter. That, as Wendy said, means hold the dose.

Not to be a broken record, but please try to focus on the lowest numbers and ignore the high numbers. The low numbers determine dosing changes. Don’t let your mind tempt you to increase based on seeing some higher and/or bounce numbers.

 

[Wendy&Neko]

I do have a question about the low blues vs the too much insulin: when do we stop attributing changes in number to the draining or depletion of the depot? 'Cause right now, he's still high at AM +8.5 358.

When you reduce the dose, the larger depot can influence 4-6 cycles after the reduction. On the higher side for larger depots. The depot will drain faster if you skip or do a reduced dose, which you did on the 25th. The nice low blues on the 1/28 AM cycle were all due to the 14 unit dose. How low he went on the PM cycle of the 29th, was also because of the 14 units dose. Yes, he could still be bouncing from that night.

 

[Jodey&Eddie&Blue]

Eddie has seen some nice low blues on this dose, even blues that are in the “normal” range on an AT meter. That, as Wendy said, means hold the dose.

Not to be a broken record, but please try to focus on the lowest numbers and ignore the high numbers. The low numbers determine dosing changes. Don’t let your mind tempt you to increase based on seeing some higher and/or bounce numbers.

I know what you are saying. My question has to do with the rise in number after the lowest numbers, which seem to be adjacent to numbers that were low enough to warrant a reduction. I guess I'm trying to understand if the depot lasts long enough after the really low numbers to produce low numbers (the blues) but when the depot is not sustained with the higher dose do numbers rise. Look, I'm just trying to understand.

 

[JL and Chip]

Look, I'm just trying to understand.

Yeah, I get that. I was responding more to your recent questioning about some of the higher BG numbers and whether they warranted a dose increase. I’m all for you trying to understand what’s happening. Wendy already addressed your question re: the “hang time” (depot impact) of the higher dose on ensuing cycles.

 

[Jodey&Eddie&Blue]

When you reduce the dose, the larger depot can influence 4-6 cycles after the reduction. On the higher side for larger depots. The depot will drain faster if you skip or do a reduced dose, which you did on the 25th. The nice low blues on the 1/28 AM cycle were all due to the 14 unit dose. How low he went on the PM cycle of the 29th, was also because of the 14 units dose. Yes, he could still be bouncing from that night.

One more thing, @Wendy&Neko Wendy, you say he "could still be bouncing from that night": should that not be over by today (Feb 2?)AMPS 499??

 

[Jodey&Eddie&Blue]

Yeah, I get that. I was responding more to your recent questioning about some of the higher BG numbers and whether they warranted a dose increase. I’m all for you trying to understand what’s happening. Wendy already addressed your question re: the “hang time” (depot impact) of the higher dose on ensuing cycles.

Hi JL, I wasn't currently asking about increasing the dose. i was trying to understand the dynamics behind a decrease and the sustained bounce. How does one determine when a reduction hasn't worked, for example? And, in the spirit of ECID, I'm trying to understand Eddie's SS and from the numbers are various times (I keep trying to record different times because Levemir and elusive nadirs) how to determine how long to hold a reduction. Can the SS guide me in these decisions, for example?

Today (Feb. 2) Eddie's AMPS is 499 (following at Feb 1 PM +8 344). Even though his appetite is good, I can tell he's out of sorts. High numbers=eat and go to sleep. Stat.