06/03 Mowgli AMPS 259 PMPS 286 +3.5 149

AmandaE

Member Since 2019
06/03 Condo

Mowgli had a very nice night last night (not me though :p) it resulted in a reduction so hopefully it holds

I’m starting my BIL training for insulin shots this week since we will be away for a wedding this coming weekend

Back to the grind... have a great Monday everyone :D
 
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I have a question around switching to Tight Regulation VS tweaking SLGS to a lower reduction threshold.

TIGHT REGULATION
I have flirted briefly with the idea of trying tight regulation in the future with Mowgli. I can not do anything earlier than 5 for shooting because of the work bus schedule, this is a hard schedule line: Leave exactly at 6:47am to catch the bus - arrive home at around 5:10pm... I can't shoot earlier than 5am because I don't get home in the evening until 5pm; I can't get more than a +1.5 because I will miss the bus.

The way my schedule works is that I would get up at 5:00am, test, feed, shoot. Then I could get a +1.5 before I head out the door to see how Mowgli is reacting, I don't feel comfortable testing anything later than +1.5 because I don't want to scramble to catch the bus. Mowgli typically has an onset by +2 but I do notice that as he approaches Nadir that he can pick up steam. I think I would be really nervous that I wouldn't have enough data to be confident to leave him during the day armed only with a +1.5 BG reading. This leads me to strongly believe TR just isn't right for Mowgli... my schedule just wont allow the risk tolerance associated with such an aggressive dosing method.

Note: I have read the post on people who follow TR and work and I have also chatted with a few people on the forum to see their strategies on following TR while working and how they work.

MODIFIED SLGS REDUCTION THRESHOLD
Another option I had considered is a modified SLGS. All of the reference material about SLGS suggests that you can modify it as you get to know your cats reaction to insulin.

What I am talking about here is considering changing Mowgli's reduction threshold from reducing anytime he falls below 90mg/dL to something like: reducing anytime he goes below 70mg/dL ( I would want to consult with the experts around here to choose an appropriate reduction point , but 70 seems like a good start based on the data I have). As I get used to this reduction point and see Mowgli's patterns with it, potentially we could lower it further with time. To me this seems like a better fit for our lifestyle than TR. But... am I misunderstanding how the fexibility of SLGS works?

What do you think? I really think that based on Mowgli's typical reaction to Lantus that I can lower his reduction point and continue following SLGS... but I don't want to be hasty.. and I don't want to alter the protocol in the wrong way.

Looking forward to any feedback :)
 
I do a modified SLGS with Furball. I reduced the number to take reductions because Furball did not hold reductions when she went below 90. Now she has to go below 60 before I reduce. I have never done TR because I don't like the idea of increasing the dose while I'm at work and can't monitor. I think you test enough, and have enough data, to safely lower the reduction for Mowgli and do a modified SLGS. You can start with 70 and lower it later if you need to. If you decided to do this, just make a note in your signature line if you have space so people will know.
 
I do a modified SLGS with Furball. I reduced the number to take reductions because Furball did not hold reductions when she went below 90. Now she has to go below 60 before I reduce. I have never done TR because I don't like the idea of increasing the dose while I'm at work and can't monitor. I think you test enough, and have enough data, to safely lower the reduction for Mowgli and do a modified SLGS. You can start with 70 and lower it later if you need to. If you decided to do this, just make a note in your signature line if you have space so people will know.
Thanks Carla!

I’m so relieved that you have a similar situation... especially since I see you as someone with a lot of valuable experience with FD :).

I wasn’t exactly sure what it meant for SLGS to be flexible, but for me it made more sense to lower Mowgli’s reduction point at a lower BG level than at 90 just based on how he reacts and recovers when he goes low.

I have the same point of view about TR and work. I just don’t think I will ever be comfortable enough to shoot, get a +1 - +1.5 and feel like I’m data ready to leave the house.

I will declare right now that I’m going to continue with SLGS with a reduction point of 70mg/dL; I will follow SLGS in every other way and in a couple of months I will check back in and see if we should try a lower / higher reduction point based on the data I pull.

I’ll make the space in my signature to include that detail. Should I also put a note in my spreadsheet?
 
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