There's no argument, I simply disagree with Sheila. We use a protocol here in LL, I'm pointing out the protocol. If Tom was dropping low, I would agree that he needs a reduction. He isn't dropping low, there's no need for a reduction at this point.
Lori can certainly choose to reduce the dose if she wants to....I just disagree that it's necessary or appropriate at this time. She holds the syringe, it's her choice.
I did not suggest that she continually increase the dose...in fact, I suggested that she reduce the dose from 1.0u to 0.75u, and I suggested that she hold the dose, not increase back to 1.0u. I see 300s for PS #s on 0.75u, not 500s & 600s. Since she is just starting to see a response to the 0.75u dose, how about if she sees how it works for more than one cycle before suggesting a dose adjustment in any direction?
You see rebound, I see response to the insulin. His numbers were already above where the PS #s are now before the insulin started having an effect. So because the PS #s are not in the ideal range after 3 days on the dose, the dose is too high...even though they are coming down? As you have already said, this insulin takes time to work. But you are not willing to allow this dose time to work before rejecting it?
I don't see any overwhelming evidence, what I see is a reference to a different insulin, which doesn't apply, and a statement that the curve shouldn't be a curve. If there is no curve, there is no response. He saw no curve for the time that his shed was filling on 0.75u...was that better, because his curve was flatter? Yes, you will see a curve, until his numbers come down. The only way you won't see a curve is if his numbers never come down.
Sheila I can't believe you said .5!!!! I was thinking dose increase. I literally gasped when I read that!
