1/18 Tiger AMPS 418, high 300s, pmps 442

Hi Deb, I saw your post on yesterday's thread and I promise I will do my best to answer your additional questions later today. I'm at work now and somehow it's really busy. If I don't know the answer or can't point you to a link with them, I will tag more experienced members. :bighug:
 
TY Angela. No hurry! When ever you have time, thx.

Tiger is playing on his trampoline today. I guess he doesn’t like lower numbers….
 
Deb and Tiger said:
Lowering the ps number makes so much sense! Yes I think 175 would make it more attainable to get lower numbers overall. I never saw this spelled out about lowering it and how to do it.
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With more time and experience, you will eventually be able to lower this down to the SLGS guideline which is 90. Baby steps though. I'm glad that you will shoot the full dose with any preshot over 175.

Deb and Tiger said:
I am not sure how to tell when to hold the dose exactly. Does there have to be nadirs below 150 every cycle?
Like this week, there have been some cycles that did go below 150 but there were some that did not.
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So when we look at the SS, we're looking for patterns over several cycles, not just one or two. Take a look at this post where @JL and Chip gave a great description of what to look for when evaluating a dose.
When in doubt, feel free to ask :)

Deb and Tiger said:
I already do his PS 30 minutes before as he grazes and takes 20-30 minutes to eat his meal. I did not know about comparing it to nadir, but that makes sense. I just didn’t know what to do because the one day (1/14) ps was his nadir….
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I'm sure you've heard the term "Lantus Curve". A great and eloquent description is HERE and says:

Example of an ACTIVE, but NOT necessarily typical Lantus and glargine biosimilars cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar/Semglee cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.​

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir/Biosimilars: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.​

It can be difficult with the anxiety of getting ready to test-feed-shoot to NOT see the BG as a "lower number" than you're used to seeing as a preshot. For Tiger, its a blue but that's because you're used to seeing pink and red preshot #s. It might help to take a step back and look at the PS # compared to where he was throughout the cycle. The benefit of the Libre is all that extra data.

Deb and Tiger said:
it may not look like it with all my questions, but I do read it over and over, along with other stickies and other posts. I really am trying to learn.
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You Won't get any judgment from me. I've been doing this FD Dance for 2 years and I STILL read and reread the basics. You don't have to learn it all at once and like I said, sometimes in the stress of the moment, our wisdom and common sense goes out the window. We forgive you for being human :p;)

Deb and Tiger said:
Tiger is playing on his trampoline today. I guess he doesn’t like lower numbers….
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The bounces will get better. Patience pants is a term passed around a lot around here. I've gone through several :rolleyes:
 
Angela & Cleo said:
So when we look at the SS, we're looking for patterns over several cycles, not just one or two. Take a look at this post where @JL and Chip gave a great description of what to look for when evaluating a dose.
When in doubt, feel free to ask :)

The bounces will get better. Patience pants is a term passed around a lot around here. I've gone through several :rolleyes:
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Hi Angela.

such great info! I understand all of it I think?

Am I right, reading the post regarding dosing, that I can leave him at this dose another week since he has had good nadirs? And then reevaluate the nadirs to decide if I should increase or decrease after another week?

I'm sure you've heard the term "Lantus Curve". A great and eloquent description is HERE and says:

I’ve looked at that curve structure before and we were following it pretty good until we started getting blues and it kind of deviated from it, actually have a nadir at PS.

Am I right to assume todays numbers are a true bounce from yesterdays lows? Bounces are confusing to me somewhat…

Thanks again for your awesome detailed answers!
 
Deb and Tiger said:
Am I right, reading the post regarding dosing, that I can leave him at this dose another week since he has had good nadirs? And then reevaluate the nadirs to decide if I should increase or decrease after another week?
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Typically those that follow SLGS can only do curves once a week. With the amount of data you get from the Libre, you don't have to wait another full week, you would looking at Tiger's patterns. If you start to see his nadirs trending up after giving time for a bounce to clear, then POST and ask for dose increase advise. Now if at any time, Tiger's BG falls under 90, you will immediately reduce the dose by 0.25units.

Deb and Tiger said:
Am I right to assume todays numbers are a true bounce from yesterdays lows?
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That's what it looks like to me:cat:. I don't mean to sound mean, yesterday's numbers were not "lows" rather they were lower than Tiger is used to.
 
Angela & Cleo said:
Typically those that follow SLGS can only do curves once a week. With the amount of data you get from the Libre, you don't have to wait another full week, you would looking at Tiger's patterns. If you start to see his nadirs trending up after giving time for a bounce to clear, then POST and ask for dose increase advise. Now if at any time, Tiger's BG falls under 90, you will immediately reduce the dose by 0.25units.

That's what it looks like to me:cat:. I don't mean to sound mean, yesterday's numbers were not "lows" rather they were lower than Tiger is used to.
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Ok I will leave dose as is and watch carefully.

Not mean at all! So true…..so not used to blue numbers, I don’t even know what to call it! LOL
Thanks!
 
Deb and Tiger said:
Ok I will leave dose as is and watch carefully.

Not mean at all! So true…..so not used to blue numbers, I don’t even know what to call it! LOL
Thanks!
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I'm never sure if there is a "tone" to my typewritten words:)
It might help to think of a distinction between "Low" vs "Lower" numbers. When following SLGS, "Low = 89 and below" (even though those are still VERY SAFE numbers) and right now, "LOWER = 90-149". Soon, Lower definition will change to 90-125 or maybe 90-100 and eventually it will fall right out of your vocabulary because you'll want 90 all the time :bighug:.
 
What a difference a day can make.

Couldn’t get off the trampoline today. Didn’t eat real well today and picky when he does. Gotta get tummy settled down for sure.

Have a good night everyone and hug your babies!
 
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