1/24 Pearl PMPS 145 +1 108 +2 75

Discussion in 'Lantus / Levemir / Biosimilars' started by Margaret (and Pearl), Jan 24, 2021.

  1. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
  2. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    PMPS update - Pearl is at 147, been sliding down all this cycle. I've never shot under 150 before. Wondering whether I shoot or not shoot?

    Thank you!!
     
  3. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Margaret

    I’m so sorry no one saw this. Did you shoot (looks like you did but I can’t tell if you shot 147 or 145).
     
  4. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    It's ok!, and thank you Marje for writing! Yes, I shot her PMPS 145. We are now +2 and she is at 75. I am giving some LC and a little MC food. I'm not panicking, last time she went green I know you said not to worry over 50. But I think this means I need to monitor hourly for some time till I know she has hit her NADIR, yes?
     
  5. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Did you feed anything at the 108 at +1? That’s a pretty big drop when she should have had a food spike. Excellent on testing and feeding. You might find, if she goes lower, you’ll need to test a bit more often but let’s see where she is at +2.

    Housekeeping: could you please revise the subject line after date and name to read PMPS 145 +1 108 +2 75. I’ll keep an eye out for you.

    Also....it would be more helpful if in your signature block, you eliminated the dose since that changes and BID because we can see both of those on the SS.

    Thank you. After the next test, I’ll have some info for you.
     
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  6. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Yes I fed her LC at PMPS, +1 and just now at +2. I added a little MC in at +2 also. Sometimes she spikes at +1 then dives, and other times she doesn't spike at all but stays steady or starts dropping at +1. So I am not certain of her pattern, looks like she has different ones - so harder for me to predict whether it's safe to shoot a PS low number of not. At +2 (just tested) she is at 75. Is that too low for +2? Will test at +3. She tends to also drop late in the cycle.

    Yes will revise title now!

    Thank you!!
     
  7. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    She’s come down quite a bit so you might be busy with lower numbers tonight but let’s see how she does with the food. Maybe a repeat of 1/22?

    Thanks on the title but you forgot the date and her name :woot::woot: It happens!

    I wanted to point out a pattern to you. She’s been bouncing starting yesterday and through last night. Today was a slow slide so a good indicator that she was clearing the bounce especially with the 171 at +10. Great job getting that test so you could see where she was headed. It was pretty predictable that she was going to give you a lower PMPS and this might br a busy cycle for you. Sometimes, it’s really hard to see the patterns from where you are sitting....you know the old “can’t see the forest fort trees”. It’s common here.
     
  8. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Hi and thanks for all the good information!! Ok, so honest question - given the sliding pattern to clear her bounce, should I perhaps have NOT shot tonight? And also - was 1/22 a good night or wonky? I am trying to start to understand what a good green cycle will look like. I shudder to think I would have to EVER increase dose if we get this low already.
     
  9. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    You did absolutely perfect!!!! That was exactly what you should have done. Great job!

    IMHO, 1/22 was a good night because it gave you a taste of dealing with low numbers without dealing with it all night. Yes...you were up testing but you weren’t struggling with numbers. Check out what my Lil Stinka girl did to me a lot on Lantus and we had only been here a few months:

    upload_2021-1-24_19-42-8.jpeg

    She did this all the time and why I moved her to Levemir.

    There are two types of dropping numbers:
    • bounce clearing
    • second dips
    The difference is that in a bounce clearing drop, the BG usually starts higher at the earlier PS and gradually comes down so the lowest number for that cycle is at the next PS as you saw tonight. A second dip occurs around +12, is lower than the late cycle BGs (i.e. +9, +10, +11) or so but it’s not lower than the nadir for that cycle. Both kinds allow you to take advantage of carryover and overlap as you can see I did above by shooting. I’ll see if I can find a second dip example on Gracie’s Lantus SS. This is obviously a bounce clearing cycle.
     
    Last edited: Jan 24, 2021
  10. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Here’s a second dip. Nadir was 45, she came up to 82 by +10 and took a second dip at PMPS. I got a little carryover and overlap but it didn’t last long before she lost duration and had a bounce on top. Actually, the carryover and overlap helped delay the bounce.

    upload_2021-1-24_19-53-46.jpeg
     
  11. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Thank you for the pics of the green cycles! That is super helpful plus your explanation! I would DIE if I saw numbers that low, lol! How did you ever get through it new to the FD game?!

    Ok just tested Pearl for her +3. She has risen to 88 now, gave some LC food. I keep testing on the hour yes?
     
  12. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    You’re welcome. Trial by fire!! We just did it...shoot low to stay low (above 50). You do remind me of us when we were new. We swore we’d never shoot below 150 and within a month, we were shooting green numbers.

    If she’s doing ok with the testing, I’d get one more in an hour and make sure she’s at least flat before giving it a little more time. You are both doing great,
     
  13. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    I have to remember that..."shoot low to stay low". Scary!, but I can see it works when I look at others' spreadsheets! Yes, I am actually really super surprised at how fast we have scaled down to numbers where we are now. It was overnight when we started the 2.25U dose, it's like her body just switched to "on" and the numbers started improving rapidly, and her bounces started not being as high.

    Yes, she is a champ with the testing - literally sits in my lap waiting for her snack while I get the blood, lol. She is very patient when I have to use more than one strip or prick, too. She is a very good girl, and has always been so patient with me, about food, attention, anything really.

    So I will test again in 45 minutes for +4 and write back. Even if she is rising, I know she will probably dip again late in the cycle too.

    Thanks so much Marje!
     
  14. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Take a look at Henry’s SS (start with 2020 tab). He looks like he read the Lantus Manual :p I know Robert was a little upload_2021-1-24_20-25-14.gif upload_2021-1-24_20-25-17.gif the first few times I worked with him to shoot low but it really paid off. This is what a Lantus “curve” looks like.....nice and flat.

    Awww..she looks so sweet! I’m sure it’s a reflection of having such a great mama.

    I’m not really seeing her dip back down at night........
     
  15. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Oh wow you're right! She only dips back down at the tail of her daytime cycle. Thanks for the other spreadsheets to check out too! I'm a data person ;)

    I just did her +4 it is 99 so she is rising a little bit! What shall I do now? Get a +6 and +10??
     
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  16. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    When are you going to bed? You could feed her a little LC snack and test at +6. If she’s flat, +10 is good. If she’s headed up by a lot, you could call it a night.

    Boy do I know the whole data person thing :rolleyes::p
     
  17. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Lol, I'm ready to go to bed now (it's 11pm here). I just set my alarm and get up to test her as needed, it's not a problem - sacrifice for data. ;)
     
  18. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    I added this above so I’ll copy it here: You could feed her a little LC snack and test at +6. If she’s flat, +10 is good. If she’s headed up by a lot, you could call it a night.
     
  19. Margaret (and Pearl)

    Margaret (and Pearl) Well-Known Member

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    Dec 23, 2020
    Oh! Thank you, I didn't see the add! I'll do the +6 and see where we are then. Thank you SO MUCH for all your help tonight, Marje! I am so grateful to have this support as I learn.
     
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  20. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    You’re very welcome...my pleasure. Sweet Pearl (I love that name) is so lucky to have such a great mom.

    Hope you rest!
     
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