10/23 Jenks AMPS 108 +3 62 +5 75 +6 75 +10 86 PMPS 131 +5 152 +10 85

[AZJenks]

10/22

Oh boy. Here we go.

Jenks broke last night's 295 PMPS in a big fashion, ultimately dropping 187 points throughout the PM cycle. He continued to slide through AMPS until he hit the 60s, then rebounded a bit into the 70s and had been hanging out there ever since. He's feisty and obnoxious, so I know he's feeling good.

But now I have a dosing problem.

One option is to try to hold the dose and see if he surfs these numbers. Unfortunately, we have no data for how he performs at this dose at lower BG readings. Just two days ago, we saw him from from 145 PMPS to 38 at +7, and tonight's PMPS reading will almost certainly be lower than that. I'm concerned about the risk, even though I'm here to monitor him all night.

Another option is to take a reduction. I just don't know how much. One unit is the obvious choice, but I'm not sure if it will have any effect once we factor in depot action. What I do know is that the reduced BCS dose of 7U given yesterday morning was not enough to control numbers. So an effective reduction would be somewhere between 1 to 6 units. Not really sure how to make that decision.

I don't know how to reconcile those two with the fact that he seems to be surfing just fine right now without any additional intervention.

 

[AZJenks]

With that 86, he appears to be coming up a bit into PMPS. That's going to mean the day cycle actually looks like a normal Lantus cycle! Yay!

Though it's still not helping me to decide one way or the other.

 

[Doodles & Karen]

With that 38 on 10/21 you need to take a reduction. I might do another BCS (50% would be 6 or 6.5u) tonight and start with a new dose tomorrow. Maybe try 12u? Having an IAA kitty myself I'm not one that likes to gamble.

ETA: as you know even if you do a BCS tonight it could still be pretty active. My Doodles in the past has kept me up all night on a BCS but most times it works well.

 

[AZJenks]

I did a real quick plot of the last 10 days BG averages. The AM Average and 24-hour Average seem to indicate that we're imminently heading below 100. We're probably nearing that point too with the AM Averages, but the 295 from the BCS dose the other day skewed the plot in the opposite direction. What I've learned from my experience graphing Jenks' numbers is that this is usually indicative of hitting a point where we're starting to get too much insulin.

Might be time to pull back to 12U to see what happens.

 

[julie & punkin (ga)]

I think I would reduce by 10%, which would be to about 11.75u. As Karen said, that 38 needs an immediate dose reduction.

There are a couple of reasonable choices for tonight that I would consider if he were mine:

You could reduce to 11.75u knowing that the depot action + an all green day on a dose that is too large (which we know from the 38) might very well mean that you're up all night monitoring or carbing him tonight.

You could give a significantly reduced shot - I gave 50% - for a one time shot tonight and come back in the morning at 13.75u.

You'd be smart to monitor either way. You've got lots of experience with Jenks spending whole cycles in green and it is nice to see him back there today. Of course, those are just some ideas from me - the choices are always yours!

 

[AZJenks]

Thanks for dropping by with your insights @Doodles & Karen @julie & punkin (ga).

He was up to 131 at PMPS, which was a nearly 50-point rise in the last two hours of the cycle. Everything considered, I opted for a full unit decease to 12, and a little extra carbs for dinner fuds. Now we settle in and wait.

I'll plan to get a +4 to see how he's doing in the first quarter. That should probably tell the tale as to what's in store for the rest of the night.

 

[julie & punkin (ga)]

Here's hoping for an uneventful night for you!!