11/2 Sya AMPS 148 PMPS 251 Not sure what's going on

[K. Sya and Sophie (GA)]

Hi,
link to previous post viewtopic.php?f=28&t=28807
So Sya was diagnosed last March. Used a 10 mL vial till June. Long slog to get her numbers better. Started a new vial in June...struggle went on, but finally got her pretty good shape on 3U. Started a new vial 10/20. Am seeing odd results. When you look at her numbers they don't show what I feel like I'm seeing, which is less regulated kitty. I get good numbers on the old insulin...less good on the new. Initially was thinking bad insulin lot. Has also been suggested that she could be sick...not sure I would be seeing the cycle with the insulin due to that was also suggested she might be bouncing because its more potent insulin and I should reduce.
Her numbers aren't horrible, but are certainly more odd than they have been. Nothing else has changed, and she seem to feel OK other than cranky when her sugar is up.
Am I being paranoid? Any advice anyone could offer would be appreciated.

 

[Libby and Lucy]

Remember that Lantus is cumulative, so each shot has some influence on the next few shots (because you are constantly building overlap). You can't really say that numbers are better on the old juice just because of lower numbers in the cycles where you have tried the old vial - those numbers are most likely caused by the shot *before* that one, more than by the shot you just gave. It's a hard concept to grasp, but you need to try to learn to look at your data not just cycle by cycle, but in "waves" that span several days.

I would pick a vial and stay with it, and I would pick the newer one because why take a chance on old insulin? Beyond that, it's difficult to tell whether the dose is too high or too low without spot checks over several different cycles. It is possible that Sya is over dose, since your last two dose increases were done without any nadir checks to be sure the increase was really needed. It is also possible that she just needs more insulin to pull her numbers down a bit. Spot checks will tell the story, but without them it is impossible to make a recommendation.