11/20 Chino|AMPS=306|PMPS=294|+3=400|+4=344

[Adrian and Chino]

Last post: 11/13

We're rejoining the double digits club I had a bad feeling about taking a reduction when he last went under 50, as it seemed to be a result of the circumstances rather than too much insulin. I posted for advice on 11/08 and ended up reducing the dose. Sure enough, the green nadirs stopped...

3 increases later, his BG values are not improving. It looks like he's started bouncing from blue, and this is the 3rd red in 5 days. There are cycles where his BG just goes up until I give a dose of R at +8. Last week was the first week without a green nadir since we switched to Levemir 9 weeks ago.

This is the first cycle on 10 units, so I'm hoping we'll see better values in a day or two. But it's difficult to remain calm and patient when all I can think about is the microvascular damage that's occurring every day while I fail to keep him out of dangerous BG levels.

 

[Wendy&Neko]

Next time you see 30's that you think is the result of circumstance not dose (though he had seen low 70's on 9 units), try taking a smaller reduction. See if a 0.25u reduction is enough to stop the lows yet still allow you to get ahead of the depot. Neko was sensitive to that size of change when she was around that dose size. Looks like Chino might also be bouncing from large drops. Last night he dropped 225 points in two hours. Are you feeding him around or just before onset?

I asked Neko's IM vet about ugly numbers, and he said it's not bad if they are only spending a few hours, not days in higher numbers. Neko was the queen of the blacks at one point.

 

[Adrian and Chino]

See if a 0.25u reduction is enough to stop the lows yet still allow you to get ahead of the depot.

Good idea, thank you.

Are you feeding him around or just before onset?

I think so, at least some of the time... by which I mean: I feed with the AM/PM dose and 4 hours after. On some nights, the +4 is higher than the +3, but on other nights it's lower. So he eats again before onset at least some of the time.

I asked Neko's IM vet about ugly numbers, and he said it's not bad if they are only spending a few hours, not days in higher numbers.

He's had a number of cycles recently that were spent almost entirely in the 300s... but at least when it goes above 400, it's only for an hour or so. And he's been coming back down to blue at least once every other day. Should I be using R more often, or using it differently? I try to give it when I see him rising but I've never given R for anything under 200, and he often doesn't rise above that until PMPS. The extent to which he responds to the same dose of R from one cycle to the next also varies considerably.