11/23 Pumbaa - Flat yellow AM cycle...but it's Friday...

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Pumbaa

Pumbaa

Member Since 2012
NOTE: Pumbaa's SS is in reverse with the most current data at the top.


Place your bets now if Pumbaa will drop low tonight 'cause it's Friday! *LOL*

For some odd reason, while on Lantus, Pumbaa used to very frequently take a low dive on Friday nights. I never could figure out why he did this on Fridays.

He did it on the Levemir last Friday night. And with his flat yellows today, it's like he's priming for a dive below 50.

I'm going to be calm. I'm not going to stress or obsess about this. This is the new me! The Patience Pants now have a coating of "Be-Calm", thanks to Sheila and Mel.

Suze
 
Sheila & Beau & Jeddie (GA) said:
I hope you can regain the better numbers on 2.25u again. He is just really sensitive to insulin I guess. 2.25u seemed *maybe* a bit too much before, but 2u didn't seem enough. Maybe you will need to try 2.15u or something if 2.25u proves to be too much again.
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Sheila, I've been meaning to ask you about this, but life got in the way.

Can you explain what you are seeing in Pumbaa's numbers that I'm not seeing, regarding how 2.25U might be too high? I keep thinking he's just not getting enough insulin, due to his continued high numbers and due to his continued bounces, and due to the TR "raise, raise, raise the dose" mantra that we all hear constantly.

Due to his flat yellows for 6 cycles at 2.25U, I'm about ready to raise his dose, not lower it a pinch. I'm worried that he's hit glucose toxicity/insulin resistance again. But, it's Friday night, so I'm preparing myself mentally for some greens. *LOL*

Suze
 
I see flat, which is good. I see nothing but yellow, which isn't good. Flat and blue would be a more welcome sight:-)
I am not seeing anything that says that 2.25u is too high. I hear what you are saying about glucose tox and resistance. I think Dr. P calls it "drowning in glucose toxicity", which she calls "the crux of feline diabetes".
Do a search for either of those quotes in PZI and you can see what she had to say about it.

C arl
 
I posted that because to seemed like the last time he was on 2.25u it caused some swings to get started - from 60s to 400s. I always approached that sort of pattern by reducing the dose a bit to stop the swings and see if things evened out and then, if necessary, raise up more slowly. I don't think anyone but Vicky and I really used/suggested that approach. It did seem to work for both of us.

So, I am just thinking if he starts that same pattern again, ending with a PS in the 90s that you feel a reduction is needed on, make it less that a .25u reduction and see if that prevents the slow climb in numbers he tends to have.
 
Confused... I don't understand why you would reduce/adjust based on a preshot number? I thought it was all about the nadir?
Carl
 
I think I'm getting the concept of slightly reducing the dose if his numbers start swinging wildly, in a attempt to flatten them out, so that Pumbaa doesn't do his bounce-on-a-bounce Superball routine, like he did previously when he was on 2.25U (from 11/7 through 11/2).

Interesting...because now that I had taken him down to 2.0U (and 1.75U for two cycles to get his shot times back on track), this time around on 2.25U he is more even instead of swinging wildly. It's taking him a long time to settle into this dose, but I truly prefer that to those huge swings in numbers, and I'm sure the little guy does, too!

So, Sheila, if he starts swinging again, I should try reducing his dose a tiny bit (not a full .25U), but only do it when a PS number is low, not if it's high, correct?

The good news is that Pumbaa finally hit blue on this current dose. I'm praying that his numbers remain relatively flat!

Suze
 
Carl: here's the thread where Dr. Lisa talks about GT: "This is the crux of diabetes. The longer a body is asked to drown in sugar, the more damage is done to the body...every part of the body...including the nerves for neuropathy."
 
Yes, doses are based on nadir, but PS's also factor in. And, no, you don't generally want to reduce (or raise) on a PS. However, if you get a much lower than normal PS, especially one under 100, and don't feel comfortable shooting it and/or don't have data showing how kitty will respond safely to it and/or won't be home to monitor then reducing is the safest thing to do.

Notice I wrote this
...ending with a PS in the 90s that you feel a reduction is needed on
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and not "...and, therefore, you need to reduce..."

Some people fearlessly shoot full doses on 60s, but it isn't something I have even been comfortable doing and I am pretty sure Suze is definitely not comfortable doing it - at least at this stage - and she is who I am making the suggestion to.
 
I'm hoping that Pumbaa's weird "nadir at PS" days are over. He seems to have been shocked out of them, once I got his injection schedule back under control.

Looking back (starting on 11/11), it's interesting that his biological clock controlled the nadirs, based on his previous 7 o'clock injection times, rather than the insulin controlling his nadirs. That never hit me until just now.

Suze
 
Pumbaa said:
...Looking back (starting on 11/11), it's interesting that his biological clock controlled the nadirs, based on his previous 7 o'clock injection times, rather than the insulin controlling his nadirs. That never hit me until just now.

Suze
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Actually that's the depot still controlling things. When you stall a shot the depot stays on the old schedule until such time you hold the new dose and new time long enough to lay down a new depot matrix. Stalling one hour moves the nadir an hour earlier in relation to the current cycle, often a good thing with the later Levemir nadirs.
 
Thank you, Heather. How's Sneakers doing? I noticed he's down to 23U per injection and still getting some blues. Yikes! I still can't believe that he gets that much insulin. I'm putting you in perpetual prayers that you win the lottery, just so you can afford his insulin! :)
 
Dale 'n' Chip said:
Actually that's the depot still controlling things. When you stall a shot the depot stays on the old schedule until such time you hold the new dose and new time long enough to lay down a new depot matrix. Stalling one hour moves the nadir an hour earlier in relation to the current cycle, often a good thing with the later Levemir nadirs.
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Hey Chippendale's! Chip is doing great!
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What you types above makes sense, but that's not what happened with Pumbaa. I was one hour late on his AM shot on 11/11, and his nadir became +12, or his PMPS. Then on both 11/12 and 11/13, his PM nadirs were his AM PS's. So how do you explain a later nadir due to delayed injection times?

Suze
 
I'll try to explain this after work when I have time...
You're overthinking it suze ;-)
A perfect cycle would have no nadir. The pefect dose would show flat green numbers all day long. Like a non-diabetic cat. As a caregiver, you are trying to "be" his pancreas, but that's impossible to do, because you can't react twice a day to what his pancreas would do by instinct 24 hours a day. There's nothing wrong with a "nadir" at +12. The problem is that you can't get the number to "stay there".
We all are guilty of overthinking this insane disease.
Carl
 
Carl: I'm a born over-thinker! *LOL* While that is a great trait for my line of work, I have to keep reminding myself that it doesn't apply to cats and FD. I keep trying to apply logic there when there is no logic. :roll:
 
Pumbaa said:
Thank you, Heather. How's Sneakers doing? I noticed he's down to 23U per injection and still getting some blues. Yikes! I still can't believe that he gets that much insulin. I'm putting you in perpetual prayers that you win the lottery, just so you can afford his insulin! :)
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Since the power-ball is so high maybe I should buy a ticket then? Somewhere around 400 million, isn't it? :lol: :lol:
 
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