11/30 Charlie amps:460, 5u

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+7: 388

I'm getting so discouraged. His numbers are getting worse and I just don't understand why. He is is good spirits, but seems a little tired. I guess these high numbers are making him not feel very well. If this is resistance, I wish someone would give me a link to some info about it, please. I don't understand why his numbers keep going up as I raise his dose. When it breaks through, will it happen immediately, or will it look like any other dose for a few days but then show improvement? Sorry this is a bit long. I feel like I'm getting desperate here. None of it makes sense to me. Should I up his dose to 5.5 tomorrow? I'll be back in 15 minutes or so to edit this to add his pmps numbers.

Pmps:389, 5u, just about his best reading of the day. It just doesn't make any sense.
 
Insulin resistance (IR) is a condition in which the cells of the body become resistant to the effects of insulin, that is, the normal response to a given amount of insulin is reduced. As a result, higher levels of insulin are needed in order for insulin to have its effects. The resistance is seen with both the body's own insulin (endogenous) and if insulin is given through injection (exogenous).

One of the actions of insulin is to cause the cells of the body, particularly the muscle and fat cells, to remove and use glucose from the blood. This is one way in which insulin controls the level of glucose in blood. Insulin has this effect on the cells by binding to insulin receptors on the surface of the cells. You can think of it as insulin "knocking" on the doors of muscle and fat cells. The cells hear the knock, open up, and let glucose in to be used by the cell. With insulin resistance, the muscles don't hear the knock as well (they are resistant), and the pancreas is notified that it needs to make more insulin, which increases the level of insulin in the blood and causes a louder knock.

The resistance of the cells continues to increase over time. As long as the pancreas is able to produce enough insulin to overcome this resistance, blood glucose levels remain normal. When the pancreas can no longer produce enough insulin, the blood glucose levels begin to rise, initially after meals when glucose levels are at their highest and more insulin is needed, but eventually in the fasting state too. At this point, type 2 diabetes is present.

Besides the insulin, something you can try adding is...if Charlie will still play...get him up and moving around a bit. Or even rolling around on the floor if needed. Tilie would play chase anything anymore, but she would happily roll back and forth and swat skyward at things. Exercise can be one type of therapy to unlock the doors of the muscles.

In the meantime, it may be time to really discuss or consult with your vet or ...I believe you said the vet across the street who was more amendable to home testing. It may be time for that insulin change. Especially since Charlie is redeveloping signs of diabetes (tiredness).
 
guess you already shot. if you haven't, pls increase dose. if you have, pls increase at the next shot. i wouldn't wait past day 3 or 4, to avoid having him adapt to the dose change. have to punch through resistance (and try to get +3s and +5s whenever possible to see how he's doing on dose).

charlie, come down from there!
 
Thanks blue! That was very helpful. One more question (yeah, right): how can one tell that this is insulin resistance and not bounces?

Chriscleo- so if I'm understanding correctly, I don't want Charlie to settle into a dose, but just keep increasing regardless? If the resistance breaks will it happen soon after a dose increase? Is that the reason for not needing to hold doses very long?

I'll up his dose tomorrow. I don't do increases at night. I desperately need my sleep and I don't like to leave him alone right after an increase. I don't often wake up to test at night unless the bun kicks my bladder and wakes me up!
 
Good question! What is the qualifying difference between insulin resistance and a bounce.

Claudia, I agree, I wouldn't do increases at night either.

Good luck tomorrow.
 
Bounce/rebound has to do with the reaction from the liver dumping more glucose. A protective measure.

Resistance has to do with the cells not being able to uptake the insulin.


That's the basic difference, although too much rebound/bounce can induce insulin resistance.


Insulin resistance (IR) is a condition in which the cells of the body become resistant to the effects of insulin, that is, the normal response to a given amount of insulin is reduced.

insulin rebound,
extreme fluctuations in blood glucose levels as a result of overreaction of the body's homeostatic feedback mechanisms for control of glucose metabolism. When exogenous insulin is given, the hypoglycemia triggers an outpouring of glucagon and epinephrine, both of which raise the blood glucose concentration markedly, so that, although the patient may actually have periods of hypoglycemia, urine and blood glucose tests will show hyperglycemia. Treatment is aimed at modifying the extremes by gradually lowering the insulin dosage so as to reduce stimulation of the feedback system of glucose regulation. The patient may need to take smaller doses of insulin or take it at more frequent intervals and at different times during the day.

One course of action is to reduce dose for rebound.

One course of action is the need to increase dose to "break" through.
 
+4: 371

Thanks for that info. I guess what I'm still not understanding is do they look different on a ss? Cuz when Charlie drops down to yellow, then shoots up to black the next day, how can you tell that it's due to IR, not bounce?
 
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