17/3, Mousie, AMPS 17.4 - increase do you think?

[Mousiesmum]

Well I thought we seemed to be getting somewhere, but when I look closer at her spreadsheet, it seems that she has had some lower days, but overall, nothing much has changed. I have the vet appointment tomorrow. I am thinking he will probably want to increase? Maybe..

What would you experts do?

She doesn't have ketone issues. I am free feeding, but having said that, she really only eats when I give her a shot. I am exhausted by this whole process, and can't get into the nitty gritty of SLGS or the other one....

 

[Wendy&Neko]

Hello and welcome to the LBL forum.

First a question for you. I see on the spreadsheet on March 14th that there is a blank in the AMPS cell. If you deliberately skip, could you put "skip" or "NS" so we know that's what you did and not just forgot to enter the data. Missing or skipping shots impacts the depot being built, and since Mousie is fairly new to insulin, this can be important. I'm rather suspicious that the night of the 13th Mousie went lower sometime between +3 of the PM and the next morning when she was 176. I'd give her another day to get over what might be the resulting bounce. Any chance you could do a curve sometimes soon?

If the vet wants to increase, I wouldn't go any higher than 1.25 units.

 

[Mousiesmum]

Fixed. What do you mean about her going lower on the night of the 13th? I am a bit confused... So do you think it would be reasonable to stay on this dose for at least another week to see if she can build up more? How long does the depot take to build up normally?

 

[Wendy&Neko]

What do you mean about her going lower on the night of the 13th?

If you take a look at the New to the Group Sticky Note, there is a description of a typical Lantus cycle. That includes a "typical nadir" or low point somewhere in the middle of the cycle. But since Mousie was even lower at +12 (AMPS the next morning), it's likely that in the 9 hours between, she went lower than than her AMPS on the 14th was.

The depot takes 5-7 days to build, so that's how long we hold the initial dose. I wouldn't necessarily hold the dose another week, but maybe a couple other days with some spot checks to make sure you aren't missing any lower numbers. I do suspect she could used a little more insulin.

FYI - as a convention here, we use the US numbers when reporting the blood glucose numbers. You can find the conversion done for you on the US tab. The person who founded this site is from the US, the server is in the US, and a lot of the people who help with dosing are Americans. I'm from Canada, so I can understand "world" numbers, but you'll get more and faster help if you use the US numbers.