? 2/23 Viamo AMPS=445, +2=376, +4=447, +6=466, how long to wait till dose increase?

Teo

Teo

Member Since 2020
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Tomorrow will be Viamo's sixth cycle since we changed to a dosage of 3 units. This was his last "good dosage", because a month ago he reached his lowest (good!) numbers while using 3 units of insulin.*

The thing is, if Viamo doesn't get a low enough nadir tomorrow, he should get a dosage increase according to the TR protocol, which we're trying to follow. And if his numbers tomorrow continue in a similar fashion as today, the protocol suggests a 0,5 unit increase.

So, in the case that his numbers do not get lower, would it be ok if we increase to 3,5?

*Bear in mind that at the time when Viamo reached his first (and only) BG values under 100, he had been on 3 units for almost a month. So I don't actually know how long it would take for him to get better if we stick to 3 units, that's why I'd prefer increasing the dosage more "aggressively" as the TR protocol suggests.
 
Increase now. To 3.5U (units).

Because you are using the TR (Tight Regulation) protocol.
That says to increase by 0.5U if the nadirs are above 300.
And the nadirs are >300.
 
Allright, you think we should change the dose right away even if only four cycles have passed?
 
Viamo's blood glucose levels at nadir are significantly above 300.

So yes increase the dose of insulin.
Either with this evenings PMPS cycle if you can monitor overnight. Get a +2 at least, and 1 more test later in the PM cycle.
Or increase the dose starting with tomorrow's AMPS cycle.

This one time only. I would not rush the dose increases faster than every 6 cycles. Usually.
 
The more I think about this, with only 4 cycles at this dose and data for only 3 cycles, I would hold the dose for 6 cycles. If you are truly going to follow TR, unless there is something like ketones developing, please stick to the protocol.
 
Sienne and Gabby (GA) said:
The more I think about this, with only 4 cycles at this dose and data for only 3 cycles, I would hold the dose for 6 cycles. If you are truly going to follow TR, unless there is something like ketones developing, please stick to the protocol.
Click to expand...

Ok. I hope you can understand that we're starting to get anxious because Viamo has not gotten better after four months of treatment. But you are right: I do want to follow the protocol.

Anyway, if Viamo's values tomorrow are the same as today (which I find highly likely), we will change the dose to 3,5 at night, as the protocol dictates.

Also, how much measurement is necessary tomorrow?
 
I'm going to ask a "silly question."
Are you making sure to get the air bubbles out of the insulin syringe?

We want to get Viamo safely up the dosing ladder. Keeping the increases at the highly recommended guidelines in the TR protocol, means waiting one more day.

You need to get at least the pre-shot tests.
Then at least one test during the usual nadir time. For every cycle.
That is usually around +5 to +7 for Viamo.
That can vary from cycle to cycle. Your choice on which time to test.

Getting a +2 in the PM night time cycle can help you decide if you want to get a later test.
 
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