2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128 +2 90 +4 88

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Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128 *Advice Please*

oops! forgot to answer your question about tomorrow morning.
get a +11 in the morning. if dillan bounces into the high 200s or 300s from these low numbers, you *could* shoot 0.5u at +11.
normally, we like to make adjustments to shot times in increments of 15 - 30 minutes, but if he zooms up you could get away with shooting an hour early.

if you have any doubts, post for advice in the morning before you shoot him...
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

Thanks Jill, I'm thinking we should be good tomorrow morning, hopefully :) As you can see he has had alot of changes over the past couple of days. I think that some of these changes are yet to show themselves as well
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

Sorry to post and run but I was soaking my hands after being mauled by my little 8lb houseguest. He's not fond of being poked to death by someone he hardly knows. Try to "babystep" your schedule whenever you have the opportunity. A schedule change is a dose change, so if you can push it back as gently as you can, you have less chance of disrupting the applecart. That said, your applecart is laying upside down in the ditch so.. LOL
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

yes, i was just telling carolyn earlier that i *suspect* dillan may have been over dose at 2 units. too much insulin can result in high numbers just as not enough insulin can. it seems counterintuitive, but it happens. drop the dose, add in the food switch, and dillan's numbers have dropped dramatically. it'll be interesting to watch what happens on this dose over the next several days...
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

Thanks for all of your help Ronnie, Carolyn and Jill. I understand that I've been changing him dramatically without the baby steps *cart in the ditch* :-D If the numbers get into the 200s or 300s in the morning should I go back to 0.75 or should I hold the 0.5 dose for 6 cycles like we were going to do with the 0.75 before his numbers did this?
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

if i were in your shoes, i'd stick with 0.5u for now. let's see what it can do. if the numbers drift upwards, the dose can always be increased...
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

Sounds good to me :-D I just kinda hope in a way that he doesn't hit the 40s tonight then I'll probably have to do another dose change right?
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

Yeah I agree with Jill, I'd be inclined to hold that dose in the AM. Like you said, lotsa changes, and if you keep having to make them, it's going to be increasingly hard to "read" the data. Dillan may have some other ideas for us, so I'm not gonna get any more smug than that LOL And yes, if he hits a 40, you get a reduction. :cool:
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

I'll let him know :-D Thanks again everyone, I'll get his +1 soon.
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

Dillan420 said:
Sounds good to me :-D I just kinda hope in a way that he doesn't hit the 40s tonight then I'll probably have to do another dose change right?

Can u note in ur SS either in the comments section or the cells (they can be expanded) that you shot an hour late

the 128 is ur actual PMPS the 1 hour stall, so from there u start testing at +1 fill in ur test number,
have LC food available for him

u will want to catch a +3 test to see where Dillan is going, depending where he is at +3
have MC and HC and strips ready...u may have to test again at +4 and +5 to catch Dillan if he goes to the 40's
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

Dillan420 said:
I just kinda hope in a way that he doesn't hit the 40s tonight then I'll probably have to do another dose change right?
"IF" that should happen, we'd have to re-evaluate because part of the action you've been seeing is from the "shed", known as the INSULIN DEPOT:

"One's subcutaneous "spare tank" of insulin, which has yet to be used by the body.

Because no insulin injection is immediately 100% absorbed by the body, the yet to be used insulin stays under the skin, the system drawing on this "reserve" as needed. Any such insulin effects that last after the insulin's expected action is over are also known as carryover in some literature.

If you're using only intermediate-acting or long-acting insulin alone (without any short-acting insulin), about 24 hours worth of insulin requirements are in your depot.

The larger your insulin dose, the larger the insulin depot in your subcutaneous fat tissue. Having a large vs smaller insulin depot means the effect of the insulin can be less consistent--more chance of it varying from day to day. This same insulin depot is the reason why it can take anywhere from 2-5 days to see any effect of insulin dosage changes.

This handy "extra tank" is also there to give you a hand if you miss or are late with an injection.

On the other hand, when you do miss an injection, your "spare tank" is very low by next injection time, and so the next injection may have less effect than expected!"



there's also CARRYOVER to consider:

"Carryover or carry-over refers to insulin effects lasting past the insulin's official duration. It's been observed that some long-acting insulins leave an insulin depot[1] under the skin that has a small residual effect that may last anywhere from 12 to 48 hours, after the principal action has ended.

Keep in mind that any substance injected into the body will be removed or broken down gradually, it won't all disappear at once. So even after there's not enough insulin left to make a noticeable dent in blood glucose, there will still be a period of time when small amounts are present and being slowly used up. In long-acting insulins, those small amounts may give a slight boost to the next day's (or three day's) doses.

This small residual effect, if it exists, may mean that the same dose given 3 days in a row will be slightly more effective each day. For example, Dr. Rand mentions in her Lantus studies[2]: "We have found it often takes 3-5 days for a good glucose-lowering effect to be seen in the glucose curves, possibly because of the long duration of action and carry-over effect of glargine."

For terminology's sake, consider the principal action of the insulin to be its onset, peak, and duration. If you shoot insulin again before the duration has expired, there will be overlap. Carryover is whatever small residual effect is left after duration has expired."



the short answer is... a drop into the 40s wouldn't necessarily indicate another dose reduction would be needed at this time. we'd really have to take a step back to look at how the prior doses may have affected the cycle.
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

cripes Jill that's too much frackin math at 1:30am! :o

::carolyn stands corrected::
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

Carolyn and Spot said:
cripes Jill that's too much frackin math at 1:30am! :o

::carolyn stands corrected::
nope. you're not corrected. we'll just have to re-evaluate if dillan should drop into the 40s. he may or may not earn a dose reduction.
if he does the norm (bounces)... this whole conversation will be a moot point. :lol:
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

Thanks for the extra effort Jill in educating me :-D Sounds like we will be sticking with the 0.5 dose for the week unless there is a huge drop later in the week.

Ronnie I did update the SS I just forgot to save and close it, so everything should be good for it now. I will probably get the test at +2 since in the past this is where Dillan showed a drop, but I have never actually done the test at +1 just because I thought it doesn't really show anything. I guess it could show if the insulin acts right away.
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

let's see how this dose works out. it may need some tweaking in another couple of days (or sooner if numbers are running low).
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

By using the whole 3-5 day analogy I can definitely look at my SS and see how upside down my cart really is lol :shock: Maybe I should have stuck with the 0.75, just because if the 3-5 days is holding true then we might not have even seen the 2 unit to 1 unit drop. Oh well if it was too much we'll just work our way back up :smile: It will show itself through the next few days.
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128

don't worry about it. just stick with the 0.5u dose for now. there have been several changes and if there's one thing i've learned over the past 3.5 years it's that lantus likes consistency. we'll go from here. who knows... you may end up reducing the dose rather than increasing! :o
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128 +2 90

He's dropped down to 90 so I think that this is a nice suddel drop. I hope your hand is feeling better Carolyn.

When would I see rebound in the morning or during tonight?
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128 +2 90

Very nice.. and totally not the direction I thought we were gonna be seeing. He's loving that no dry food thing huh? Thank you, it's not terrible, but it was a bite and I have flashbacks to some very ugly pics one of our board members posted when she got bitten so I scrubbed, soaked and medicated it so much that I imagine THAT is why it hurts LOL
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128 +2 90

Yeah not only is the wet food doing wonders for his numbers, he loves eating it too. Sometimes he gets the food all over his face its halairious, I will try to get a pic next time. I loved your condo today with the picture of spot he is so adorable
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128 +2 90

I'll be doing a +4 test but I'm sure it will be very late for you there and I'm sure his number is going to be good, I just fed him the rest of his food too so this will steady his number. Thanks for all of your help today carolyn
 
Re: 2/6 Dillan AMPS 167 +8 67 PMPS 117 +13 128 +2 90

You're welcome! You have a great night and I hope Dillan has no further surprises for you for at least 8 hours LOL
 
Numbers are still looking good it seems like Dillan has started surfing already at +4 I'm going to feed him a snack of LC and head to bed. Goodnight Lantus Land.
 

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Not sure if you will check this in time, but;

To regain your hour, you can move shot times by 15 minutes without any issue usually. If you absolutely need to recover your hour by tomorrow, you'd need to hoot 20 minutes early on the next 3 shots. Bear in mind doing this, is like giving a smidge increase.

There's obviously also the chance that the way Dillon has been going that you may have to delay other shots due to lower pre shot numbers.

If time is going to be an issue for you, might be worth getting an +11.30, then posting and asking for peoples thoughts.

Nice going last night. :-D
 
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