21/11 Brian AMPS 47 feb carb. Can i get some feedback

[Nate2021]

Yesterday Brian was dropping in his cycle at +4 with 58 which wasn't usual for him, usually trends up at this time and ndairs quite late. Gave him some dry food which bumped him to 198.

Looking at the spreadsheet am I to assume today and yesterday is finally seeing what a 3.5iu dose does to him?
and am i right to think reverting to 3.25 is ideal?
Right now I've tried to drain the depo by delaying the shot two hours, and giving a carb buffer, and reduced down to 3iu today.

Side notes...I'm not able to monitor as closely with work, so trying to be cautious.
Cues to me that the 2.6 was low enough for extra action was the extreme hunger behavior.

*also curious if there is a mechanism for the body to dump extra insulin into the blood after given a carb when not used to it, could that have potentially caused a bigger drop after the carbs wore off, like inverse of panicky glucose dump?

 

[Wendy&Neko]

For now, a reduction to at least 3.25 units is a good idea. He is not a newly diagnosed cat, so would theoretically need to go below 40 (2.2) to earn a reduction, but it doesn't look like you are able to do enough testing to follow TR. TR requires a minimum of 4 tests per day, 2 each per AM and PM cycle. That is for safety. 11/17 there wasn't even a PMPS test to make sure he was high enough to shoot. It would be safer to follow SLGS for dosing and reduce when he goes below 90. It's possible he went below 50 even on 3.25 units, given that you did test him in the 50's on that dose.

also curious if there is a mechanism for the body to dump extra insulin into the blood after given a carb when not used to it, could that have potentially caused a bigger drop after the carbs wore off, like inverse of panicky glucose dump?

Not so much that. But depending on when you give the extra carbs, you could cause a loss in duration if given late in the cycle after nadir. Meaning the insulin wears off early and his numbers jump up. The following cycle might see a steeper drop.

The link to your last post here for continuity: https://felinediabetes.com/FDMB/threads/11-15-help-please-amps-106-pmps-342-10-58.295707/

 

[Nate2021]

For now, a reduction to at least 3.25 units is a good idea. He is not a newly diagnosed cat, so would theoretically need to go below 40 (2.2) to earn a reduction, but it doesn't look like you are able to do enough testing to follow TR. TR requires a minimum of 4 tests per day, 2 each per AM and PM cycle. That is for safety. 11/17 there wasn't even a PMPS test to make sure he was high enough to shoot. It would be safer to follow SLGS for dosing and reduce when he goes below 90. It's possible he went below 50 even on 3.25 units, given that you did test him in the 50's on that dose.

Not so much that. But depending on when you give the extra carbs, you could cause a loss in duration if given late in the cycle after nadir. Meaning the insulin wears off early and his numbers jump up. The following cycle might see a steeper drop.

The link to your last post here for continuity: https://felinediabetes.com/FDMB/threads/11-15-help-please-amps-106-pmps-342-10-58.295707/

Hello thank you. I need to fill in some missing data, he is getting around 5 tests a day and always the preshot test, i just use the app data on my log and haven't filed in all of the spreadsheet, days when are less entries is because of flat curves. It's just this current weekend i can't test as much.

Looking at my old spreadsheet before his remission i had the issue of consistently late ndairs, right through his reductions from 3.5iu to remission i was shooting low at preshot time and his lowest bgs were around +10. I'm suspecting it is the same this time. I'll switch to SLGS though if that's the safest option this time round

 

[Wendy&Neko]

Update your spreadsheet with the full data, and we can see if you can stick with TR. It's OK to back off of a dose for a weekend if you can't monitor as well.