3/25 - Gryphen - curve shows hold dose/modified TR

(previous) 3/24 - Alphyne - PMPS @ 304 | Feline Diabetes Message Board - FDMB

So, based on the curve today, it looks like Gryphen didn't like the dose increase threat, and I should hold her dose? If I don't increase, I feel like she might stay in the blues forever?

I think for Gryphen, TR would be a better choice, but since I will continue to feed kibble, can I modify the SLGS? I am fine holding the dose until we hit a lower value. I know all cats are different, but since I'm still so new to this, I'm not sure if things get really messed up if I just lower the reduction point? I'm guessing that's just a matter of my comfort level.
(previous) 3/22 - Alphyne & Gryphen - possible dose increases | Feline Diabetes Message Board - FDMB

In looking at what my vet gave me recently (after I've gone through several different protocols with her), it says to reduce if nadirs are < 80. That is using an AlphaTrak2 meter, but if I use 80 for both types of meters, that might give me a little more leeway to keep Gryphen in the green longer? (And I say both types of meters in case I need to do a curve for my vet; I'll have to use the AT2...long story...I'm looking in to a different vet...options are limited here.)

Sorry - I feel like I keep bringing up the same subject, but these girls have me jumping through hoops right now, so I want to make sure I have it straight in my head! Things can also get lost in translation when you are reading something as compared to chatting, and I want to make sure I understand correctly. I've misunderstood before! Thank you!

 

You can modify SLGS, but not TR. Once you have enough data, and know the girls onset, nadir, duration and reaction to carbs, you can think about changes to SLGS. One of the first changes people will start with is lowering the reduction point a bit. See what happens if you lower it to 80.

Good play on the increase for Alphyne tomorrow.

 

Thank you...I was wondering if it would have been more accurate to say 'modify SGLS'!

In your opinion, should I hold Gryphen at .1? I did double tracking today with the AT2 (again, vet reasons), and she still stayed in what would be the blues there, too. So I hold that dose until she reaches 80? How long do I hold the .1 before I make the determination it's not working, especially since she's heading away from 80, not toward it? Having a value to shoot for on reduction is much easier than saying hold between 90-149...that's such a large range.

I was feeling so hopeful for a while, and now I feel I'm floundering. With both of them fluctuating so much lately, I'm struggling. I know it's a marathon, not a sprint, but...

Thank you again!

 

With SLGS, you hold a dose that is getting you nadirs in the 80-149 range (using your modification). So yes, hold unless she goes below 80, or she drifts up and you stop seeing numbers below 150. You evaluate the dose once per week.

 

We are all the same in this, we have continuous doubts and worries about what decisions are right for our beloved kitties

i think what you have to clarify for yourself is what is your goal with your girls: keep them in a safe range or go into remission.

Anything under 200 is safe from a long term point if view, they can have a full life without any health complications but you would have to keep injecting insulin and making a curve from time to time to decide if the dose still does what its supposed to do.

i believe it is very rare when someone will get into remission with SLGS. Most kitties that i see on the forum that go into remission spend most of their time under 100 before they can go without any insulin.

I believe that both goals are the right thing to do, only they have a bit different paths. You have to understand what is your goal and take your decisions based on that

if the first is what you aim for then you are doing all the right things and Wendy gave you some good dosing advice

i hope what i wrote makes sense