3/31 George AMPS-488 +4-367 +6-314 +8-294 +10-290 PMPS-402

[Alaina and George]

Good Morning everyone! After getting a low reading yesterday morning, I decided to skip a dose and now were back in the 400's PS. I hope I didn't set us back by not shooting but I'm going to use today as a way to collect some data for the future.

The link to yesterday's condo is here: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=92121#p988074

George and Buddy fought yesterday and played with each other for the first time in weeks. It was good to see and also quite entertaining

It's a little scary to see almost normal numbers for the first time, even though that's what we want.

Also, random thought that might have nothing to do with being on insulin but I've noticed that George is really not shedding anymore and he used to shed something terrible!

I am planning to test every two hours today, but I'm wondering when you feel you get the best readings? I read the tight regulation note about testing but wanted to see if you agreed that the beginning and end of a cycle provide better info than the middle. I have gotten quite a bit of info during the +4-5 hours range...

Thanks everyone!

 

[Sienne and Gabby (GA)]

Re: 3/31 George AMPS-488

The value of a curve is that it gives you information about when Lantus onset begins, where the nadir falls, and how much duration you are able to get. Right now, it's helpful to think about testing as a means of becoming "data ready" to shoot lower numbers. If you can the Board, you'll see that most of us who have been at this for a while will shoot numbers in the 50s and above. With Lantus, the mantra is "Shoot low to stay low." However, you need to have the data to do this.

A former member wrote this on becoming data ready:

Let's talk specifically for Lantus and Levemir. This is about fine tuning your curves.
Are you data ready to handle a lower preshot number?

This is where the very early cycle spot checks (those +1's, +2's) and those very late cycle spot checks (the +10's, +11's) come into play. Call them the "neglected" spot checks. Everyone gets those +6 spot checks, but there is a reason to collect data in the very early and very late part of the cycle.

Say you get a preshot of 150. Well if you've collected the data on the average time it takes the insulin to start having any effect for your cat and what happens after +12, then you might see that shooting a 150 is actually very safe in your cat. Kitty will be in the 200's before the insulin starts working. You are then using the lag time (aka overlap and carryover) between shooting and effect time to your advantage.

So why the +10's and +11's? Well say you are on day 5 of a dose increase change and your storage shed is now not only full, it is overflowing... and your +10 or +11 was way higher than your preshot. Good way to stay out of trouble cause now you know you would have shot a still dropping number, not a good idea. so what is the plan then?.... keep testing, and not 2 hours later, every 20-30 minutes would be better, so you can catch the minute it turns and do not loose all your overlap. If you miss the rise and cat is way up there BG wise before you shoot, remember the number is just going to continue to rise in those hours before the insulin has a chance to kick in, and you have a roller coaster curve going rather than the flat curve that is ideal.

Also some Lantus and Levemir users notice a dip at the end of the cycle, meaning that their preshot is always a bit lower than their +10 or +11. It is important to know if your cat is one of those because if you are not raising your dose because your PS doesn't seem to call for it, yet your nadir is not so hot... this could be the reason why.

If you want to choose less important times to test, really the +8's and +9's and the +4's and +5's are the numbers that yield the least amount of important data once you have well established the nadir in your cat. Yes, get them here or there on spot checks, but do not forget to get the "neglected" spot checks... the very early and very late parts of cycle. They are more useful than most realize.

Know thy cat. Be data ready to handle the situation.

 

[Tara & Buster]

Re: 3/31 George AMPS-488, +4-367

Hello there! We haven't visited your condo yet - just wanted to stop by and say welcome! Good luck with your curve - I hope George gets down to safer numbers soon!

 

[Marje and Gracie]

Re: 3/31 George AMPS-488, +4-367, +6-314, +8-294

Alaina and George

From Marje, Mike, Gus, Gracie, and Tobey

 

[Sienne and Gabby (GA)]

Re: 3/31 George AMPS-488 +4-367 +6-314 +8-294 +10-290 PMPS-4

Alaina:

One quick point. I just realized you're using an AlphaTrack meter. For all of the dose reduction info that's in the sticky notes, you need to subtract 30 points. The animal specific meters are calibrated 30 points higher than human meters. So, normal range on a human meter is 50 - 120. On an AlphaTrack, the range is 80 - 150. You will be able to reduce George's dose if he falls below 80 on your meter.

FWIW, most of us do not use the AlphaTrack. The strips are far more expensive compared to a human meter and they are not widely available. At the very least, i'd encourage you to get a human meter as a back-up. Murphy's Law always catches you when you are most vulnerable. You will not be able to find AlphaTrack strips at the corner Walgreen's if you run out.