4/12 Mikey PMPS 104 +2 75 +4 75 Dose Advice Please!

Status
Not open for further replies.
MikeysMom

MikeysMom

Member Since 2011
AMPS 165
+2 185
+4 164 Another ugly inverted curve this morning. While Mikey's PM cycles have been OK, his preshot numbers haven't been as good and his AM cycles have been flat blue with a big (food?) spike that makes his +2 still higher than preshot. He is eating exactly the same thing morning and evening: 1 can FF Classic chicken, beef, or turkey at PS, 1/4 can of Great Choice around +1 and another 1/4 can Great Choice at his +2 test. (When I can afford a few cans, I sometimes substitute the Great Choice with Merrick BG Turkey, which is roughly the same in carbs) The only thing that's slightly different is that sometimes in the AM, I give the second meal a little earlier so I can get a little extra sleep before the +2 test. In the past, that didn't make a difference.

So, do I raise the dose to .2 or .25? I've been holding the .1 for a couple weeks extra as it was suggested that his SS looked like he might be getting too much, not too little, insulin. And some of his AM cycles DO look like bounces from the night before. Early on, he'd have a green PM and bounce to a flat yellow. He got over that but is he bouncing with those flat blues, or does he need more insulin? We had a 52 on this dose the other night, but overall, his 2-week average has crept up from a 114 to a 118 (not much, I know). We'dlove some experienced eyes to help us choose a direction from here.
 
Re: 4/12 Mikey AMPS 165 +2 185 +4 164 Dose Advice Please!

Aw, Mikey...thought you were gonna work that .1u????

no dose advice from us, but hope you get some good input.

work-cat.jpg
 
Re: 4/12 Mikey AMPS 165 +2 185 +4 164 Dose Advice Please!

PMPS 104 Better than it has been, but we were getting greens...
 
Re: 4/12 Mikey PMPS 104 Dose Advice Please!

it is so strange how he is all blues in the day and all greens at night.

this is fine-tuning beyond my knowledge, so i don't want to offer an opinion on the dose. at least it will bump you up.
 
Re: 4/12 Mikey PMPS 104 Dose Advice Please!

Amy --

I don't think you're seeing an inverted curve. I suspect you're not factoring in meter variance. Mikey's numbers look pretty flat to me. If the curve were inverted, you'd need to get some additional tests that are closer to nadir. Even during the PM cycle when you are testing closer to mid-cycle, you've got a flat curve.

It's entirely your call if you want to add a drop to Mikey's dose. It does seem like his AM numbers trend a bit higher than his PM cycle so if you fatten the dose, you'll need to monitor carefully.
 
Re: 4/12 Mikey PMPS 104 Dose Advice Please!

I agree with Julie....let us see if we can Jill's or Libby's eyes on his SS. They are really good at reading inverted curves (not sure if this is one or not) and fine-tuning.
 
Re: 4/12 Mikey PMPS 104 Dose Advice Please!

My +2 and +4 tests are around nadir; he usually hits that around +3, then goes back up. In the daytime, he has a second drop and that one nadirs around +11-12. I agree that 160 and 180 are not that different with meter variance, but he seems to be trending that way almost every day, which makes me think it's more than a meter thing. The AM/PM differnce is evident from the start, and I think at the beginning, he was bouncing into the 200's after the fast dives into green at night, and clearing his bounces fairly fast. He stopped bouncing that high nearly overnight with no change in dose in January, his preshots came down. He was on .25U for a while, but earned a reduction, and then i was out of town so I reduced him to .1 again, and he has done ok, but lately seems to be hitting a plateau. Part of that could be that my insulin is reaching the end of its usefulness, but I don't think that's a major factor given his PM numbers. I jest feel like were were doing really well and now we're just doing okay.
 
Re: 4/12 Mikey PMPS 104 Dose Advice Please!

+2 75. These flattish green evening cycles are quite nice (though I wish Mikey's nadir wasn't three hours earlier than normal...) I just wish we could get him consistent.
 
Re: 4/12 Mikey PMPS 104 +2 75 Dose Advice Please!

as odd as it is, i wonder about increasing his carbs every night cycle, starting with the pm shot, and keeping the food as it is now during the day cycle, while increasing the dose a shade.

in other words (just picking carb numbers, i don't know exactly what you do) - continue giving him 5% carbs for breakfast and whatever you feed him that cycle, change his evening food from his normal 5% to a 9%, raising up the evening cycle numbers. then increase his dose and see if you can bring the entire range down.

is that too crazy of an idea to try?

i feel for you, amy, because he was doing so well not very long ago. he has obviously not read the manual on how to do FD! :lol:
 
Re: 4/12 Mikey PMPS 104 +2 75 Dose Advice Please!

Hmmmm...nothing he gets now is over 4%.... I do control his PM numbers with carbs if I have to, but I try not to, and I can certainly continue to do so, rather than raise them across the board, which would be a last resort. I gave him some 5% the other night at +2 and it caused him to shoot up so that the +2 was the lowest of the cycle. It is something think about, though. His numbers weren't scary on .25, and I could go to a fat .1/skinny .25. I'm just not sure if I should do that if what I'm seeing are constant bounces.
 
i'm not suggesting different doses am and pm. i think it's important for the dose to stay the same, i'm just throwing ideas out to brainstorm. before you do anything, let's see if others have ideas that might be helpful.
 
Re: 4/12 Mikey PMPS 104 +2 75 Dose Advice Please!

MikeysMom said:
Hmmmm...nothing he gets now is over 4%.... I do control his PM numbers with carbs if I have to, but I try not to, and I can certainly continue to do so, rather than raise them across the board, which would be a last resort. I gave him some 5% the other night at +2 and it caused him to shoot up so that the +2 was the lowest of the cycle. It is something think about, though. His numbers weren't scary on .25, and I could go to a fat .1/skinny .25. I'm just not sure if I should do that if what I'm seeing are constant bounces.
Click to expand...
there's only a couple ways i know of to figure out if what you're seeing is constant bouncing:

a). more PM cycle spot checks on the off chance he's dropping again later in the cycle and we don't know it
b). start an OTJ trial

either one of those strategies would rule out a bounce. getting those spot checks later in the cycle would mean some loss of sleep... or at least setting an alarm to sleep test.
 
Status
Not open for further replies.
Back
Top