5/14/24 Mazi AMPS 126A/141L +2 120L +3 70L +4 66A/69L PMPS 143A/131l/L +3 105L +4 71/L + 7 80L

@Wendy&Neko when you have time, can you take a look at Mazi's spreadsheet please. He dropped to 66A/69L at +4 when he was do for his snack. If he had his snack in him he may have hovered in the 70's.

I had to step out at +3 to run a quick errand when my significant other checked Mazi and he was a 70/L. He should have prolly given Mazi a little snack then, but instead waited for me to get home bc he knew I wasn't going to be gone long and I had told him Mazi usually gets his snack at +4.

I'm wondering if that is true reduction because I was 15 mins late with his snack. So when I took his BG it was exactly +4 but normally would have had a snack in him if I had checked it at +3.

I'm just worried about putting him on a 0.1U dose, when that may possibly be too low of a dose and his BGs sky rocket.

He has his sensor on that the vet is going to see his data and I want the data to look good so it supports my choice in dose reduction and changing his diet to 1/2 can a day with a snack mid cycle for each cycle. Bc the vet wanted my to only feed him 3/4 can a day BID with no snacking and I didn't support that.

Just want to keep the data on the sensor looking good.

Thanks!
 
Below 68 on the AT when following TR means reduce. That cell should be lime coloured. However, this is only the third cycle at 0.25 units. The larger depot influences 4-6 cycles after a reduction. We don't do back to back reductions with TR, unless below 40 (human meter).
 
@Wendy&Neko

SS updated with correct colors.

Okay so in other words, wait another 1 to 3 cycles before considering a reduction for a BG < 68 on the Alphatrak and < 50 on a human meter unless Mazi drops lower than 40 on the Libre. Sounds like a plan!

So far Mazi has been doing great today and no crazy drops last night. I gave an 18% medium carb snack last night before bed, I think I gave him a little too much because he went up to the 140s around 330 to 4 am last night according to the Libre graph. However, he was back down to 111 by 5 am when the boyfriend woke up and scanned him.

Thank you!
 
18% is considered high carb food. Medium carb is 11-15%. So yes, that was a little too much.
 
@Diane Tyler's Mom opps thats my fault I didn't update my spreadsheet. I switched to TR yesterday. Well, im doing a TR trial to see how comfortable I am with that method. So far so good! Sorry about that!!! Updating SS right now!
 
@Diane Tyler's Mom opps thats my fault I didn't update my spreadsheet. I switched to TR yesterday. Well, im doing a TR trial to see how comfortable I am with that method. So far so good! Sorry about that!!! Updating SS right now!
You need to change your signature also ,you can leave SLGS then /TR as of and the date .also on your SS you should have left SLGS and did it this way
SLGS/ TR as of and the date
That's how we prefer it done

If you can put a blank line above the date you switched to TR that would be good and highlight it any color , just put Switched to TR
@Mazi's Mom
 
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@Wendy&Neko or @Diane Tyler's Mom a few questions about TR.

1. What is a failed reduction?

2. Based on the SS, how would I know Mazi is close or has a good chance of remission?

3. Based on Mazi's numbers he's producing now, do you think he has a good chance of remission?

I know its hard to predict, and you ladies don't have a crystal ball, so I understand if you don't feel comfortable answering that question. Some days based on Mazis green numbers I think he's close to remission and also bc he continues to go hypoglycemic. I get hopeful that he's making his own insulin. However, then other days, I just think I'm getting too hopeful and its really just that the 0.5U dose is too high and thats why he's going low. Additionally, when I see his blue preshot numbers or more recently on the 0.25U dose when I see him creep up to blue at +10/11 I lose my hope and tell myself, nope his pancreas isn't making his own insulin and its all the Lantus giving me those lovely green numbers. With that said, that leads me to my next question.

4. Mazi has higher preshot numbers (blues) sometimes gets a blue at +10/11, but will dip down to mostly all greens after onset and stays there till right before the duration ends. Is that good? What exactly does that tell me besides he spikes when the duration of action of the insulin is over?

If I had to guess, that tells me he's still pretty reliant on insulin injections. And the medication is still doing most of the job keeping his blood sugars within normal range or in greens (which are the healing numbers you want to be in) instead of his pancreas starting to make its own insulin to keep him within normal limits of a healthy cat. I think I may have just repeated myself.

5. If he continues to produce blues after a certain amount of cycles would he have to go back to 0.5U, even thou 0.5U was dropping him low? If so, how many cycles or days of blue before I would increase the dose and go back to 0.5U?

6. Can some cats be on extremely low doses, like Mazi and never reach remission?

7. Am I correct in saying that the more time a cat spends in green numbers, the better chances of the pancreas healing and in turn the better chance of remission REGARDLESS OF THE DOSE?

8. For example, and my next question, can a cat reach remission on a 6, 3, 1, 0.5U dose? Or do they have to work their way down to 0.1U or less in order to reach remission?

9. Is remission possible no matter if the cat has had diabetes for years? I know the earlier you diagnose DM and treat it the best chances for remission. But I'm just curious if you've seen a cat who was a diabetic for 5+ years finally reach remission. Or does a long term diabetic have very little chance to reach remission due to the destruction of the beta cells in the pancreas over the years?

10. I understand what bounces are, its when a cats BG'S drop too fast or they drop too much to numbers that the kitty is not used to and the liver then compensates and releases stored glucose which then increases BG numbers. How high does a bounce or rebound of high blood sugar go? I'm having trouble identifying bounces on Mazis spreadsheet. Im looking for the obvious big bounces where numbers increase a 100 or more points than their normal pattern of numbers. Are their subtle bounces where a cats bounce is only like 50 points, and maybe hard to identify?

11. Do you see any bounces in Mazis spreadsheet that you could identify to help me better spot them?

A few weeks ago Mazi had a few yellows, which was out of the norm, and at that time I wasn't doing much night time testing. I interpreted those yellows as bounces bc at that time yellows were not a normal BG number Mazi was producing. For about a month and a half now Mazi has consistently been in blues and greens.

I have a lot more questions, but I'll stop here bc I already asked 11 questions and I dont want to take up a lot of your time. Which I probably already have. I'll save my other questions for another day.

Thank you so very much for your time and helping me understand how to interpret Mazis spreadsheet. Trying to understand insulin, and interpreting Mazi's spreadsheets is so much more difficult than understanding kidney disease, heart disease, cancer, etc. A lot of people think cardiologists and/or neurologist are some of the most intelligent and respected people. Nope, im starting to learn that it's actually the people that completely understand Endocrinology and hormonal disorders that are the real geniuses!
 
We're only at + 5 and we already had two hypos today. I can't wait for the depot to get used up so we can actually see Mazis true numbers on the 0. 25U dose.
 
Yup, I just saw it. I just got done writing her a novel on my other post about Mazis twitching and im just getting to this one right now...lol
 
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