5/25 Penny AMPS 95 What's your PM "Do Not Shoot" number?

[Robyn and Penny]

Happy Memorial Day to my US peeps! After a long 5 months of dealing with glucose toxicity after Penny's relapse from remission, I finally have some good numbers today! But, tonight, I'm so afraid of either a)putting her back into glucose toxicity or b) worse yet, her hypo'ing overnight. I can get up to test but her nadir has been floating anywhere from +6 to +12 and she's only on day 2 of a dose increase so I don't feel she is predictable enough to shoot all that low.

I just want some feedback with those who shoot low numbers or other Levemir users out there with your experience?

I'm thinking at this point my "do not shoot" will be 100 and maybe BCS 150-100 (half her current dose of 3.75u) but I'm so afraid of screwing up this ride one way or another!

Any feedback will be greatly appreciated!

 

[Wendy&Neko]

Awesome cycle today! Great to see that progress.

The no shoot number depends if you are following TR or SLGS. I am following TR and have shot as low as 52. Neko's nadir is often at preshot time and she doesn't onset until after after +5 so I have plenty of time to use food to get her up after shot time. I find that getting a +9 or +10 is really helpful for me. If Neko is coming up from then until PS, then I don't need another test until after onset. If she is on her way down at preshot then it's more likely that I'll need more tests. Neko's nadir is also quite variable.

If you are following SLGS, Jill recently put some information on shooting low preshots into the SLGS sticky note. Experienced SLGS peeps don't shoot below 90 and a reduced dose below 150 is one of the options, so your thinking is on track.

 

[Robyn and Penny]

I just dont' wanna screw her up. I know her chances at remission are low this time around, so how much do I wanna risk her to get greens? Looks like the past day or two her nadir has been at preshot, which is why I was okay shooting full dose at 95 this morning. But she eats all day, and she doesnt eat all night. She's a social eater so will only eat if we get up but even if we do get up before 5am, she doesn't eat b/c she's not used to eating at night. I think if her nadirs were more consistent I would feel more comfortable with it, you know? But her nadirs have floated anywhere from +6-12. I def think until she stabilizes a bit and is more predictable with lower numbers I should follow that SLGS rule then. When she was on insulin before I had shot full dose with an AMPS in the 60s, but PMPS do not shoot number was 120 and BCS shot was 200-120, but I didn't deal with 5 months of glucose toxicity back then either lol. But I think I will do that till she settles in and gets more predictable, especially since her shed is still loading on the dose increase and then a before bed test and like 4am if needed.

She's gonna hate me tomorrow morning but gotta keep her safe! lol

 

[Wendy&Neko]

Having data on low preshots goes a long way to relieve the anxiety. I found Neko's cycles with low preshots looked a different too. Good luck!

 

[Robyn and Penny]

Yeah, she's new to low preshots after losing her remission so I have to be conservative till I know for sure. Plus for this week her nadir appears to be at shot time, till it switches back to +6. And then her bratty liver keeps panicking! I def decided to be conservative as you outlined above with BCS of 2.25u if she's 150-100 and no shot under 100. And of course bed time test, maybe 4am test and cross my fingers at AMPS lol. AT least till I have more consistency in knowing how she will react. And especially bc she trends low at night. Although she could be high at PMPS b/c that's been her trend the last few days and this is how she looked before she went OTJ last year with Lev. High PMPS, lowest and AMPS and rising throughout the day. Wish us luck! Test and shoot t -1h!