? 5/28 Silver AMPS 203 PMPS 229 - What is going on?

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Juliet

Member Since 2017
Can anyone see what might be happening with Silver's numbers? He went into lime green with 3u just ten days ago so I reduced him to 2.75 where we saw nothing but yellows and high blues ever since. Increased him up to 3.5 now as he is obviously failing these reductions and I should have increased sooner given his history.

Increased back up to fast? Drop back down to 3u? Keep increasing?

Insulin is good. No greens in last ten days for to him to bounce off.

He is totally fine. He's gaining weight back and is back to his normal self. No ketones. No clue what's going on with the numbers. He was racing down the dosing ladder after the dental now no greens at all.
 
I think you jumped up both too fast, and by too much. You only held the 3 unit dose for 5 cycles, which isn't enough time for the depot to build. Then you jumped up by 0.5 units, which is a bigger increase than even the more aggressive TR would have you do, cause you were seeing blues on 3.0 units.

Given the data you have, I don't think you can say for sure he's failing reductions.
 
Wendy&Neko said:
I think you jumped up both too fast, and by too much. You only held the 3 unit dose for 5 cycles, which isn't enough time for the depot to build. Then you jumped up by 0.5 units, which is a bigger increase than even the more aggressive TR would have you do, cause you were seeing blues on 3.0 units.

Given the data you have, I don't think you can say for sure he's failing reductions.
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Ok so what do I do about it now?

The reason I jumped up by 0.5 was because I dropped dose by too much given his lime greens.

The failed reduction is the one taken on May 18th from 3u to 2.75. Very clearly a failed reduction as we went from lime green to nothing but yellows and blues. Increased up to 3u after 10 cycles which likely was too long to hold after the fail. I should have increased back up to 3u sooner. Granted, the increase to 3.5 was perhaps too soon and too much but I don't think the reduction from 4u was earned down anyways so by rights he should still be at 3.5u which is why I put him back to it.
 
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I can't tell if that reduction on the 18th was a failure. It's very possible he went lower during the day on the 22nd when he broke his bounce, and that started another bounce. The night of the 18th you also reduced the dose and the depot had to rebuild.

Since the 3.0 dose got him to lime green fairly recently, I wouldn't have been so hasty to jump past it. Since you didn't wait long enough for the depot to build on 3.0, you have no idea how low it was taking him. The increase was even too fast for TR.

The timing of SLGS is for safety, given your limitations on testing. I know you are balancing that with ketones. Gotten any ketone tests in lately?
 
Wendy&Neko said:
I can't tell if that reduction on the 18th was a failure. It's very possible he went lower during the day on the 22nd when he broke his bounce, and that started another bounce. The night of the 18th you also reduced the dose and the depot had to rebuild.

Since the 3.0 dose got him to lime green fairly recently, I wouldn't have been so hasty to jump past it. Since you didn't wait long enough for the depot to build on 3.0, you have no idea how low it was taking him. The increase was even too fast for TR.

The timing of SLGS is for safety, given your limitations on testing. I know you are balancing that with ketones. Gotten any ketone tests in lately?
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I think I already said above that ketones were zero. His lowest is +11 so if anything he may have been a little lower - perhaps around 6 on the 22nd. I DO know his patterns. Him not being back in green is classed as a failed reduction as per both protocols and both protocols say not to wait 7 days when its a failed reduction. Many people have said on here that the depot builds back up in 4 cycles so yes, I did wait for the depot to build. I already explained my reasons for increasing and you already said in your first post it was wrong. Got it. But you didn't answer my question - okay so it was wrong. What do I do now? Not much point looking backwards but what can be done now.
 
I think since you are already on the 3.5 unit dose, you should hold it until he earns a reduction. You don't want to be bouncing around doses or you won't be able to really tell what he is doing on dose. I do agree with Wendy that you need to be careful if you increase by more than 0.25 units. You don't want to jump up too fast and push Silver's numbers down suddenly or miss a good dose. I'm glad his ketones are zero and he is doing well overall.
 
carfurby said:
I think since you are already on the 3.5 unit dose, you should hold it until he earns a reduction. You don't want to be bouncing around doses or you won't be able to really tell what he is doing on dose. I do agree with Wendy that you need to be careful if you increase by more than 0.25 units. You don't want to jump up too fast and push Silver's numbers down suddenly or miss a good dose. I'm glad his ketones are zero and he is doing well overall.
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Thanks Carla. I'll hold dose.
 
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