5/9 Lucian AMPS 324,+4/270,+7/110,+10/215,PMPS 550

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nckitties3

nckitties3

Member Since 2013
Didn't raise dose because I will be gone for several hrs during the crucial time in his cycle. Of course his preshot is 75 points lower than yesterday, no wonder it's so hard to figure out what to do with him. Seems like, on any given dose, he can be fine, too high or too low. :shock:
 
Re: 5/9 Lucian AMPS 324

Remember algebra?

Result = f(x), where f = x + y + z + (a * b) + (c to the d) - e / anything but 0 ...

There are lots of factors involved in mediating the blood glucose and we only know a few.
- insulin amount as best we can measure
- food batches which can vary from the manufacture, so values are estimates
- activity levels
- other hormones and processes within the body too numerous and impossible to measure at home
And so on.
 
Re: 5/9 Lucian AMPS 324

good morning, debbie!
try not to be discouraged. all you can do is continue to chip away at those BG numbers... slowly and methodically... as you're doing.

look at the "waves of action" on his spreadsheet. he'll drop into greens than bounce for three or four cycles and then come down again. that's quite an improvement over what was going on a couple of weeks ago. try to look past the bounce cycles. i think there's some real improvement to be seen here!

have a good day! :mrgreen:
 
Re: 5/9 Lucian AMPS 324

:lol: Nooo! Don't make me remember Algebra!

Jill, when I get depressed about it, I look at a couple months ago, a couple weeks ago wasn't so bad. :-D He only recently had his first 10 day period with no black. :o
 
Re: 5/9 Lucian AMPS 324,+4/270,+7/110

Nadir, Nadir who's got the nadir? Will check in a couple hrs, he just ate.
 
Re: 5/9 Lucian AMPS 324,+4/270,+7/110

nckitties3 said:
Nadir, Nadir who's got the nadir? Will check in a couple hrs, he just ate.
Click to expand...


Its all part of that equation .... (ducks)
 
Re: 5/9 Lucian AMPS 324,+4/270,+7/110

haha_smiley haha_smiley You kill me!

I think I understand though, that any one or more, if not all, of those factors can contribute, correct? (go easy on me, I'm not real bright. :lol: )
 
Re: 5/9 Lucian AMPS 324,+4/270,+7/110

Absolutely - any and all of those factors, plus some I don't know or haven't thought of!

We're lucky we get any consistency, really, given all that can vary.
 
Re: 5/9 Lucian AMPS 324,+4/270,+7/110,+10/215

Missed that +9, time got away from me. But the +10 ain't too bad. :-D


Question - On that 110 today and 97 yesterday, aren't you supposed to hold that dose and not increase it? I realize it's not a full curve, but come on, I test a lot! :lol:

i.e.If the lowest point of the curve is above 150 mg/dl (8.3 mmol/L), increase the dose by 0.5 unit.
If the lowest point of the curve is between 90 and 149 mg/dl (5.0 and 8.2 mmol/L), keep the dose the same.
If the lowest point of the curve is below 90 mg/dl (5.0 mmol/L), decrease the dose by 0.5 unit.
 
Re: 5/9 Lucian AMPS 324,+4/270,+7/110,+10/215

After the initial Lantus shed builds up, you have to wait for 3 full days (6 doses) at the same dose before evaluating for adjustment unless you go too low, in which case a reduction is more likely than an increase. Tomorrow's nadir will guide any increase.

And it depends on how low you are comfortable taking him. Some folks in Lantus TR shoot low to stay low and steer with food to keep safely above 50, the idea being to rest the pancrease as much as possible. If you can't be home to do all that testing and steering, though, it isn't safe to do!
 
Re: 5/9 Lucian AMPS 324,+4/270,+7/110,+10/215

the guidelines you've both cited apply to dose increases, not failed reductions.

you can take a dose right back up... no waiting... if the reduction is not holding.


edited to add: the nadirs we've seen since the reduction to 1.75u are trending higher (97 and 110).
options are to maintain the current dose or bring the dose back up. although, if the dose is not brought back up, i suspect nadirs will continue to trend higher as the depot from the 2 fat unit and 2u dose disappears.
 
Re: 5/9 Lucian AMPS 324,+4/270,+7/110,+10/215

debbie, i'm in the middle of making dinner and i have a couple of appointments tonight. i have to walk away from the computer, but wanted to add...
again, there is no right or wrong answer. whether you bring the dose back up or decide to ride it out with the 1.75u dose is entirely up to you.
you have my/our support with whatever you decide.
 
Re: 5/9 Lucian AMPS 324,+4/270,+7/110,+10/215

OK, I think I know. I swear, I'm not usually so dense. Seems like nothing wants to sink in any more, I think I need more RAM. :lol:

So I would only use that guideline, when he had been on a dose for a while, without earning a reduction, THEN I'd use his nadir to determine what I needed to do with the dose?

I think I am rapidly losing brain cells. :o Things just don't sink in like they use to or if they do, they don't make sense when I try to refer back to 'em.

Thanks for explaining, again. I'm sure ya'll feel redundant, I'm sorry. Feels like I have crammed so much stuff in my head in the last 5 months, that instead of being in my brain's filing cabinet, where I can get it when I need it, it's all mixed together in a pile and confusing me. :shock: :-D

I'm considering taking him back to 2.0, that should be ok then, right? Not concerned about tonight, my pt is at 3:15pm tomorrow afternoon, that should be fine, weekend is good, don't have to go anywhere, but will be gone all afternoon Monday. It is so hard to get into my surgeon's office, I have to take the time they give me usually, if I try to change it now, it'll be 6 weeks before I can get back in. I will make sure my next appt is in late afternoon, to avoid this.

Has anyone else absolutely HAD to go somewhere and their cat was running down near hypo? What did you do? How do I handle that, just in case he's running low and I have to leave?
 
If you absolutely have to go, and he might get to low numbers, I'd want to find someone to back me up.

With no one to do that, I might leave out lots of food based on knowledge of how sensitive the cat was to carbs.

If there were any possibility he would hypo, I'd take him to the vet for observation.
 
i had to abort a cycle in 2011 when DH had a brain aneurysm. i was running alex in low numbers at the time... she was pretty much green 24/7. it was early morning. i didn't know anything was wrong with DH until after i had given alex her shot. i immediately fed her HC and left out tons of food all over the house in all her favorite places... both wet and dry... because i had no idea when i would be able to return home.

there have been other times when i knew i had to leave the house at a certain time. i monitored her carefully leading up to the time i had to leave (that's the key) so i would have some idea where she was headed. if i thought she might go too low i fed her HC to slow down/stop the action of the insulin. i also left plenty of food out for her. if i thought she was dropping too fast, i would slow things down with food early on in the cycle so she wouldn't drop too low.

i've also changed shot times to accommodate my schedule. did that one about a week and a half ago. her morning shot was 3 hours late... purposely.

another option i've used on numerous occasions is to simply skip a shot if i had any inkling she'd drop too low while i was out. i've also skipped plenty of shots in order to get some much needed sleep when i've hit a wall (gasp!)

alex was diagnosed 7 years ago this coming july. she's been OTJ about 3.5 years during that time. i've gone from devoting every waking moment to her care to living my life with a cat who just happens to have diabetes (and other diseases/conditions, but that's another story). we've found a balance in caring for her. late shots, skipped shots, aborted cycles... they're not the end of the world. sometimes those things will cause a minor setback, but i'd rather deal with a setback than put her life in jeopardy. bottom line: i do what i have to do to keep her safe and still manage to have a life. :-D
 
I can certainly understand not giving a shot in an emergency. My concern was after I had already shot him. I'd just have to carb load him I guess and hope for the best. He won't eat food that's left over and he's so unpredictable. Wish I knew where he was going based on his preshots, but I don't.
 
nckitties3 said:
I can certainly understand not giving a shot in an emergency. My concern was after I had already shot him. I'd just have to carb load him I guess and hope for the best. He won't eat food that's left over and he's so unpredictable. Wish I knew where he was going based on his preshots, but I don't.
Click to expand...
yes, you'd have to/might have to load him up with carbs (depending upon the particular circumstances) as i explained in the first 2 paragraphs of my last post. none of us can be 100% certain where kitty's going based on preshots alone. your meter becomes your best friend. if lucian is dropping rapidly and you know you're going out later... be proactive in slowing him down with food. in other words, don't wait til it's an hour before you have to walk out the door to begin managing the cycle.
 
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