6/21 Heart AMPS 410, +8 292 - Increase this PM?

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I guess it might be time to increase. I'm not sure.

You've been on Lantus for 5 days in total now and have gone from 1 unit to 2 units.
(just saying that because it's not clear when the switch happened by glancing quickly at the spreadsheet).

anyway... I'm just kind of bumping this up so someone with more experience replies :)


(yaaaay Yellow!)
 
Hello Sophia,

In regards to increasing Heart's dose....this is the protocol that we follow....you can find it at the top as one of the stickies....

Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Heart has been on the 2U for a consistent 6 cycles with one <300. It is hard without more spot checks to see if he had more BG's that were <300, so you could increase by 0.25 (with the one BG >200 but <300) or 0.50. I think you are safe with increasing 0.5u. Please get a spot check before bed. :mrgreen:
 
I increased 0.5 units today. I can't really increase in smaller increments, because my needles only show every unit. I can guess the half between lines, but can't narrow it down further on this batch of needles. Besides, he's a big cat, so he can handle it :)

Yes, I plan on getting another spot check in before bedtime for sure!
 
I increased 0.5 units today. I can't really increase in smaller increments, because my needles only show every unit. I can guess the half between lines, but can't narrow it down further on this batch of needles. Besides, he's a big cat, so he can handle it :)

Yes, I plan on getting another spot check in before bedtime for sure!
 
Sophia:

You'll need to get needles that are marked in 1/2u increments. The vast majority of increases and decreases, according to the dosing protocol that we use, are in 0.25u amounts. I know these syringes are a little more difficult to track down in Canada. I'll see if I can track down someone who can tell you what ones are available. Just because Heart may be a big guy, you need to remember that insulin is an exceptionally powerful drug. Sometimes, one drop can make a huge difference in response.
 
Hi Sophia,

BD brand is a good choice for 1/2 unit syringes.
Write this down, k?
One of the commonly used is BD Ultra-Fine two, 3/10cc's, 1/2 unit markings, 28 to 31 gauge, short, I used the 31 gauge with no issues.

They come in a package of 10 or a box of 100 or so. Check your local pharmacy.
 
Those are the syringes that we use. I get them at London Drugs most of the time. Also they have a loyalty program for test strips. I forget how many you have to buy but they keep track for you and then when you have you get a $25 gift card that you can use on anything in the store.
 
Ronnie & Luna said:
Hi Sophia,

BD brand is a good choice for 1/2 unit syringes.
Write this down, k?
One of the commonly used is BD Ultra-Fine two, 3/10cc's, 1/2 unit markings, 28 to 31 gauge, short, I used the 31 gauge with no issues.
Click to expand...

I use the short, 31-gauge 1/2 marking ones too.

Last time I was at Costco, I asked if they had them in their cheaper brand, and the assistant said yes... but i didn't actually see them. It was busy so I didn't ask him to bring me a box because I didn't need any at the time. I'm still not sure whether they actually have them or not. (They do have the BD brand ones)
 
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