911 6/4/15 Marmy's PMPS 99

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tonimarmalade

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so I test again in 15minutes.her numbers after going back up to 1.3 have not even been green but now a99 preshot. Please advise what or if to shoot.
 
I can't advise. I wish I could, but it looks like she is still dropping from her +9. From what I understand, wait and test again, but I don't know what to advise after that.
 
Will you be able to monitor over night? It doesn't look like you typically do a lot of tests past +5. Would you be able to keep testing if the numbers drop, and do you have all the hypo supplies.

If the answer is yes, then I say give the full shot, but you have to be comfortable with shooting this lower number. If you are not comfortable with that, then you can either give a reduced dose or skip, but this will more than likely result in higher numbers for AMPS. There is still a possibility that she will bounce after the lower numbers, but that is better than draining the depot.
 
That's a great preshot number! Remember when we talk about New Dose Wonkiness? Well, you just saw it. This is the 7th cycle after the increase and the shed has stabilized. now you are seeing the full effect of the dose.

How are you set for dealing w/ low numbers? Test again half an hour after the last test. If it is up or staying the same I would shoot the regular dose. You can continues to stall for up to two hours, after that call it a skip. Stalling will help to drain the shed a little, but you will have to adjust your shot schedule.

I can't stay w/ you to advise though.
 
Stall, don't feed and test again in 20 minutes. Be thinking about the lowest number you feel comfortable shooting. Will you be able to monitor closely tonight? Do you have high carb food and lots of strips for testing?
 
I will test again in 15 minutes and then decide I guess. I will test her as long as I can if she keeps dropping later and feed her high carb. All suggestions are welcome.
 
Tina just pointed out that you fed her so the number could be food influenced. I did see that you shot a similar number one morning cycle.
 
Yes I just fed her at 6:25 but low carb. Before I tested her again but dropped to 96. I have plenty of strips and high carb food, Karp, etc. Hope I don,t need them.
 
Are you stalling food as well? If you have already fed then any test will be food influenced and you would just need to make you determination on shooting based on the 99/96 that you already got, not any tests after food.
 
Yes I just fed her at 6:25 but low carb. Before I tested her again but dropped to 96. I have plenty of strips and high carb food, Karp, etc. Hope I don,t need them.

Since you already fed, then just make your decision to shoot or not. There is no need to stall the shot at this point unless you are going to skip.
 
I thought the food would bring numbers up. wrong!Just retested. 152 so I will shoot but 1.1 shave a bit.
 
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In the future, you will want to stall food as well if you are trying to determine if you are going to shoot or not. You don't want your tests food influenced.
 
Toni

You would be shooting a dropping number which is fine to do if you are prepared and could stay up testing. If you didn't give her much LC food...less than a tsp, then the next number won't likely be too influenced.

You have some options:
--test 30 mins or so after the food and see where she is; if she's on the way up, you could shoot the full dose but you'll need to be on your toes with the testing as she could come back down.
--shoot a reduced dose but you need to keep testing until she's on her way up because she still might come low tonight
--skip....just for safety if you can't be up to test.

You can afford to get behind in your shot time a little and make it up 15 mins each cycle or 30 mins one cycle a day, right?

Also, keep in mind if you still very long, she could keep dropping to a point where you couldn't shoot. If you have the supplies and can stay up to test, you might think about shooting so you can get food in her and start getting the numbers up.

Normally if we suggest you shoot, we stay with you but I won't be around tonight and I'm not sure who will be so factor that in your decision.
 
Ok I shot 1.1 about 15 minutes late as she ate some more food. I will watch her numbers closely for as long as I can. For future reference, should I not feed her if the preshot is under 100 or 200?
 
The only time you need to stall food is if you are stalling the shot because you are worried that the number is dropping and you are nervous about shooting. Once you get comfortable you don't ever need to stall, but since you are still fairly new at this sugar dance you need to build up that confidence and also have the data to know what could happen.

There have been times when I have giving Sammy a shot when he was 54 at PS. Now understand he was at a smaller dose, but I had no reservations about shooting that number. The only time you really don't want to shot, unless you have extensive data is if Marmy is under 50 at PS. I once saw @Melissa & Tarragon shot a PS in the 30's but she has extensive data on how Tarragon reacts to food and insulin so she felt comfortable shooting that number. It is all about how comfortable you are.
 
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I think Tina explained it just fine but I would suggest that even once you have more experience and data, you don't shoot below 50.

I also have lots of data and experience and Gracie is on levemir which means she onsets later than Lantus users and I still wouldn't shoot in the mid 40s much less 30s.

I would highly urge you to get a +1 and +2 test so she doesn't surprise you.

Could you also please take the 911 down now that you've shot? Thanks, Toni. You did great!!!!!
 
I think Tina explained it just fine but I would suggest that even once you have more experience and data, you don't shoot below 50.

I also have lots of data and experience and Gracie is on levemir which means she onsets later than Lantus users and I still wouldn't shoot in the mid 40s much less 30s.

I would highly urge you to get a +1 and +2 test so she doesn't surprise you.

Could you also please take the 911 down now that you've shot? Thanks, Toni. You did great!!!!!

I just want to clarify, I wasn't suggesting that you shoot below 50, I just wanted to show that with the right data some people do. I personally wouldn't shot below 50 either. Obviously I shot at 54, and sometimes 52, but not 49! And technically they all are all the same number. LOL!
 
In answer to Tiffmaxee, eating usually raises Marmy's numbers so when she was at 96 after I fed her, I was unsure how to proceed. Thanks for your question.
 
In answer to Tiffmaxee, eating usually raises Marmy's numbers so when she was at 96 after I fed her, I was unsure how to proceed. Thanks for your question.

The reason I asked was because I think I misunderstood you. When you wrote you fed but it was lc I thought you were not expecting the +1 to be food influenced. Some here don't get a food spike. I just wanted to make sure you were prepared for a drop early since the PMPS was food influenced. I hope I'm not confusing you. If so the just ignore this. :)
 
I am easily confused when it comes to trying to understand how all this diabetic stuff works. Am I correct in thinking that if I want to raise a low number food should help do that?. And if the number is very low( below50) I should get out the high carb food and some Karo to get the numbers up and not shoot if numbers are not rising. What is the range for safe shooting? :nailbiting:
 
Good job shooting!

Once you've had a lower preshot, chances are very good that you'll have another one before long. Here's a little reading you can do in prep for the next time it happens:

Shooting a dropping number - look for post #6
Shooting Low - slide down til you see the discussion about it

You're absolutely right about food increasing the blood sugar. The reason people were saying not to feed is that if you do feed the cat you're raising the blood sugar, but food carbs can wear off in about an hour, so you don't want to inflate the preshot number if it's too low for you to shoot.

In your case, it really wasn't a low number, just the lowest you had shot so far. As long as you can monitor the rest of the cycle, and you have strips and high carb supplies, i think you are ready to shoot everything over 50ish. That's the path to regulation, and if possible, to going OTJ.

Make sure to get a +1 and a +2 tonight.

 
Well, I missed +1(other kitties and a sister needing my services) but + 2 of 243 made me wish I had stayed the course at 1.3 which I will go back to in the am unless some much smarter person here tells me not to do that.
 
Whenever you reduce a dose for some reason other than the cat earning it by going below 50, then you'd return to your regular dose whenever the reason that made you reduce has passed. In other words, if your cat's not eating so you reduce, then go back to the regular dose when she is eating. If you reduce because you can't monitor, or because the preshot is lower than you're comfy with, then also go back to the regular dose.

It's actually a really good situation to get a green preshot - it's an opportunity to reduce the whole blood sugar range and flatten everything out.

It may be that she's going to bounce, and that's what you're seeing beginning.
 
oh, about the 911 - if you scroll to the top of this page, look on the right side for "thread tools." From there you can edit the subject line of your post and remove the 911.
 
Toni

The first time you shoot green, we are more cautious about you shooting a dropping number, etc. it's for safety. We need to know what Marmy might do. I doubt you will see even a blip from shooting 1.1 vs 1.3.

Now that you know she might rise, you can work towards shooting a dropping number. It is an excellent tool but yo should be cautious the very first time.
 
Marje & Gracie said:
I also have lots of data and experience and Gracie is on levemir which means she onsets later than Lantus users and I still wouldn't shoot in the mid 40s much less 30s.
I've got even more data than Marje and I don't shoot below 50 either. There is just no margin for safety if you shoot that low.
 
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