6/6 Lucky AMPS 427 PMPS 319

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Luckyducky

Member Since 2012
Hi again everyone! Thanks so much again for your help last time. It's been 3 days since I reduced Lucky's dose to 1.5u bid and I had some questions about possibly increasing the dose. Here's his spreadsheet for his readings these past few days, and here are his numbers for today:

AMPS 427
+5 346
PMPS 319
+3 249
+6 306

I had some questions about changing the dose, but first I had some things I thought might be important to mention.

It looks like Lucky might have had a bounce last night, because his numbers jumped up surprisingly high this morning (it's unfortunately hard to say, since I didn't have the chance to get another reading last night). I was wondering how bounces are factored into considerations for dose changes, like if I should wait or not, etc.

Another thing is that I just today finished off the insulin in Lucky's Solostar Pen, and I plan on starting a new pen tomorrow morning. Part of me wonders if the pen I just finished might have lost efficacy in the remaining insulin, and if that might explain some of the higher numbers Lucky had today (I should say, I didn't use up all of the insulin in the pen, but it was very low before I threw it away). Another part of me wonders whether it might be better to first use a new pen for a few days before changing a dose.

So now, my question about changing the dose is: my gut instinct from looking at the numbers is that the dose should be increased, but I'm not sure I fully understand how the Tight Regulation protocol is supposed to be followed in this circumstance. The sticky mentions that after 3-5 days the dose should be increased if the nadirs are less than 200 --- and it seems some of Lucky's nadirs are less than 200. It also says that if the nadirs are greater than 200 it should be increased by 0.25u --- and it seems some of the nadirs are greater than 200 and less than 300. It also says that if the nadirs are greater than 300 that the dose should be increased by 0.5u --- and it seems at least one of the nadirs is greater than 300. I guess I'm a bit confused as to how I'm supposed to apply the protocol to the numbers Lucky recently got, i.e. when I should change the dose and by how much.

Any guidance with these questions would very much so be greatly appreciated. Thank you all again so much for all your help! :smile:
 
Re: 6/6 Lucky AMPS 427 PMPS 319 Dosing Advice?

Regarding dose changes, the idea is to look at the majority of where the nadirs are. If the nadirs are generally either above or below300, use that to guide your dose change. In addition, if you are seeing blue nadirs, I'd lean toward the smaller increase. I would also not factor in where the nadir is on a bounce cycle.

In most cases, you do want to wait for a bounce to clear before increasing the dose. The reason is that if you are seeing blue or green nadirs, it's possible that once the bounce settles, the numbers will be lower. You want to have a good idea of how low the numbers are ranging so you don't overdo it. (On the other hand, if numbers are really high even before bouncing, you have more latitude to increase.)
 
Re: 6/6 Lucky AMPS 427 PMPS 319 Dosing Advice?

Thanks so much for the information Sienne, that really clears up some things I'd been wondering about. :smile: I've decided to wait another day or so to see if his numbers stabilize, since it does look like he had a bounce yesterday morning. Hopefully his numbers go back down, but I guess we'll see. Thanks again, it's much appreciated!
 
Re: 6/6 Lucky AMPS 427 PMPS 319 Dosing Advice?

Hi...glad you got your question answered. :-D could you please take the "dosing advice please" out of the subject line. We cruise the forum for questions so once they've been answered we can help others. Thanks very much :-D
 
Re: 6/6 Lucky AMPS 427 PMPS 319 Dosing Advice?

Oh! Sorry about that, I've made the change in this post and some of my older posts, I'll keep that in mind for future posts too. :smile:
 
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