Re: 7/24 Checkers pmps 417
Hi Barb
The trickiness in using R comes with being able to tell exactly when it's ok to use it. You have to avoid using it when it can overlap nadirs with the lev (or Lantus for Lantus users) and you also have to be careful about using it as the lev onsets just because the first hour or two, it can drop them fast. You want to time it with the onset of the bounce. What you don't want to do is let him bounce a whole cycle and then give it because he's still high. There's too much of a chance he will come down too fast.
If a cat clears bounces in one cycle or, like Tess, their bouncing is unpredictable (e.g. clears in one cycle one time, bounces three cycles the next, etc), then it's more challenging to use and it's probably best to not do so.
The goal is to not bring numbers down but to keep them from going up. You will likely see some drop but the goal would be to stop the increase in BG and see only about a 50-150 mg/dL drop over four hours.
When I was using it with Gracie, I found that, in general, the first hour stopped her from rising or brought her down a bit but by R+2, she could drop alot. And I was only giving 0.1u which is what you need to start with. I can measure it with my calipers most consistently and it is such a small amount that I can barely tell there is any insulin in the syringe. If you find doing a drop is easier for you, you can try that but it's going to be crucial that you dose consistently when you use it.
The other thing that you need to be prepared for is the after effect. Many R users have noticed it. R does not have a depot but it, in effect, stops those counterregulatory hormones and opens the door for the lev to do its job. Almost in every situation where I used it with Gracie, she went lower in the cycle or two AFTER I used it because the bounce was clearing and the lev stepped in.
