8/11 Joplin PMBG 87 - Dosing Advice Please

[Cherylockholmes]

As you can see by his SS, Joplin had a a bit of a scare today, falling to 26 nadir. He's currently at 87. Unfortunately, I just fed him. All of the other cats needed to eat, and there was no way of feeding them and not him. Should I shoot now, and if so how much? Or should I wait?

Thanks

 

[houghtam]

I am too much of a newbie to give advice... just wanted you to know that Hardey and I are sending good vibes your way. I know that when our numbers were that low, I didn't shoot. I tested every few hours to see what the numbers did without shooting and tested again in the morning to see where they were at that time and then decided what to do....

 

[Ella & Rusty & Stu(GA)]

Hi Cheryl,
Normally, if you have a number that is much lower than usual you can do one of 3 things: 1) stall and test every 20-30 minutes until you get a rising number. DO NOT FEED when stalling (food will raise bgs artificially). When you get 2 rising numbers in a row, it is OK to shoot. Remember to move your next shot so that it will be 12 hours from the time you shot.
2) Shoot a reduced dose (for example: half of your normal dose)
3) Skip the shot and resume at your normal shot time the next cycle.
Since you have already fed Joplin, option #1 is not a good choice.

Be sure to read the "Sticky" on how to deal with shooting low numbers. Print it out so that it will be available if no one is here to advise you.

Looking at your spreadsheet I see that you seem to be jumping around in dose. Generally speaking, for Lantus to work the way it is supposed to work, the dose should be consistent, only changing according to the TR protocol. If you are making too many dose adjustments too close together it will be difficult to regulate Joplin.
I hope that one of the very knowledgeable people on the board will be along soon to guide you in your decision. I think that I would skip tonight's shot if I were in your situation.

Welcome to LL (this is my first visit to your condo),

Ella & Rusty

 

[Cherylockholmes]

Hi Cheryl,
Normally, if you have a number that is much lower than usual you can do one of 3 things: 1) stall and test every 20-30 minutes until you get a rising number. DO NOT FEED when stalling (food will raise bgs artificially). When you get 2 rising numbers in a row, it is OK to shoot. Remember to move your next shot so that it will be 12 hours from the time you shot.
2) Shoot a reduced dose (for example: half of your normal dose)
3) Skip the shot and resume at your normal shot time the next cycle.
Since you have already fed Joplin, option #1 is not a good choice.

Be sure to read the "Sticky" on how to deal with shooting low numbers. Print it out so that it will be available if no one is here to advise you.

Looking at your spreadsheet I see that you seem to be jumping around in dose. Generally speaking, for Lantus to work the way it is supposed to work, the dose should be consistent, only changing according to the TR protocol. If you are making too many dose adjustments too close together it will be difficult to regulate Joplin.
I hope that one of the very knowledgeable people on the board will be along soon to guide you in your decision. I think that I would skip tonight's shot if I were in your situation.

Welcome to LL (this is my first visit to your condo),

Ella & Rusty

Thanks for your input. The reason I'm adjusting the doses is because an amount that works one day, either is not enough, or is too much the next day, so I am trying to find the correct dose. When Joplin has high blood sugar, he is peeing all over my house...he doesn't seem to do it when he's low/normal. I had been following the "raise dose every 7 cycles", but it was not having any effect on Joplin. Someone then suggested increasing the dose every 3 cycles, and only then did it begin to make a difference. As for tonight, I waited til 1.5 hours after feeding and he tested at 127, so I gave him a reduced dose of 3.25 units.

 

[Sienne and Gabby (GA)]

I'm not sure who suggested raising the dose every 3 cycles, but that's too fast. It doesn't allow enough time for the dose to settle and you risk putting Joplin over what could be a good dose. The fastest I would raise the dose is every 4 cycle (2 days). You need to reduce the dose to 3.25u tonight.

Can you afford to stall for 30 min? I'd like to be sure that Joplin's numbers are on the rise before you shoot.

 

[Cherylockholmes]

I'm not sure who suggested raising the dose every 3 cycles, but that's too fast. It doesn't allow enough time for the dose to settle and you risk putting Joplin over what could be a good dose. The fastest I would raise the dose is every 4 cycle (2 days). You need to reduce the dose to 3.25u tonight.

Can you afford to stall for 30 min? I'd like to be sure that Joplin's numbers are on the rise before you shoot.

I'm sorry, I didn't mean 3 cycles, I meant three days. I ended up giving him the 3.25, and he has already shot up to 191 at +2.5.