8/19 Eddie AMPS 436, +2.5/249, +6/185

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Jen&Eddie

Member Since 2013
Yesterday's Condo

Yesterday: AMPS/365, +2/329, +5/183, +6.5/141, +7.5/126, +8/120, +9.5/94, +10/103, +11/107, PMPS/116, +2/220, +2/182, +3/147, +4/128, +5/86, +5.5/96, +6/101, +7/128
Today: AMPS/436, +2.5/249, +6/185

Hi LL,

Deanna, Elise, and Wendy, thanks for stopping by Eddie's condo last night. He dipped his toes in green last night, so that was two back to back cycles with dips into green which doesn't happen much lately. I suppose those two back to back cycles were just too much for Eddie's panicky little liver. He didn't stay in green last night and it looks like he probably started heading up quite quickly after PM +6.

This morning, Eddie was blasting being cheerful, so his nasty red AMPS was a bit of a shock. DH retested and the 436 was the lower of the two tests. I got some BTB time and when I checked at +2.5, Eddie had dropped almost 200 points to 249. :o At lunch time he's still going down, but had slowed down a bit. It will be interesting to see where he's at when DH gets his in-the-door test. I tried to explain to Eddie that there is no prize in FD for the biggest dive, but he still felt he deserved a treat.

Looking over Eddie's SS, it does seem that dropping after pre-shot seems to be happening fairly frequently as of late. I'm toying with the idea of feeding at PS, +1, and +2, rather than at PS and +2. I'm trying to figure out logistically if that will work. For clarification, it's my understanding that Lantus generally starts to onset around +2 or +3. Is that right? So, the early cycle drops are either 1) early onset, 2) overlap from the previous dose, 3) and/or bounce clearing. So, for a 200 point drop to occur by +2.5, it's either a big "chunk" of the current dose being utilized to metabolize that much excess glucose, or it's "bounce clearing."

I'm trying to wrap my head around what physiologically is happening with bounce clearing. I've been trying to put down on virtual "paper" for a long time my thoughts on bouncing, so I hope you'll forgive the novel here and the layperson's interpretation.... My understanding is that insulin down-regulates it's own receptor cells. So, when those cells are "full" of insulin, the insulin basically turns those cells off, until the effect of the downregulation wears off. Then, when the downregulation has worn off, the receptor cells "open" again, allowing active insulin from the shed to metabolize more glucose. Good nadirs means that the cells are able to metabolize sufficient insulin and glucose to bring the circulating glucose levels into the "normal range." When the cells are "full," they stop metabolizing the active insulin and the circulating glucose. Add the release of a glucose "bomb" from a panicky liver, and you've got a sharp spike in glucose that the receptor cells can't metabolize even though there's active insulin present, because the receptor cells are "full," and have been "shut off" by the down-regulatory effect of either the insulin, or due to glucose toxicity. Throw in some other counter-regulatory hormones that arguably have the effect of down-regulating the receptor cells, and you get the high-flat bounce cycles that last for several days. Glucose toxicity causes the receptor cells to downregulate as well, meaning that there aren't as many available cells to metabolize the insulin and glucose. Based on my understanding, too much insulin can also cause downregulation resulting in high flat cycles.

So, if my understanding about the physiological mechanism of bouncing is correct, and feel free to point out if I'm wrong, what if anything can be done differently about bouncing (and diving)?

Prayers and vines to all kitties and beans in need today.
 
Oh Eddie - red is such not an attractive color or orange cats - or any other for that matter. And there are no prizes for biggest dives. :roll:

I've heard that onset is typically around +2, some earlier, some later. Neko is one of those that onsets later. I've seen some SS where it seems to happen around +1. If you take a look at Gabby's SS, she's often in full dive mode by +1, which is why Sienne always tests and feeds her then. (a well as +2 and +3). You might want to experiment with testing at +1 when his PS is higher than the nadir of the previous cycle and see what you get.

Sorry, no help on the bounce clearing theory. For me, it just happens when it does. There are so many factors at play and insulin is a hormone which adds to the lack of predictability. Did you read the articles references in Julie's post on Feline Diabetes and Glucose Toxicity? I had a hard enough time wrapping my head around Neko's acromegaly (excess growth hormone from pituitary gland going to liver where insulin growth factor is created, which block cell receptors, etc.). And BTW, we use the phrase depot instead of "shed". "shed" is an LL only thing and if you talk to anyone outside of here (eg. the vet) depot is more likely to be recognized.
 
I don't have any idea on your theory about bouncing. I've tried to figure it out and can't. It just drives me crazy. I hope Eddie slows down his dive today and doesn't bounce back up.
 
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