I'm glad Sienne made it here to answer your questions.
Here is some good info on
Glucose Toxicity. When kitties stay at higher numbers longer, it takes more insulin to break through those high numbers. Sometimes th dose might have to go up quite a bit to get to a breakthrough dose.
You said TR is not what is making him bounce. But taking him so much lower than his liver is used to is exactly what makes him bounce. So if I avoid the greens, he shouldn't bounce so much. He is getting more used to blues and he doesn't bounce so much or as long from blue numbers. And **I** can't deal with numbers below 90. My panic is as bad as his liver's! I see no reason to force him down lower than 90. I know you all like greens. Not me. I want him in the blues. Maybe, if he comes under control in the blues I will consider greens, but not yet. I also do not want to shoot below 150. So those are my goals. So, please help me with how to manage that.
A cat can bounce from a fast drop and also can bounce from blue numbers if they aren't used to them. That's why I don't think TR is the culprit. Almost all cats bounce whether the caregiver does SLGS or TR. Yes, the flatter you can keep them, the less they will bounce but just saying you want him to stay 100-200 doesn't mean he will because he's a cat
I reduced his dose this morning by a quarter. If I hadn't fed him at 51 the other night he would probably have "earned" a reduction anyway. But why make him go that low when I **KNOW** he will bounce and bounce for a few cycles and feel crappy and not be able to walk very well when he is high that long. Besides, the glucometers are not accurate enough to differentiate between 51 and 49. So why make 50 required to get a dose reduction?
He doesn't have to go into green. If you want him in blue, tweak the dose so that's where he is.
I have tested pretty rigorously in hopes of learning something but I see no patterns or information in my spreadsheet except the following: his nadir is usually between +4 and +5 but not always. It can also be at pre-shot or any other hour. So that doesn't help me much that I see.
Sometimes it is hard to see patterns. I think Sienne gave you a good idea of what she is seeing. I will have to study it in order to give you my thoughts.
I can't answer those questions from the data. I have data but I can't make sense of it. Can you help me with my data and those questions?
Yes, I will look at his SS tomorrow and see if see anything to add to Siennes thoughts.
I am having trouble finding a higher carb food that is grain free from the carb content food lists. Many of the grain free foods don't seem to be on the food lists. Is it okay if I just use a little simple sugar syrup instead? (karo is corn and corn is grain so I would make my own or just use my hummingbird food, which is sugar syrup). My plan is to feed him his own food and supplement with a little syrup. Given his pancreatitis and allergies, I don't want to introduce strange foods when he is low.
Although its only 5%, I've found the WN Core turkey/duck works well for Gracie. Siennes Gabby is gluten sensitive so she uses honey with her LC food to manage low numbers. You can too!
How can I tell IF a high number is a bounce?
If numbers pop up really high, fast, after he's been in lower numbers, it's usually a bounce. If you have time, look at other SSs.
What is a strategy for getting some sleep? I don't want him to go low in the night EVERY NIGHT. Free feeding is at odds with getting him to lose some weight. I would like to test only once in the middle of the night.. Before bed and +5 are my goals for night testing.
I think Sienne gave you a strategy. I'd get a +2 at night and if it looks like he has the potential to come down, Id check again sooner. If his BG is way up from PMPS to +2, you are probably good for sleeping.
I
would occasionally like to leave the house for as long as 6-8 hours. If he goes low, like say to 31 like he did in the night not so long ago, how long does it take before damage is done? I am feeling like I have about ten minutes. Do I have longer than that?
Once we recognize his patterns, you will be able to figure out how long you can get out.
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And why shouldn't I shoot a little early if he is high or a little late if he is low? Why not use timing to adjust the depot a bit?
You can!
