Re: 9/16 Reuben AMPS 159 +1/125 +2/73 +2.75/54 +3.25/49
Alexa,
The best place to try to wrap your head around the "depot" is to read the sticky thread:
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=150
As someone who used PZI, and not one of the "L" insulins, the concept was completely foreign to me, and something I really had to read and reread a few times before it started making any sense to me!
The most important part, for me, was understanding that the shot you are giving "right now" does not act independent of the "depot".
In other words, just because it is a smaller dose (or even a skipped or token dose), that doesn't mean you will automatically see less activity with the BG levels this cycle. The depot is still at a level that was determined by the previous higher dose, and it can impact this cycle, and still have an effect for a couple cycles, until the depot adjusts down to the new dose.
Same thing when you increase the dose. Just because you go up by .25u, that doesn't mean you will see any increased effect in the next cycle. A part of the increase is going to the depot, until it fills to the new higher dose level. This can take one cycle, or it can happen 5 or 6 cycles later.
I think that this is important because many times, people will increase or decrease, and "nothing" changes immediately. So you sit there wondering "but why isn't it working?" That's because it takes time to see the full effect of either an increase, or a decrease. People call it "settling" and you will see that lots of times, when someone advises that you have to wait for the dose to settle, or for Reuben to "settle into the new dose".
Tonight, you will most likely shoot a decreased dose. But you may not see the results of that decrease tonight, or tomorrow for that matter.
In my humble opinion, the greatest characteristic that a user of Lantus or Levemir - the depot style insulins - can possess is "patience". It really does require a large measure of patience on the bean's part to deal with all of this.
In that sticky thread, I think the most valuable bit of advice that Libby gives us is this:
Try to look at your spreadsheet not in 12-hour cycles, but in “waves” of action over a period of several days. Look for overall trends more than individual numbers. If something jumps out and doesn’t seem to make sense, go back 2-3 days and think about any changes that might have occurred in insulin, timing, exercise, health, food, etc. If the big picture is making sense but you see one cycle that doesn’t fit, then keep that 20-50% variation in mind and just wait it out.
I'm sure someone will be along to better help you understand the depot, but reading the sticky a half dozen times would be a good place to start! It worked for me :lol:
Carl
