9/2 Austin AMPS 349 (and a question)

Status
Not open for further replies.
Tara and Austin (Aussie)

Tara and Austin (Aussie)

Member Since 2010
If yesterday was my first real day of even numbers in the 300's after changing the dose back to 1 unit - following the tight regulation protcol would I change it on Saturday (3 days at only 300's) by a .5 unit?

Btw, I've ordered Hocks .5 unit syringes so I can do these easily. Thanks everyone for your guidance.
 
Are you asking about an increase? Hopefully someone will come and take a look shortly...
but yes, we usually do wait 6 cycles or 3 days and then increase...but usually we increase by .25u.
Let's see what the others say...

Just wondering if you are feeding now after checking the preshot number?
We usually do not feed for at least 2 hours before the AMPS or PMPS...at that time, we test, feed and shoot the insulin...
 
Tara and Austin (Aussie) said:
If yesterday was my first real day of even numbers in the 300's after changing the dose back to 1 unit - following the tight regulation protcol would I change it on Saturday (3 days at only 300's) by a .5 unit?
Click to expand...
preshot numbers in the 300s don't tell us how low kitty is dropping. increases are mostly based on nadirs. grab some nadir checks.
those mid-cycle spot checks will determine if and how much of an increase is needed...
 
Pat+Raja+Shadow said:
Are you asking about an increase? Hopefully someone will come and take a look shortly...
but yes, we usually do wait 6 cycles or 3 days and then increase...but usually we increase by .25u.
Let's see what the others say...

Just wondering if you are feeding now after checking the preshot number?
We usually do not feed for at least 2 hours before the AMPS or PMPS...at that time, we test, feed and shoot the insulin...
Click to expand...

Hi Pat, right now I am checking him at 630am (+11) and then feeding him - and then taking the AMPS at 730am. I know this isn't the perfect way, but after a few days ago when I had the 90's # and wasn't sure if I should shoot or not - basically started this trend. I could check him at 530am but it would be a +10 and not a true AMPS. I need to leave the house at some point! So perhaps if I grab some more numbers after work, and after he is fed I'll know a bit more what his #s look like. I got the .5 unit because after reading the tight regulation it looks like if he is 300 or more regularly it would call for a .5 rather than a .25. I don't mind increasing by a .25 instead though.

I will also start feeding him in intervals rather than 2 meals in 12 hour increments and see how that helps.
 
Tara & Austin said:
right now I am checking him at 630am (+11) and then feeding him - and then taking the AMPS at 730am. I know this isn't the perfect way, but after a few days ago when I had the 90's # and wasn't sure if I should shoot or not - basically started this trend.
Click to expand...

This strategy is a bit of a problem. If you're feeding at +11, you have no idea how much the food is driving the numbers up. If you look at the "perfect" curve into in the New to Lantus sticky, you'll see that an hour after a meal, you'd expect a food spike. We encourage you to not feed anything within 2 hours of your shot time so you can get a pre-shot test that is not influenced by food artificially raising BG numbers. At a 349, this is likely not a problem. with a number like a 90, it could be. We use pre-shot BG tests to inform us whether it's safe to shoot. If you're feeding an hour before the shot, you won't know what the actual BG level is and could wind up having shot on a number that you would otherwise not have the data to shoot.
 
Tara and Austin (Aussie) said:
Hi Pat, right now I am checking him at 630am (+11) and then feeding him - and then taking the AMPS at 730am. I know this isn't the perfect way, but after a few days ago when I had the 90's # and wasn't sure if I should shoot or not - basically started this trend. I could check him at 530am but it would be a +10 and not a true AMPS. I need to leave the house at some point! So perhaps if I grab some more numbers after work, and after he is fed I'll know a bit more what his #s look like. I got the .5 unit because after reading the tight regulation it looks like if he is 300 or more regularly it would call for a .5 rather than a .25. I don't mind increasing by a .25 instead though.

I will also start feeding him in intervals rather than 2 meals in 12 hour increments and see how that helps.
Click to expand...
by feeding at +11, the preshot number is not a "true" number. the number is artificially inflated by a food spike. all you're doing is giving yourself a false sense of security because when the food spike clears, the insulin will start to go to work on a lower number. remember, the onset of the insulin isn't until a couple hours after you shoot. this is why we try to withhold food within a couple hours of shot time. make sense?

Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose


as far as increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.


Peak/Nadir - the lowest point in the cycle

at this point, we have no idea how low this dose is taking austin. once you're able to get some mid-cycle spot checks done, we'll know if in fact the dose should be increased and by how much per the guidelines suggested in the tight regulation protocol.
 
Thank you both. It all makes sense. I have a really tight work schedule so I leave around 7am and don't get home until 630pm. I shoot (or used to) at 630am & pm. Although going back and forth a few days ago it's 730am & pm now. I know I am supposed to hold food for 2 hours - however if I need to get out of the house and feed him around 630am, the AMPS isn't 430am because that's not when I'm shooting. Does this make sense? Sounds like I need an automatic feeder.
 
now i'm confused! :mrgreen:
i test at shot time... immediately feed and shoot while alex is eating.
this all takes place within a matter of minutes. would something like that work with your schedule?
 
Your ideal shot time is 6:30 but it is pushed back due to the delay the other night, right?
You may move the time by 15 minutes each day if you want to get back to the 6:30 shot time.

I will use the 6:30 shot time as an example.
Take the BG number at about 6:15 or so, (that will be your AMPS)
feed,
then shoot at 6:30.
You do not feed from 4:30am up until you feed at 6:15. The food will raise the BGs and we want them to be fasting for at least 2 hours before we test for Preshot.


(When he was low the other day, you took a BG reading at +11 so everyone could figure what dose he should get that night, right? You don't need to do a +11 check all the time now.)

Did that make it clearer?
 
Sorry for the confusion! That is what I was doing - feeding and shooting at 630am and getting ready for the day. Except in the past I was not taking a AMPS. He is definitely in my bed with me fasting until we both get up. I can take a reading at 630am without any food being given for 2 hours and get the number. I can also work my way back to 630am.
Phew!

Got it - no more +11 checks. The only problem is I can't really get a +1 +2 +3. etc...However he does eat everything all at once - so when I get home at 630pm he has definitely fasted and I can test then.

So - Saturday - 6 cycles at 1 unit - if his nadir is in the 300's should I raise .5?
 
How about this: get as many checks in as you can...evening and before bed time checks...and then on the weekend maybe you can do a curve so we can see what Austin is doing mid-cycle, okay?

So what you might do for the curve is check him at +3 and +6 and +9...and if you give him a snack at any one of those times,feed after you get the BG number.

As Jill said before, food brings their numbers to an inflated level...higher after the food...
Then, they drop lower after about an hour or two.
What you want to see during the curve is how Austin's numbers look all during the day, before meals and a few hours after meals.

There are experienced dosing people here who will watch his numbers on your SS and they will analyze those numbers and tell you when they think it's good to raise the dose...they are very knowledgeable and have lots of experience...so you don't need to worry about the dose increase or how much for now...just try to get the tests...that is the one thing that they do need in order to figure Austin out...okay?

Oh and Tar...you can take your question out of your header...unless you have another one...
I hope I described this properly to you...is it clear now? :razz:
 
Hi Tara...it's me again...the big pest!!
You need to go back to your first post of the day and edit that....then take out the (and a question) from that first post, okay? You will see that the first post's header is the one that carries through all the posts...you can put updates there too...like +4=82 or whatever the number is...

We like to put the BGs in and leave the AMPS up there. You can put a few new BG numbers in and then the PMPS ...not too many along in the string because you don't want your header to wrap around into two lines...know what I mean? You are doing great...all these little housekeeping things... :mrgreen:
 
definitely get the mid-cycle checks whenever you can. You know he has had at least one nadir under 300, or he wouldn't have ended up at 96 one day! Now he is probably just bouncing from that green, so we have to wait for the bounce to clear AND we have to wait and see if he goes back to green after the bounce clears. Any time you can get tests will help. Are you off any days this weekend?
 
Status
Not open for further replies.
Back
Top