9/25 Pumbaa AMPS/335 +4/289 +6/315 PMPS/309

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Pumbaa

Pumbaa

Member Since 2012
Okay, this is only Pumbaa's second cycle on Levemir, and he's only at .50U right now, so I'm sure that there won't be anything interesting to report, but I wanted to get back in the habit of doing these daily posts. :)

Suze
 
Re: 9/25 Pumbaa AMPS/335 second cycle on Levemir

Looking forward to "interesting", but interesting in terms of nice even, low, non-bouncing numbers, none of that 'up all night' with a drop to the 30s :roll:
 
Re: 9/25 Pumbaa AMPS/335 second cycle on Levemir

Thank you, HM and Sheila!

I would love nothing better than to have the ride with Levemir to be oh-so-boring!
Flat, flat, flat. Raise dose. Drop in numbers. Flat, flat, flat. Raise dose. Drop in numbers. Lather/rinse/repeat until it's: Drop in numbers. Reduce dose. Flat, flat, flat. Drop in numbers. Reduce dose.

Okay, so I'm delusional, but please, at least give me this fantasy for a short time. *LOL*

Suze
 
I just updated Pumbaa's profile to reflect all of the changes lately: meter, insulin, etc.
 
Well - looks like he has achieved "flat" for now... no doubt you will need to raise the dose, but not until he has been given time to settle - maybe Thursday evening.

You are testing for ketones, right?
 
Trying to test for ketones. Pumbaa is resisting. It was so much easier when he had to pee every 5 minutes. *LOL*

I'm so impatient...we have to wait until Thursday evening to increase his dose?

Yes, flat is good. Flat is so much better than dives and bounces, but I hate to see him with numbers this high.

Patience pants...where did I put those? Hmmmmm..

Suze
 
I think he is still settling on this dose, but he will probably need to be raised anyway, so you could probably go to .75 now. Just let that settle three days. Can you do a curve on Sunday?
 
Suze

I have a different take on all this :-D bet you aren't surprised.

I think it's wise to roll the dose back a bit (30%) when switching insulins. I worry that going from 2.25u to .5u is rolling it back way too far. IMHO, I would increase his dose to .75u tomorrow morning. When I switched Gracie, she was on .75u of lantus and I started her on .5u of lev. I raised her after two cycles and then again after four and then started giving her 6-10 cycles.

She had to go up to 1.25u for a breakthrough dose. While I hope that lev will flatten Pumbaa out...it did Gracie to a certain extent...lev is not a miracle insulin to stop bouncing. I can show you many bouncy cats on lev...including Gracie.

I really really hope that this will be the perfect match for Pumbaa. I feel lantus was NOT good for Gracie and she has been much better on lev...but she still bounces and occasionally dives. But she also has long periods of amazing flat.

She's going through a rough patch now because she got an infection. As the A/B resolved it, her insulin needs decreased and she started diving/bouncing when she had been doing great. I reduced her by .25u which is huge for her, waited six cycles, and it just kept getting uglier. So I'm taking her back up but it's slow. I have found with her that increasing her dose and managing the curve with food totally smooths out her bounces.

I look forward to see how great Pumbaa will do. I hope this has given you a much needed break :-D
 
I meant to start a new thread for the 9/26 numbers, but clients and life kept me hopping yesterday.

I'm tickled that Pumbaa started this morning at 249 on such a low dose. I'm also tickled that he's was pretty dang flat since yesterday at AM +4. He bounced during his 4th cycle on Lantus last April.

Sheila, I will raise him to .75U tonight. I'm hoping that he drops below 200 for his AM nadir today, and agree that raising by such small amounts is still very prudent to help with the bouncing/diving.

Marje: Life would be so boring if everyone always agreed on everything. *LOL* Actually, I had rolled back a lot worse than from 2.25U of Lantus to .5U of Levemir....I had taken Pumbaa off the insulin totally until Sheila explained why that was insane. So he actually went from 1.0U of Lantus to .5U of Levemir. So sorry to hear about Gracie's infection and the resulting havoc on her BG. And yes, this not having to test 24 hours a day to watch for dives has been a wonderful and much-needed break! Especially since I am still swamped with work and juggling between two clients. How are YOU doing? Are your stomach issues resolved/being taken care of? I haven't had much time to read the various condos in the last couple of weeks, so I feel totally out of the loop on what has been going on.

Suze
 
Suze

I did study his SS and saw that you dropped from 2.25u of lantus, then 1u, and then the lev. But the depot from lantus can affect up to six subsequent cycles and the higher the dose, the larger the depot. So there is a good chance
that you were still working on the 2.25u depot when you finally started lev.

I know you aren't following TR....but maybe it would be a good idea to try until you are seeing more normal numbers. I love what I'm seeing so far....flatter and that blue is definitely nice!

I'm much better, thank you. Long story but I don't need to take up time with it here. Gracie is doing fine other than her numbers but time will sort it out. I know what I need to do to get her back in normal numbers. I appreciate you thinking of us.
 
Marje and Gracie said:
Suze

I did study his SS and saw that you dropped from 2.25u of lantus, then 1u, and then the lev. But the depot from lantus can affect up to six subsequent cycles and the higher the dose, the larger the depot. So there is a good chance that you were still working on the 2.25u depot when you finally started lev.
Click to expand...
That is what caused my insane thinking to stop the Lantus altogether on Friday night when I was 100% confident that I would be starting Pumbaa on the Levemir on Monday night. *LOL* To give the Lantus 6 cycles to clear his system.


Marje and Gracie said:
I know you aren't following TR....but maybe it would be a good idea to try until you are seeing more normal numbers. I love what I'm seeing so far....flatter and that blue is definitely nice!
Click to expand...
I'm loving the flatter numbers, too! And that blue was beautiful on such a small dose of Levemir.

I appreciate your advice about TR (((HUGS))), and know that you believe in it, but I'm just not a fan. Was that blue number last night due to the .5U dose, or was it a result of the dose increase that cycle to .75U? I don't know...and I know that there are different opinions on the depot/shed, and if the current injection affects the numbers or if those numbers are only coming from the insulin in the depot/shed. I'd rather play this one by ear with the help and advice of other Levemir users, and not push Pumbaa to the point where he starts bouncing and diving again.

To me, it looks like Pumbaa settles into the dose on Levemir quicker than he did on Lantus, due to the lack of pink numbers since the morning of 9/26. But he's only had 9 cycles of Levemir so far, and that is too short of a time to make judgements.

I just don't want him to go back to the routine of bouncing/diving, bouncing/diving, ad nauseum. My immediate goal is to get Pumbaa to have regular, flat numbers under the 250 renal threshold, daily. Then we will go from there. :)

Marje and Gracie said:
I'm much better, thank you. Long story but I don't need to take up time with it here. Gracie is doing fine other than her numbers but time will sort it out. I know what I need to do to get her back in normal numbers. I appreciate you thinking of us.
Click to expand...
I'm so glad to hear you're much better! Sorry to hear that it's a long story, but if the end result is that you are much better, that is all that counts. (((HUGS))) Yep, I have no doubt that you'll get Gracie all sorted out again, too.

Suze
 
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