9/28 Henry

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It's almost a 100 pt drop though from PS, so at least that's something. I still vote for a higher dose at night. When I used to shoot late with Bix, like +13 or +14, the best I ever really got was pretty much flat, and even with an extra 0.1 or 0.2 thrown in. It was pretty much hopeless with him to get a good nadir on a late shot (given that I was too chicken to really bump the dose up more than a teeny bit).
 
PMPS @+14 258 3.3 U
I went up from 3.2 to 3.3 in the evening a few days ago and left am dose the same at 3.2.
Should I go up to 3.4 or 3.5 for PM dose and hold AM dose at 3.2 or give the change in PM dose a few more days to do anything?
 
Angela,
It looks like Henry hasn't "noticed" you upped it by .1 yet. His AMPS have been the same (within 10 points or so).
Just my opinion here, so don't change until somebody else chimes in -

It looks like you have at least 100 points to play with on the AMPS number, so an increase to 3.5 I think would be fine. The only hesitation is that you don't really have a clear picture of what is going on in the wee hours of the morning. When you have gotten a nadir check in the middle of the night, it's a "blue" though.

Let me recap this theory though, to see if I finally have it right....
Henry's problem on a 12/12 schedule was that his AMPS were drastically higher than his PMPS, right? So you started giving him his PM shot 2 hours later so that you would get lower AM readings. And you have done that. It looks like there used to be about a 200 point difference all the time, and now it looks like a 100 point difference.

So if you also up the PM dose, it should push the AM number down more, correct?

Do I have this right?

Carl
 
Yes thats right, the goal is to get the AMPS lower so hopefully the nadirs would be lower.
Now a few months ago, he was consistently lower in the AM from mid-upper 200's to lower 300's. AFTER he had a dental in mid July, I noticed the AMPS numbers inching up again into mid 300's and lately some upper 300's. Hes almost always in blues when I do overnight spot checks. He must shoot up right before shot in the morning. A few times I have fed him tested him an hour to hour and a half before his PMPS and shot, then fed and his number dropped from test an hour before PMPS after eating. I have read about "dawn syndrome" somewhere on the board but can't find it now, it sounds a lot like him. Its where numbers spike early in the morning due to some hormonal? thing. He was a bit better today, he was higher in the AM but got a better drop today on same dosages hes been getting. That is a trend I have noticed with him a lot too, if hes quite a bit higher at his AM shot, and I give the same dose I usually give he gets more movement downward than a lower AM BG with the same dose of insulin.
I was at dentist being tortured all afternoon, so just had a chance to get here.
Opening a new thread for today's numbers.
 
The discussion on "dawn syndrome" was in this forum, two or three weeks ago. I think it was in one of your threads, because I remember posting about it! The thread was about rebound, smogyii, and dawn effect or syndrome.
It's actually fairly common in human diabetics I think.
It is when the BG goes up overnight for no good reason, because a person is sleeping all night and not eating any food. The blood glucose drops due to no food, and the liver kicks in glucose to "save" the body from low BG. Diabetics who suffer from it are encouraged to eat a snack just before bedtime so that their liver stays asleep when they go to sleep.

I'll find the thread and link it...

Carl
 
Thanks Carl, going to read a little of it now, rest will have to wait until tomorrow when I'm not so tired I can't see straight :lol:
 
Angela&Henry said:
That is a trend I have noticed with him a lot too, if hes quite a bit higher at his AM shot, and I give the same dose I usually give he gets more movement downward than a lower AM BG with the same dose of insulin.
Click to expand...

That's a pretty typical pattern I think overall with PZI, it seems like a lot of cats get that. I think of it as with a lower PS they are on their way up, so the insulin is counteracting that upward pressure, leaving the numbers kind of flattish without a lot of drop. On a higher PS the movement up is (hopefully) done and they are just riding high, so the insulin can really bring the numbers down - no upward pressure countering the move. That may or may not make sense, and may or may not actually be correct :mrgreen: depends a lot on what their zoom rate is and stuff like that.

That is why in many cases I'm not a big advocate of lowering the dose a lot on lower PSs. I hear what some others say about "if you got that much drop on the high PS, imagine how low they might go on the lower PS" but from what I have seen (ECID), a lot of times that just isn't how it works. With the lower PSs the curve often seems more compressed, like the insulin is keeping them in a tight range, like a rubber band stretched to just the right point that it can hold the tension, while with higher PSs it ranges really widely up and down.

Well anyway.... just wanted to mention it so you wouldn't feel like he is alone in that pattern.
 
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