Can I get any help with MPM?

AliceL

AliceL

Member Since 2023
Is there anyone available to help guide me through my first time on MPM?
I posted a few days ago that I don't know what to do in response to low preshots but didn't get any responses and I'm literally just winging it here and feel like I'm failing miserably.

I have read through the dosing guides multiple times and I'm trying to follow it as best I can but there are readings I am getting that are confounding me. Specifically low preshots and how to react to them. Do I shoot the full dose on a low preshot or not? The MPM guide says I can reduce the dose if I don't have data but it doesn't say what to do after that - I've found after reducing the dose on one cycle I get a strange see-saw effect in the following cycle and then I get trapped in a sort of situation where one cycle has a preshot number safe enough to give full dose but then the next cycle's preshot number is too low to give a full dose again (requiring another temp reduction).

Reducing a dose obviously doesn't work then - am I supposed to just shoot a full dose (despite preshot number) until the nadir is under 50? Even if her preshot number is 100 points lower than normal, ignoring what the same dose did to her on the last cycle? Maybe because it's my first time I'm finding it hard to wrap my head around the concept that this won't send her straight into hypo... but is the goal of TR maybe that I should 'trying' to chase that bright green number to in order for her to offically earn a dose reduction?

Maybe I'm just being dumb but I can't understand it.
 
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AliceL said:
Is there anyone available to help guide me through my first time on MPM?
I posted a few days ago that I don't know what to do in response to low preshots but didn't get any responses and I'm literally just winging it here and feel like I'm failing miserably.

I have read through the dosing guides multiple times and I'm trying to follow it as best I can but there are readings I am getting that are confounding me. Specifically low preshots and how to react to them. Do I shoot the full dose on a low preshot or not? The MPM guide says I can reduce the dose if I don't have data but it doesn't say what to do after that - I've found after reducing the dose on one cycle I get a strange see-saw effect in the following cycle and then I get trapped in a sort of situation where one cycle has a preshot number safe enough to give full dose but then the next cycle's preshot number is too low to give a full dose again (requiring another temp reduction).

Reducing a dose obviously doesn't work then - am I supposed to just shoot a full dose (despite preshot number) until the nadir is under 50? Even if her preshot number is 100 points lower than normal, ignoring what the same dose did to her on the last cycle? Maybe because it's my first time I'm finding it hard to wrap my head around the concept that this won't send her straight into hypo... but is the goal of TR maybe that I should 'trying' to chase that bright green number to in order for her to offically earn a dose reduction?

Maybe I'm just being dumb but I can't understand it.
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Alice. Are you there? We can talk. I am sorry you didn’t get a response. It’s been crazy for me recently. If you need help, please send me a PM and let me know. I think I saw your thread and thought we were all caught up. My apologies. I would never purposefully leave you hanging.
 
AliceL said:
Is there anyone available to help guide me through my first time on MPM?
I posted a few days ago that I don't know what to do in response to low preshots but didn't get any responses and I'm literally just winging it here and feel like I'm failing miserably.

I have read through the dosing guides multiple times and I'm trying to follow it as best I can but there are readings I am getting that are confounding me. Specifically low preshots and how to react to them. Do I shoot the full dose on a low preshot or not? The MPM guide says I can reduce the dose if I don't have data but it doesn't say what to do after that - I've found after reducing the dose on one cycle I get a strange see-saw effect in the following cycle and then I get trapped in a sort of situation where one cycle has a preshot number safe enough to give full dose but then the next cycle's preshot number is too low to give a full dose again (requiring another temp reduction).

Reducing a dose obviously doesn't work then - am I supposed to just shoot a full dose (despite preshot number) until the nadir is under 50? Even if her preshot number is 100 points lower than normal, ignoring what the same dose did to her on the last cycle? Maybe because it's my first time I'm finding it hard to wrap my head around the concept that this won't send her straight into hypo... but is the goal of TR maybe that I should 'trying' to chase that bright green number to in order for her to offically earn a dose reduction?

Maybe I'm just being dumb but I can't understand it.
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I will now study her spreadsheet and see what may be happening. Be back in a little while. I have a few more cats to feed.
 
Oh Suzanne, I wasn't referring to you directly. You've been wonderful. I know people have their own lives and I don't expect instant answers.
I've just been spinning out not knowing what I'm doing so I thought I'd see if anyone could help me.
 
So I think your reduced doses are just too small. That’s not your fault; you have to try until you see that it’s not enough. Many times you are better off shooting the full dose if you can monitor and steer the numbers with food/carbs — or just shaving a small amount off the dose. Let me point out a few recent cycles so we can talk about them.
 
AliceL said:
Oh Suzanne, I wasn't referring to you directly. You've been wonderful. I know people have their own lives and I don't expect instant answers.
I've just been spinning out not knowing what I'm doing so I thought I'd see if anyone could help me.

—. No worries
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Bases on 22 March p.m. cycle — next time she’s around 150 preshot, try 2.2 instead of only 2 units.

On 22 and 23 March she was over 200 at AMPS and I would have shot the full dose on those days.
 
Today, based on previous cycles where she started out higher and only received 2 units which turned out to not be enough insulin— I might have tried the 2 unit dose with the AMPS of 160.
 
Suzanne & Darcy said:
On 22 and 23 March she was over 200 at AMPS and I would have shot the full dose on those days.
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Suzanne & Darcy said:
Also 24 March same thing. She was over 200 at AMPS and I would have shot the full dose.
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Ok. I reduced to 2u because I was shooting 2u for evening cycles two days in a row. I didn't know if shooting 2.4u during the day and 2u at night was the right thing to do. Those were my questions over on my old thread. I reduced to 2u to gain some control over that high day, low night dose situation. But noted, if over 200, shoot 2.4u (full dose).

Suzanne & Darcy said:
Today, based on previous cycles where she started out higher and only received 2 units which turned out to not be enough insulin— I might have tried the 2 unit dose with the AMPS of 160.
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Today I think I made a mistake reducing to 1.8u. I was reducing my dose based off the last cycle (last night 2u) thinking it would still get her under 100 at nadir. I dont know what has happened on today's curve, it seems to be inverted.

So tonight, straight back up to 2.4u if over 200? 2u if around 150? Is that what you are saying?
(Even though I shot 1.8u this morning)
 
Just for future reference, if I temporarily reduce her dose because she has a low preshot, is it ok if that happens a few days in a row? Ie, the previous situation March 21 and 22, where I was alternating doses day and night.
 
So as often as you can, I would try to shoot the full dose. If you are monitoring the cycle and have food and carbs available, then you are in control and can steer her numbers if needed. If she’s 200 or above at preshot during the a.m. cycle, shoot the full dose. She does tend to have lower numbers at night, so for now we will also take that into consideration. I still think that the last 2 nights you could have tried 2.2 units at least. The first night she had green and the next she didn’t — so it’s not always going to be the same. If you were testing and saw her dropping into green earlier in the cycle than expected or if you saw she was at say 70 earlier than nadir, you could feed more carbs. At night you may want to make her snacks a little higher carb anyway. That is just an idea and it may not make a difference— but we never know until we try. What are the new foods I see on her spreadsheet? There’s Pingo and there are various types of something called AC. What are the carb contents of those foods? What happened to Coshida? That one is really low carb, isn’t it?
 
AliceL said:
Hang on, why are these different? Around 150/160, do I reduce to 2u or 2.2u?
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Sorry. The difference between the two is that one was a p.m. cycle where she gets lower numbers typically and the other was an a.m. cycle where she usually runs a bit higher. Sorry for the confusion.
 
AliceL said:
And also just wondering where to go on the very next dose, tonight's cycle. Straight back up to 2.4 units? (if over 200 at preshot)
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In the evening cycle of 18 March, you shot 2.4 units with a PMPS of 215. She stayed in blue that night. So I would be comfortable with you shooting 2.4 units with anything 200 and above as long as you will be testing and feeding.
 
For tonight, she’s definitely on track to give us a PMPS over 200 since she’s in mid yellow now.

You have not been wasting your time these last few days with the reduced doses, and you have not been doing anything wrong. These numbers are a bit unfamiliar and you have tried a few reduced doses. It’s okay. You got a lot of good data for us to use.

Overall, she was doing better on the 2.4 dose with nadirs and spending more time in lower numbers. Since she is a long-term diabetic, we will not necessarily reduce her dose if she drops into the 40s occasionally. If it’s a pattern then we, of course, would say she had earned a reduction from her regular dose.

When a lot of “temporary” reductions are given one after the other, it starts to get confusing about what the regular dose is/was before all those reduced doses. Evie’s full dose at this time is still 2.4 units.
 
AliceL said:
Just for future reference, if I temporarily reduce her dose because she has a low preshot, is it ok if that happens a few days in a row? Ie, the previous situation March 21 and 22, where I was alternating doses day and night.
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March 21, I think it was fine what you did — giving 2.4 in the morning and a temporary reduction to 2 in the evening (although I think you could have even tried 2.2 units in the p.m. cycle and just given a few more carbs if necessary based on numbers.)
 
Suzanne & Darcy said:
What happened to Coshida? That one is really low carb, isn’t it?
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I always thought the Coshida was ok for her but now I think it was also spiking her inflammation. Remember she had that constant runny eye and I didn't know why.
Well, last week when we trialled a new food called Animonda Carny Pure Chicken which is a single protein food, her eye cleared up completely. Plus she had really good BG results even though it's 8% carb. But remember I said only bought a trial pack, I ordered more last week but we still waiting for it to be delivered! Everything is slow in this country. When we ran out of the AC Pure we went back to Coshida and saw the runny eye return instantly. I translated the Coshida pack using AI and saw it has some fish in it - she is allergic to fish. I didn't pick it up before, or maybe they changed their recipe, I don't know.

We had to feed her something while waiting for the good food to arrive so I tried some other Animonda Carny poultry-based flavours we had in the cupboard. That's why you see AC TCL (turkey chicken liver) and AC CTDH (chicken, turkey, duck hearts) on our spreadsheet for a cycle or two. Runny eye persisted on these flavours, they aren't single protein so I don't know what is upsetting her about the ingredients - organ meat maybe? We ran out to the supermarket and got another brand we have used in the past - Pingo ActivePet, it's a chicken pate, low carb 3.38%. She was actually eating this when she went into remission last time. The eye has cleared up on the Pingo now so I think it's ok as a temporary measure. When the Animonda Carny Pure Single Protein arrives this week she'll go back on it and we won't have supply issues again because I ordered plenty.
It's been a mad scramble to try and figure out foods this weekend.
 
Suzanne & Darcy said:
For tonight, she’s definitely on track to give us a PMPS over 200 since she’s in mid yellow now.

You have not been wasting your time these last few days with the reduced doses, and you have not been doing anything wrong. These numbers are a bit unfamiliar and you have tried a few reduced doses. It’s okay. You got a lot of good data for us to use.

Overall, she was doing better on the 2.4 dose with nadirs and spending more time in lower numbers. Since she is a long-term diabetic, we will not necessarily reduce her dose if she drops into the 40s occasionally. If it’s a pattern then we, of course, would say she had earned a reduction from her regular dose.

When a lot of “temporary” reductions are given one after the other, it starts to get confusing about what the regular dose is/was before all those reduced doses. Evie’s full dose at this time is still 2.4 units.
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Ok. I will stick to this from the very next cycle.
 
Suzanne & Darcy said:
Overall, she was doing better on the 2.4 dose with nadirs and spending more time in lower numbers. Since she is a long-term diabetic, we will not necessarily reduce her dose if she drops into the 40s occasionally. If it’s a pattern then we, of course, would say she had earned a reduction from her regular dose.

When a lot of “temporary” reductions are given one after the other, it starts to get confusing about what the regular dose is/was before all those reduced doses. Evie’s full dose at this time is still 2.4 units.
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Ok, yes. I've seen this on the MPM guidelines. Go back to the last good dose. Ok, I understand now.

Suzanne & Darcy said:
In the evening cycle of 18 March, you shot 2.4 units with a PMPS of 215. She stayed in blue that night. So I would be comfortable with you shooting 2.4 units with anything 200 and above as long as you will be testing and feeding.
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Just want to state that this was when she was still eating food that I suspect was spiking her inflammation. Since the food change, she dropped down to 60s at nadir on the 2u dose. Anyway, tonight I start with 2.4u again, and let's see. Hope and pray she will not be a low preshot tonight because that when it all starts throwing me for a loop! We shoot in about an hour so if anything weird happens I'll update you.
 
AliceL said:
I always thought the Coshida was ok for her but now I think it was also spiking her inflammation. Remember she had that constant runny eye and I didn't know why.
Well, last week when we trialled a new food called Animonda Carny Pure Chicken which is a single protein food, her eye cleared up completely. Plus she had really good BG results even though it's 8% carb. But remember I said only bought a trial pack, I ordered more last week but we still waiting for it to be delivered! Everything is slow in this country. When we ran out of the AC Pure we went back to Coshida and saw the runny eye return instantly. I translated the Coshida pack using AI and saw it has some fish in it - she is allergic to fish. I didn't pick it up before, or maybe they changed their recipe, I don't know.

We had to feed her something while waiting for the good food to arrive so I tried some other Animonda Carny poultry-based flavours we had in the cupboard. That's why you see AC TCL (turkey chicken liver) and AC CTDH (chicken, turkey, duck hearts) on our spreadsheet for a cycle or two. Runny eye persisted on these flavours, they aren't single protein so I don't know what is upsetting her about the ingredients - organ meat maybe? We ran out to the supermarket and got another brand we have used in the past - Pingo ActivePet, it's a chicken pate, low carb 3.38%. She was actually eating this when she went into remission last time. The eye has cleared up on the Pingo now so I think it's ok as a temporary measure. When the Animonda Carny Pure Single Protein arrives this week she'll go back on it and we won't have supply issues again because I ordered plenty.
It's been a mad scramble to try and figure out foods this weekend.
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What a “food Odyssey!” I am happy that the Pingo has been working and cleared up her runny eye. Maybe you can keep this in your arsenal along with the Animonda Carny pure chicken.
 
Suzanne & Darcy said:
What a “food Odyssey!” I am happy that the Pingo has been working and cleared up her runny eye. Maybe you can keep this in your arsenal along with the Animonda Carny pure chicken.
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Yes I will, as an emergency back up food. I don't trust it 100% because it's a supermarket brand and I don't really know what is in it. Ingredients say chicken and 'animal by-products' so who actually knows? But at least it's better than anything else we have currently (according to Evie's symptoms)

Another thing to consider, as Evie is struggling with food allergies (which do spike her BG) I don't know what's going to happen when I have to feed her high-carb foods to prevent a hypo. I have food and treats that are 15% and 20% in my hypo kit but they are not single protein foods. There is a chance when I rescue her from low blood sugar she is going to spike up higher than expected because the high-carb food agitates her system too. I actually need to do some more research on high-carb hypoallergenic foods for my hypo kit...
 
Overall, I think it’s looking like she needs more insulin rather than less. I think we are at the point where you will have to be brave and shoot her regular dose as much as you can or just shave a little off. I do agree that there could be differences since you are now feeding her the food which seems to agree with her more — so perhaps while we see the full effect of her new food you can take extra caution. There are quite a few cats who will level off in green when they get their normal dose on a lower preshot. It is really nerve wracking for their people until they feel confident that their cat can do this. It’s a process.
 
AliceL said:
Yes I will, as an emergency back up food. I don't trust it 100% because it's a supermarket brand and I don't really know what is in it. Ingredients say chicken and 'animal by-products' so who actually knows? But at least it's better than anything else we have currently (according to Evie's symptoms)

Another thing to consider, as Evie is struggling with food allergies (which do spike her BG) I don't know what's going to happen when I have to feed her high-carb foods to prevent a hypo. I have food and treats that are 15% and 20% in my hypo kit but they are not single protein foods. There is a chance when I rescue her from low blood sugar she is going to spike up higher than expected because the high-carb food agitates her system too. I actually need to do some more research on high-carb hypoallergenic foods for my hypo kit...
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The amount of time we spend on food research is amazing! You seem like a pro at it though. I am impressed.

A lot of people who have only one kind of food that their cat can eat due to allergies just add a drop or two of corn syrup or honey to their cats regular food when they need to bring up the numbers. Usually this would only be done when the cat drops to below 50, but if you are in a situation where MC might be given to help steer numbers then you could try a drop. Again, it’s a lot of trial and error. You can tell this FD is not a “hard science,” right? Even making decisions on how much to shoot is a lot about past experience, yes, but it’s also about “know thy cat” as we say. I do look at a lot of spreadsheets and help a lot of different cats and their people — so I have an advantage, but still the cats love to throw is curve balls and try to make us look like fools!
 
Suzanne & Darcy said:
A lot of people who have only one kind of food that their cat can eat due to allergies just add a drop or two of corn syrup or honey to their cats regular food when they need to bring up the numbers. Usually this would only be done when the cat drops to below 50, but if you are in a situation where MC might be given to help steer numbers then you could try a drop.
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This is actually a great idea for us.

Suzanne & Darcy said:
You seem like a pro at it though. I am impressed.
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Hardly! I am getting a hard crash course in inflammation, allergies and controlling it. As mentioned before I never put much thought into it previously but now I feel it's the key to controlling her diabetes - control the inflammation first. When I look at the last 8 weeks of shooting insulin we have been fraught with error - food issues, dodgy insulin etc. We have only now started to get a handle on things and I'm hoping all will start improving soon.

Suzanne & Darcy said:
Any idea what her numbers did today after the +5.5
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No, but she is 229 now at pre-shot. I just gave her 2.4u and will see how she does tonight.
 
AliceL said:
This is actually a great idea for us.


Hardly! I am getting a hard crash course in inflammation, allergies and controlling it. As mentioned before I never put much thought into it previously but now I feel it's the key to controlling her diabetes - control the inflammation first. When I look at the last 8 weeks of shooting insulin we have been fraught with error - food issues, dodgy insulin etc. We have only now started to get a handle on things and I'm hoping all will start improving soon.


No, but she is 229 now at pre-shot. I just gave her 2.4u and will see how she does tonight.
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Okay. I think she will be safe. I hope she will have a nice cycle. How far into the cycle do you test her and when does your husband take over?
 
Honestly, I don’t know how you do it — working full time and doing all this for Evie. I am worried about you having to leave town again for work for an extended period of time! You mentioned an upcoming trip.
 
Suzanne & Darcy said:
How far into the cycle do you test her and when does your husband take over?
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Lately I've been doing shifts from 5am up to 11pm because I just can't go to sleep when she is coasting low. Charlie usually does the very last test on the night cycle, anywhere from 11:30-1am just to make sure her BG is coming up, because at that point I just can't stay awake anymore! This limited sleep schedule might have something to do with my panic and not getting MPM right immediately :smuggrin:

Suzanne & Darcy said:
Honestly, I don’t know how you do it — working full time and doing all this for Evie. I am worried about you having to leave town again for work for an extended period of time! You mentioned an upcoming trip.
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I'm not leaving, I took an extended leave of absence to look after Evie.
I am self-employed and work in healthcare which is absolutely physically and mentally exhausting so I just can't go back to work right now when I'm worried about Evie's health. Evie comes first, she is my baby.
 
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Exactly right.
I already fed her Pingo 3.3% at +2, but I've also just fed her AC Pure 8% now at +3 when I saw her BG because it's quite a steep drop...
Opened my one reserve can of the 8% single protein food because it's all I have that's slightly higher carb and non-inflammatory.
 
That 82 is at +3 after a snack at +2... quite fast considering she already had her +2 snack. Anyway, I gave her the higher carb and will check her again soon.
 
Between +4 and +5 we were checking every 10 mins because she was dropping hard and not staying up. We have stopped the drop now but I think I gave her too much honey and high carb food. That was too scary. 26 BG is not a joke.
 
@Suzanne & Darcy BG in the 40s don’t scare me, but I haven’t cultivated the nerves to be dealing with 20-30 BG so early in this process! She hardly reacted at all to her mid carb food at +3, even the high carb snacks and then HC food at +4 didn’t keep her elevated. After honey she popped up to 75 but then fell back down again to 40 20mins later. I know honey is short acting but it still made me panic I because it was quite early in the cycle and I didn’t know how quickly she was going to drop again. She is now climbing steadily, I think I gave her too much. We are at 147 @+6.5
 
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Sorry to bombard you with a million comments now. So it’s a reduction tomorrow but are you sure we shouldn’t go back to 2u and work our way up slowly? 2.4u was really too much for her tonight and I’m even scared about shooting 2.2u tomorrow night. She had a very delayed reaction to the high carb food, over an hour to pop her up. The day cycle doesn’t worry me too much to shoot 2.2u but during the night cycle she drops much lower. I’m really nervous about it.
 
AliceL said:
Sorry to bombard you with a million comments now. So it’s a reduction tomorrow but are you sure we shouldn’t go back to 2u and work our way up slowly? 2.4u was really too much for her tonight and I’m even scared about shooting 2.2u tomorrow night. She had a very delayed reaction to the high carb food, over an hour to pop her up. The day cycle doesn’t worry me too much to shoot 2.2u but during the night cycle she drops much lower. I’m really nervous about it.
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Alice

I’m so sorry no one saw your posts. This forum is not so active so please know you can always post on Main Health if you get a low preshot and don’t know what to do. That’s a more active forum and others are more likely to see you as long as you indicate in the subject line you need help with a low number and it’s PS time.

We normally wouldn’t take such a big reduction as 2.4u to 2u. I would agree with Suzanne that a reduction to 2.2u is consistent with MPM.

Good luck with the reduction!
 
You know, based on her previous numbers on the 2.4 dose, I would not have expected this reaction. It is good that you have a lot of experience in handling low numbers and are familiar with the frequency of testing, etc.
 
Suzanne & Darcy said:
Wow. I am so unhappy that you had to deal with those low low numbers. That really is scary. How is Evie doing?
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It was really scary. But the scariest thing was her BG wouldn’t react to the high carb food which is my only protection against hypos. I gave her 3x 20% HC licky treats + a whole can of the 18% HC food + rubbed honey on her gums about 6 times. After almost a hour of feeding she would just not stay elevated above 50 and I freaked out. The insulin was pushing her down hard and we were only at +5. I eventually gave her a teaspoon of diabetic kibble (highest carb stuff in the house ironically at 25% carb). I know I shouldn’t have done that but the cat was not reacting to the HC wet foods. The kibble popped her up from 46 to 90 after 15mins. I am exceptionally nervous to shoot her 2.2U dose this evening now. Evie didn’t even react much to such low BG, and she was more than happy to eat whatever I gave her. Afterwards she had loose stool (hypo foods aren’t anti inflammatory).

Suzanne & Darcy said:
You know, based on her previous numbers on the 2.4 dose, I would not have expected this reaction.
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Yesterday I said mentioned she didn’t dip low on 2.4u because she wasn’t on the non inflammatory food. She went down into the 60s on her 2U dose though (after the food change). I think tonight on 2.2u is going to be a similar situation to last night and I’m nervous. I don’t want to have to feed her the inflammatory foods just to keep her from hypoing. That’s not nice for her tummy.

Suzanne & Darcy said:
It is good that you have a lot of experience in handling low numbers
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She was on a lower dose last time and reacted better to food spikes, ie was able to bring her up quicker. Feeling a bit out of my depth this time.
 
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@Suzanne & Darcy Today I feel sick to my stomach about what happened last night, it was actually traumatic. I am seriously reconsidering continuing with MPM until she has built up enough data on a lower insulin dose eating 100% non inflammatory foods. I think if the insulin had not been dodgy and she was eating the right foods we would have never got to her 2.4u dose in the first place. It’s clearly way too much for her. In reality we have less than a week’s worth of data to refer to (on the new vial and eating non inflammatory foods). That’s evident by the way 2.4u did not send her plummeting previously but now it has.
This morning I did shoot 2.2u but it is the day cycle so I’m sure it will be better but I’m still hoping for another reduction today. Terrified about shooting 2.2U tonight.

I have to go get more hypo foods today, we just about emptied out our hypo box.
 
I understand. I know I would be feeling the same post traumatic stress type reaction. That was very hard on you, Alice, with all those stress hormones flooding your body. You must be physically and mentally exhausted. It sounds like Evie was all right through the whole thing as far as not being symptomatic and being alert throughout and eating all the different foods. I am worried about her poor GI tract today though (diarrhea?)
 
Hi @Suzanne & Darcy. I did shoot 2u tonight.
I just could not bring myself to shoot 2.2u as the 2.4u last night pushed her down so quick and hard that I just could not bring her up using food safely and quickly.
I really thought Evie was going to die and I'm just not prepared to have a repeat of that situation tonight.

I feel there are too many variables at play here to truly understand what is going on and proceed safely on MPM at the moment.
- A week ago I changed insulin. I don't think we can safely use any readings from the last vial to make dosing decisions because I do think it is a lot more potent now.
- Our food issues are a big one. She is currently eating non-inflammatory foods whereas 10 days ago she was still eating foods that were upsetting her system. I only realized this a few days ago. In the past, she tends to run higher on inflammatory foods and lower on non-inflammatory foods. Last night I had to give her inflammatory hypo foods. This adds to the confusion about what is truly going on with Evie's readings today.

Seeing the +1 result on tonight's cycle I think we are in for a dive again. It is not usual for Evie (old vial, inflammatory foods) to be 70 points lower one hour after food and insulin.
She is usually slightly lower or even still elevated at +2 to +3. Tonight she is already much lower at +1, despite a big meal at insulin time, and that really scares me.

I just fed her another meal now at +1 of inflammatory foods (as she tends to run higher afterward) in an effort to stop the drop. Remember yesterday I could not stop the drop feeding meals using non-inflammatory foods. She is already coughing and that's just what I said this morning - I don't want to HAVE to feed her inflammatory foods just to prevent her heading for a hypo. My poor girl. I think we are not only dealing with how insulin affects her but also how food affects her and that's no way to be handling MPM safely. For example, if the inflammatory foods prevent her from going too low tonight, it's very easy to deduce her insulin dose on this cycle was just not enough...but that probably wouldn't be accurate. We just don't know, too many variables.

What I propose is a complete reset. I would like to reduce her dose even further starting tomorrow and go back to SLGS for now. Once our big delivery of the non-inflammatory food arrives I will feed her only that food going forward. Once we remove the food variable we can revise how the insulin is affecting her and pick up on MPM at that time. What do you think about that plan?
 
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Hi @Suzanne & Darcy. Curious about what you think about all this, even if it is in disagreement.
The 2u last night still dropped her hard and I steered it at +1 with 4% carb food that happens to be inflammatory - I've noted her response on it before. I don't think the carbs matter as much as the inflammatory response right now and that's why I couldn't get Evie to come up safely from the hypo two nights ago. I have no way of knowing how inflammatory our hypo foods are, all I know is she didn't react to the high carb. How do I prevent a hypo? If you have any ideas I'd really like to know because I'm doing my best to try figure this all out.
 
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AliceL said:
What I propose is a complete reset. I would like to reduce her dose even further starting tomorrow and go back to SLGS for now. Once our big delivery of the non-inflammatory food arrives I will feed her only that food going forward. Once we remove the food variable we can revise how the insulin is affecting her and pick up on MPM at that time.
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I think this is just a fine plan. I also think, though, that it would be better for Evie to have honey or corn syrup instead of the inflammatory foods, when trying to raise numbers, but that’s just an aside. I think you should let things stabilize on the new food and see how the numbers look after she is consistently eating the new food.
 
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