Derek is 92 @ +13... should I shoot/reduce shoot?

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JohnZ

Member Since 2015
Hi...
As luck would have it Derek is 92... about 30 minutes ago (ReliOn Confirm meter) and it has been about 13 hours since his last shot (1 unit of Lantus)... I just finished his spreadsheet this morning any haven't linked it to my signature yet... but here's the link to it... he's on low carb and was feed... can someone advise? I'm going to take another reading now...

https://docs.google.com/spreadsheets/d/1gb6F1bFyy0bIclophNatv13NssXStNFwzbhebc3IINw/pubhtml

Thanks!

John
 
OK- tested him again at he's now at 151... did give him quite a few pieces of canned chicken over the last 45 minutes or so.

so- his number are coming back up- but still not sure if I shoot/reduce shoot or wait until tomorrow...?

I try to shot every 12 hours but am running late this afternoon.
 
Sorry for multiple posts... I'm on the east coast.

The AM shot needs to be around 1:30 to 2:00 because of my work hours. If I shot him this afternoon (it's now 4:00 PM) I have to back him up (next 4 shots would have to be 11 1/2 hours apart instead of the 12 hours)... any thoughts?
 
He's obviously rising, but I'd hold off until he gets to a number you're comfortable shooting and above 200. I'd also give a reduced amount, as that 1 unit of Lantus took him low, way late in the cycle, telling me it's too big of a dose. However, I'm not experienced with Lantus, so hopefully someone else will soon be along to give you better advice. Also, you mentioned you gave him canned chicken, so that's helped to get his numbers up a bit, but your last test was taken with chicken/food on board. Insulin amount and timing should be based on a number not affected by food. Food should be unavailable at least two hours before preshot testing. As for changing his shots to 11 1/2 hours apart instead of 12, that's do-able with some insulins such as ProZinc, but someone experienced with Lantus should advise on that. If you are able to do 11 1/2 hours apart, a smaller dose would be a good idea, as lessening the time between doses is equal to an increased dose.
 
Thanks for that... he hadn't eaten prior to the pre-shot test... gave him the chicken after getting the low number. In the past... with low numbers (not this low)... like 112 or... my vet had said... no problem... go ahead shoot... which I'm not sure about at all.

Anyway- I'm going to skip this shot... and get back on track tomorrow...

Hopefully someone experienced with Lantus can advise further....

His numbers are getting getting much better (see spreadsheet)... at some point... I believe it's OK to shoot the lower numbers- just don't know how or when... any advise/help would be greatly appreciated!

Thanks!
 
John, I think your decision to skip tonight's shot is wise. Better high for few hours than low for even a minute. Hypos are really scary and can be deadly (I'm sure you already know that), so you'll be avoiding that and getting a fresh start, tomorrow. Actually, that's just what I would do... and have done in the past. Your vet's advice to hold the dose might be correct for Lantus, but like you, it makes me a bit unsure. I know I wouldn't do that with ProZinc... not at such a nice, low number. And, yes, at some point you will need to shoot those lower numbers, but first you need advice and experience so you'll know how to proceed with confidence. You sound very sensible! Good for you! And best of luck to you and Derek. His spreadsheet definitely shows progress. :cat:
 
I just had another thought. Maybe you could post your question (or a link to it) on the Lantus board so that someone who has Lantus experience would see it and offer advice. That might make it a little more high-profile.
 
Hi John and Derek!! If you couldn't monitor tonight, skipping is always the safest thing to do!

Looks like maybe Derek is getting the message! It'll be really helpful if you can get some mid-cycle tests in during the AM cycle and at least a "before bed" test on the PM cycle. Lantus dosing is based on how low it takes them, not how high the Pre-shot numbers are.

If you absolutely can't get mid-cycle tests in, it's that much more important to get a "before bed" test and then run a curve at least once a week so we can see how low the current dose is taking him

Think of the spreadsheet like a puzzle...if the only pieces you have filled in are along the edges, it's impossible to see what the picture is. If you sprinkle pieces throughout, the picture becomes clearer!

Just a few notes on what I see so far on your spreadsheet (and thanks for doing it!) Besides the extra tests, if you'll post daily, those of us that use Lantus will be able to help you learn when it's time to increase the dose. Holding a dose too long leads to glucose toxicity which makes it harder to gain control. Lantus works best when you can shoot lower numbers too. It's not near as good at bringing down high numbers, so IF you can be home to test and have plenty of supplies, it'll be important for you to learn to shoot lower and lower. We suggest posting and asking for help if you get a number under 150 (once you move to the Lantus Forum) If someone offers to stay with you when you shoot lower than you're used to, one of the promises we make is that we won't leave you until you're comfortable with how things are going.

It'll also help us to not have to ask the same questions over and over if you'll add some info to your signature line (which I think you plan on doing tonight) Information like I have in our signature line would be great, plus if he has any other diagnoses, add those too

Please come on over to the Lantus and Levemir Forum and start posting over there. Everyone there uses Lantus or Levemir so you'll get the most experienced eyes there! Here are some hints on "Making the most of your Lantus and Levemir ISP experience" to help explain how we post there.

Look forward to seeing you and Derek there....and it'd be great if you could add an avatar picture too! We'd love to see your sweet kitty!
 
Hi John and Derek!! If you couldn't monitor tonight, skipping is always the safest thing to do!

Looks like maybe Derek is getting the message! It'll be really helpful if you can get some mid-cycle tests in during the AM cycle and at least a "before bed" test on the PM cycle. Lantus dosing is based on how low it takes them, not how high the Pre-shot numbers are.

If you absolutely can't get mid-cycle tests in, it's that much more important to get a "before bed" test and then run a curve at least once a week so we can see how low the current dose is taking him

Think of the spreadsheet like a puzzle...if the only pieces you have filled in are along the edges, it's impossible to see what the picture is. If you sprinkle pieces throughout, the picture becomes clearer!

Just a few notes on what I see so far on your spreadsheet (and thanks for doing it!) Besides the extra tests, if you'll post daily, those of us that use Lantus will be able to help you learn when it's time to increase the dose. Holding a dose too long leads to glucose toxicity which makes it harder to gain control. Lantus works best when you can shoot lower numbers too. It's not near as good at bringing down high numbers, so IF you can be home to test and have plenty of supplies, it'll be important for you to learn to shoot lower and lower. We suggest posting and asking for help if you get a number under 150 (once you move to the Lantus Forum) If someone offers to stay with you when you shoot lower than you're used to, one of the promises we make is that we won't leave you until you're comfortable with how things are going.

It'll also help us to not have to ask the same questions over and over if you'll add some info to your signature line (which I think you plan on doing tonight) Information like I have in our signature line would be great, plus if he has any other diagnoses, add those too

Please come on over to the Lantus and Levemir Forum and start posting over there. Everyone there uses Lantus or Levemir so you'll get the most experienced eyes there! Here are some hints on "Making the most of your Lantus and Levemir ISP experience" to help explain how we post there.

Look forward to seeing you and Derek there....and it'd be great if you could add an avatar picture too! We'd love to see your sweet kitty!

Thanks for the warm welcome!

Added information to my signature line.

My job doesn't allow me to test during the AM cycle- I'm up at 1 AM- test, feed and shoot Derek, and leave for work by approx 2:30 AM.

Get home around 12:30 PM... just before the PM cycle.

It's off the bed at around 6:30 PM (if I'm lucky)... so any mid-cycle testing is usually done between 12:30 PM and 6:30 PM.

Weekends are a little better- but I'm not always at home.

I need to know/learn when it's best to reduce/adjust the dosage, skip a shot, or not shot at all... and will not always be at home to test.

Guess I'll give the normal 1 unit in the AM?

Maybe I'll do a quick post in the Lantus Forum... not sure... it's way past my bed time!

Thanks Again!
 
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