Dose advise - insulin in 1 hour

Hi all
Could you please take a look at Wolvi's SS
In 45 minutes it's shot time and I really don't know what to do.
In his SS you have a tab for freestyle Libre.
you have the BG on tab 2021
Thank you

 

At PS he was 140 on FSL and 128 on countur next one and instead of the usual 2U I gave him 0,8U.
I'm really nervous

 

You don't have a method listed, I know we mentioned them before, so by default I assume SLGS reductions at 90. So today he definitely earned a reduction to 1.75U. I think 0.8 was a good call. Please start with a +1 and +2. I won't be around, so: if he's flat or rising, retest in 2 hours. If you see a drop of 30 pts or less give a little LC. A bigger drop, feed 1-2 tsp MC and retest in an hour.

If at any point he's in the 50s, 1-2 tsp MC retest 30 mins. Repeat until in 60s (no food if 60 or higher).

If in 40s, 1-2 tsp HC. Retest in 20 mins. Follow note above until 60s or higher. 30s is 2 tsp HC plus a drop or two of karo, retest in 15. Follow steps above til in 60s.

 

Hi

He Has a Freestyle Libre - I'm kind of testing him every hour

TY for your help

 

It looks like you may be breaking through some glucose toxicity. Earned another reduction even on a token dose.

I would make your new dose 1U, and only shoot that if 160 or higher (assuming you can monitor). 130-159, I'd go 0.5U (also assuming you can monitor). Under that is up to you...stall without feeding until he's at a number you're comfortable shooting, or a dose like 0.1U (as best you can guess on the syringes you have). I would not shoot 110 or below right now.

Does he have a history of ketones or DKA?

 

Thanks for your answer.
I think that I don't understood what you say... maybe because my English is not good enough.

I understand what you sugest to do but don't understand the reason.

No history of ketones or Dka

 

Ah sorry! I usually try to use words that Google Translate can easily translate if needed. Hopefully this works.

Glucose toxicity is when blood glucose is high for a long time, which hurts the pancreas.

As insulin shots start to bring blood glucose numbers down, the pancreas starts to heal. When this happens, the pancreas starts to work again and make it's own insulin - this means you have to give less insulin in your shots.

It looks like that is what is happening with Wolvi - his pancreas is starting to work again. So you don't need to give as much insulin. Per the SLGS guidelines your new dose would be 1.25U, but I want to be more cautious and say 1U. And hold that dose for a few days to see what happens - if he keeps going low even that may be too much.

 

Ohhh thanks. Now I completly understand.
It looks like what happened in 2019 when he went OTJ.

 

Good morning
Now at Amps he is 422
I will give him 1 U

 

Bouncing! Hopefully comes down soon

 

I would have done 1.75... Maybe 1.5. But it's fine you went more conservative with the 1. I like those nice, healing blue low blue and eventually green numbers.

 

@JanetNJ
Ty I was so happy with those blue and greens and this morning.
Now he is 321 (+3)

I will go for 1.5 just in the middle between your sujestions ladies.

Thanks once again @FrostD and @JanetNJ