Dosing advice needed - why does she seem to stagnate on increases?

[Carys'n'Moira]

Hi there - I feel like I need a bit of a sanity check with Moira's numbers. We went away a few weeks ago and the cat sitter was unable to give insulin. When we got back we opened a fresh bottle and increased by 0.25u every week. We're not seeing much movement on 1.75u apart from one random blue halfway through the week. Overall there's less reds and just a sea of pinks, but the numbers aren't dropping much at all. This is definitely just a case of more insulin needed right? There's no way I'm overdosing her?

 

[Suzanne & Darcy]

Hello Carys! It’s good to hear from you. You are doing such a great job of testing her BG. She wasn’t doing much differently before the couple of days when the pet sitter couldn’t give insulin. I definitely recommend increasing to 2 units as soon as possible and not holding the doses too long. Doses being held too long in cases like this where the numbers are mostly pink and red can result in glucose toxicity which makes it harder to budge her out of the higher numbers. I would increase and give it 6 cycles and make a decision then about another increase or holding the dose a little longer (based on the nadir.)

 

[Suzanne & Darcy]

And no, you are not overdosing her. You do more than enough testing to verify that. If she was overdosed you would have caught a low number below 68 on your pet test meter. She’s just not yet getting the insulin she needs.

 

[Carys'n'Moira]

Hello Carys! It’s good to hear from you. You are doing such a great job of testing her BG. She wasn’t doing much differently before the couple of days when the pet sitter couldn’t give insulin. I definitely recommend increasing to 2 units as soon as possible and not holding the doses too long. Doses being held too long in cases like this where the numbers are mostly pink and red can result in glucose toxicity which makes it harder to budge her out of the higher numbers. I would increase and give it 6 cycles and make a decision then about another increase or holding the dose a little longer (based on the nadir.)

Thanks Suzanne. Nice to see you again Yeah I know her numbers were a bit rubbish before the sitter came - I didn't really want to increase just before we went away. She was going to be there on her own and it was our first time leaving her since she was diagnosed so I was quite anxious about it.

Part of the reason I've not been going quicker up the doses is because one half the week im in work so harder to get midcycle daytime tests. My OH is at home but is less proactive with the testing so needs a few phonecalls reminding him.

I'll increase to 2u in the morning and I guess we will take it from there! Thanks suzanne