Dosing advice. PMPS is 72.

Heather and Gizmo

Heather and Gizmo

Member
Hi Everyone! I am looking for some dosing advice. Gizmo's PMPS is 72. Do I skip this evenings dose? I am sure this would make Gizmo really happy. I just want to make sure I am making the right choice. Any help would be appreciated.
 
Gizmo is pretty close to the getting low warning point right now (68) so I think skipping is the most reasonable option as long as Gizmo has no history of ketones or DKA. The lowest you've shot so far is 143 so we have no idea what he might do if you were to give even a token dose of insulin. You could try stalling for 30 minutes without feeding to see if his BG comes up on its own but if he's hungry his BG could go up due to hunger "stress".
 
I did do another test to confirm. I did go ahead and feed him because he was famished. It is the quickest I have ever seen him eat his food. I did another test a half an hour after feeding him and he is up to 89 after his meal.
 
Heather and Gizmo said:
Should I reduce his dose tomorrow? What would I reduce it to?
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Based on the data you have, it looks to me like his nadir has moved later and the difference between AM and PM pre-shot values has gotten bigger. So, I personally would reduce. It seems that things need to level out some. I would probably drop to 2.5 and hold that a few days to see the impact. It doesn't look like 2.5 was held very long in the past.

Keep in mind that you will probably see a high number in the morning since he didn't get a shot this evening. Also, if he has a bounce, those can take a couple/few cycles to clear. So, resist the temptation to crank up the dose prematurely. Things need a chance to calm down. Ideally, you want to end up with a dose where your AM and PM test results are both consistently 'shootable' numbers, and you don't have to skip or reduce every couple of cycles. Consistent dosing can go a long way toward leveling things out.
 
Thank you for explaining this to me in a way that makes perfect sense. It is hard to see high numbers and easy to over react to them. I will reduce to 2.5 tomorrow morning and see how that goes for a few days. Thanks again for all of your help.
 
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