Dosing help!

[Nicole- Spicy Sushi]

Sushi’s numbers have been all over the place! Tonight we got a PS of 166… we have never shot that low so I made the call of only giving her .5U. She has been on 2U 2xday since switching from Vetsulin to Lantus on 2/8. Now I don’t know what I do about tomorrows AM dose? If she’s high again say over 200 do I go back to 2U? 1.75? I’m assuming she’s going to be high with barely giving her any insulin. We are almost 6 months into this game and haven’t been in this situation yet. I’m hoping this is a sign she’s got her depot full and is responding to the new insulin? But what dose do I go back to tomorrow? Thank you!!

 

[Sienne and Gabby (GA)]

The depot should be stable after a week. I'd encourage you to read through the SLGS guidelines. Ordinarily, you would have wanted to evaluate Sushi's dose after a week. I can't emphasize enough that you need to get at the minimum, a test before you go to bed every night. Lantus dosing is based on the lowest number in the cycle (i.e., the nadir). if you are not testing at night, not only are you missing half of your data, it's likely that you will miss a dose reduction.

It's likely that Sushi will be in higher numbers due to both the reduced dose and because there's likely to be a bounce due to the limited amount of time that Sushi has been in blue numbers.

When you reduce the dose due to a low pre-shot, you go back to your usual dose unless a dose reduction was indicated (i.e., you had a test value that is less than 90).

I'd also encourage you to start posting on the Lantus board. There's a great deal of expertise there about Lantus. You will, however, get considerable suggestions to consistently get at least 4 tests per day -- your pre-shot tests and at least one test each cycle.

 

[Nicole- Spicy Sushi]

The depot should be stable after a week. I'd encourage you to read through the SLGS guidelines. Ordinarily, you would have wanted to evaluate Sushi's dose after a week. I can't emphasize enough that you need to get at the minimum, a test before you go to bed every night. Lantus dosing is based on the lowest number in the cycle (i.e., the nadir). if you are not testing at night, not only are you missing half of your data, it's likely that you will miss a dose reduction.

It's likely that Sushi will be in higher numbers due to both the reduced dose and because there's likely to be a bounce due to the limited amount of time that Sushi has been in blue numbers.

When you reduce the dose due to a low pre-shot, you go back to your usual dose unless a dose reduction was indicated (i.e., you had a test value that is less than 90).

I'd also encourage you to start posting on the Lantus board. There's a great deal of expertise there about Lantus. You will, however, get considerable suggestions to consistently get at least 4 tests per day -- your pre-shot tests and at least one test each cycle.

Thank you for your response! It’s tough because Sushi is very difficult, hates to be touched and needs to be restrained, so I’m depending on her dad for help and it just isn’t feasible to get that many readings in consistently. We did do a curve after 7 days and her two PM cycle readings were in the 300s but we stopped at +5 and then she was at only 200s in the AM so I’m thinking she might be dipping at closer to +7 or +8. I may be able to convince her dad to get up with me at night once or twice a week to see what’s going on but the fact that we’ve been able to even manage the amount of readings that we have thus far and have survived it has been nothing short of a miracle hahaha.