How in the world to figure out the correct dose?

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WV Mom

Member Since 2014
Could someone kindly look at Joe's bg spreadsheet (link in signature) and give us some guidance on how to figure out the correct dose for Joe?

For several weeks, from August 20 through September 11, we routinely gave 1.0 unit bid, and it wasn't enough. Most readings were in the 300s or 400s, with a few 200s and 500s thrown in. A fructosamine on September 12 was 554, so we were told to increase his dose to 1.5 bid.

Since then, the readings have been better, but he's bounced around like a rubber ball. In response, we've given him 0.5, 1.0, or 1.5 based on where his bg was when it was time to shoot. It's dang confusing!

We think we've learned that 1.5 is okay if he's in the mid 200s or higher. If he's mid 100s to mid 200s, give him 1.0. If he's below the mid 100s, give him 0.5, but don't skip it completely (notice what happened on September 22).

  • Have we learned the correct lesson, i.e., does this seem about right?
  • Shouldn't he eventually get to where he gets the same dose, all the time, without this "sliding scale"?
Any advice you could give, based on examining his spreadsheet -- especially the readings since September 12 -- would be much appreciated!
 
Welcome to the Relaxed board!

It seems you've been doing a pretty good job figuring out things as you go along. One note about Lantus and the way it works is that it's a depot insulin (meaning each shot builds off the last and there's a "repository" of insulin stored from previous shots). Because of this, it craves consistent dosing, so yes, you're right that he should be getting the same dose BID and not using a sliding scale with Lantus (which defeats the purpose of the depot).

It looks like you guys are close to that dose. I'm thinking 1.25u would be a good dose to try and hold consistently over the next few days. 1u is too little and 1.5u looks to be a tad too much. There aren't any syringes with quarter unit markings, so the key to giving .25u doses is...consistency! :lol: You don't have to be accurate, but try to draw up to the same spot on the syringe every time. Some people eyeball it, some people use a ruler or calipers and ignore the syringe markings. Whichever you think will be easiest (and most consistent ;-) ) for you to do.
 
I agree. It can be trying, so you need patience, but it sounds like you have a lot of that! Good luck and welcome!
 
Thank you for the replies! I would've said so earlier, but I was away from a computer, which is both a blessing and a curse.

Joe's readings have gotten even stranger. We're starting to wonder if the 1.0 we were giving him late-August to mid-September wasn't too low, but too high! Since Sunday evening, we've given him just a smidge of Lantus -- a quarter unit or even less -- and he's had beyootiful readings. I guess time will tell if we're on to something, but if anyone wants to offer an opinion, we'd be happy to hear it!
 
Nice catch and yes I would say you now have him where he needs to be with a very good chance for remission. That is what makes this dance so dang tough is too much and too little look just alike.

But Joe looks dynamite now.

Mel and The Fur Gang
 
Looking really good and great catch about reducing the dose! :thumbup It could also partly be that he's trying to go Off The Juice, which can make dosing all that much more difficult.
 
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