? How the heck to regulate when nadir's are all over the place?

[Misterbeesmom]

i was just tallying some averages and looking over our numbers trying to figure out if we're improving or not. feels like we're stuck. feels like my cat's body avoids the 100's like the plague, and i'm ripping my hair out and ready to start dragging my fingernails down my face. i look constantly like Munch's The Scream.

there is no pattern to his numbers. the pattern IS that there is no pattern. now we're into 9 months post dx. you can imagine how mental i've gone by now.

overall, since 6/26 when i started using human meter, looking at the range of his nadirs (+6's), his worst was actually a RISE of 82 points, and most dramatic was a DROP of 225 points.

how the hell am i supposed to know what to do with such variables when it comes to dosing? WHY IS THIS SO DIFFICULT?! this is like rocket science for crying out loud. how can some cats go into remission if it is this complex to treat?

i was trying to follow TR but if i did i think we'd be up to 10u by now at this rate, and from past experience it looks like 5u was too much and landed mr b in the hospital.

 

[HyperJMA]

*hug*

 

[Jill & Alex (GA)]

...from past experience it looks like 5u was too much...

Maybe. Maybe not. There were only 4 consecutive cycles at 4.5u before the dose was increased to 5u bid and then the 5u dose was held for only 4 consecutive cycles, so who knows if 4.5u or 5u was too much? Most Lantus/Levemir kitties need at least 6 consecutive cycles at a particular dose in order to deduce what the dose is capable of doing.

In any case, that was then. This is now. Looks to me like glucose toxicity may have set in while the dose was prematurely reduced. If that's the case, don't be surprised about the need for higher doses of insulin.

An observation: With only a single spot check between 7/6 thru the morning of 7/10, we don't have any idea how low the dose the 4u dose took Mr. Biddles. See the 400 @ AMPS on 7/9. It's possible he dropped enough to cause a bounce. He may not have dropped too low. He may have simply dropped lower than his body has been accustomed. Either can cause that kind of bounce.

In my opinion and given the circumstances, you simply haven't reached a good dose yet. Based on the data you've collected, I think you'll have to continue increasing in increments of 0.25u before you'll see a significant break through.

Hang in there, Jen! If you haven't been, please post in the Lantus & Levemir Insulin Support Group for a boat load of experienced help.


FWIW, just my thoughts...