? Increase dosage?? Low Nadirs

[Summers Mom]

Summer is on lantus and i am doing the TR protocol. She is on 2.25 units 2 x daily. She has been on the 2.25 for 3 days now. The TR says when increasing the dose to hold the dose for 3-5 days IF the nadirs are under 200. My question about that is does that mean they have to have nadirs under 200 for all the days while on the increased dose or does it apply to just one or two of those days? Summer has had low nadir under 200 on day one of the 2.25 units and today she had low nadirs under 200. But her Pmps was back up to 276. I was going to increase her up to 2.5 units in morning but i am not sure. Please help..

 

[Stacy & Asia]

I am not one of the experts, so take my advice with a grain of salt, but I think it's a generalization: you could have one nadir under the number or several. The basic idea is to see what that dose is doing and give the dose enough time that it's clear what it's doing and you're not dealing with a bounce or a funky shot or what have you.

To my eyes, your nadirs under 200 are a technicality, they are so close to being 200 and with meter variance, they could easily be yellow (or a lower blue, but judging from the rest of your data, more likely to be closer to yellow). I would think an increase is in order, but please don't take my word for it and see what others have to say.

 

[Summers Mom]

I am not one of the experts, so take my advice with a grain of salt, but I think it's a generalization: you could have one nadir under the number or several. The basic idea is to see what that dose is doing and give the dose enough time that it's clear what it's doing and you're not dealing with a bounce or a funky shot or what have you.

To my eyes, your nadirs under 200 are a technicality, they are so close to being 200 and with meter variance, they could easily be yellow (or a lower blue, but judging from the rest of your data, more likely to be closer to yellow). I would think an increase is in order, but please don't take my word for it and see what others have to say.

Thank You.

 

[Chris & China (GA)]

We're shooting for nadirs in green, so since most of yours are yellow (or close to it) you'd want to go ahead and increase in the morning to 2.5

If you start to get some low blue nadirs, you'd want to hold the dose for 8-10 cycles