? Joshi PMPS 170 - dosing advice

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LaraB

LaraB

Member Since 2015
I tested Joshi's PMPS and her BG is at 170 (read, twice, on a Relion Confirm). She is currently on 3U of vetsilin twice a day. What I remember reading here is that you should give insulin when the BG is below 200 - is that correct? I would rather err on the side of caution. I went ahead and gave her her normal food and might test a little later.

These past 2 weeks, her insulin schedule was slowly adjusted later because we were going to be out past her normal shot time last Monday. After Monday, we slowly shifted her schedule back to normal. I'm hoping this didn't throw her out of whack. She's been particularly perky this week, so I know she isn't feeling poorly.
 
Next time, you can try stalling. Wait 20 minutes without feeding (food raises blood glucose levels) and retest. If she is rising and above 200 , then you can shoot.
 
Okay...40 minutes after feeding, her BG was up to 245. I gave her 2.5U rather than the full 3U to be safe, but I'll test her afterwords a few times. Hopefully that was not a dumb decision.
 
It should be okay, but I would definitely get a test before going to bed so if she is going to drop, you can catch it.

We'd definitely suggest testing before each shot, to be sure the dose is right for the number. She does seem to drop mid cycle; getting some more data would help you see whether the dose should go down a smudge or not.
 
Yeah...the AM shots are an issue. I go to work before her morning dose, so my mom is in charge of the morning routine. Unfortuantely, my mom STILL will not do BG testing. I'm not happy about it. :( She's so worried she will do it wrong...even after I've showed her numerous times. *sighs* I may have to start doing a test before I leave, even if it's an hour or more before her shot.
 
LaraB said:
Yeah...the AM shots are an issue. I go to work before her morning dose, so my mom is in charge of the morning routine. Unfortuantely, my mom STILL will not do BG testing. I'm not happy about it. :( She's so worried she will do it wrong...even after I've showed her numerous times. *sighs* I may have to start doing a test before I leave, even if it's an hour or more before her shot.
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I understand... I just rearranged my schedule to get a +1 before I go to work:cat:
 
Crap! BG PMPS+2 is at 76. Fed her some Temptations treats. 20 minutes later, BG was 60. I had some higher carb wet food - mixed some Karo syrup in with it. She ate it readily, thank goodness. So far, I'm not seeing any symptoms, but I'm watching her like a hawk.

I'm so angry with myself right now. I should have gone with my gut and skipped the dose tonight. Not going to be sleeping anytime soon. And I REALLY hope this gets through to my mom why she needs to be testing, too. I'm a little upset with her right now, too. Going to have serious talk about this with her - I work full-time so I'm not always going to be around if things go wrong. This just adds yet another level of stress that Joshi and I don't need.
 
LaraB said:
Crap! BG PMPS+2 is at 76. Fed her some Temptations treats. 20 minutes later, BG was 60. I had some higher carb wet food - mixed some Karo syrup in with it. She ate it readily, thank goodness. So far, I'm not seeing any symptoms, but I'm watching her like a hawk.

I'm so angry with myself right now. I should have gone with my gut and skipped the dose tonight. Not going to be sleeping anytime soon. And I REALLY hope this gets through to my mom why she needs to be testing, too. I'm a little upset with her right now, too. Going to have serious talk about this with her - I work full-time so I'm not always going to be around if things go wrong. This just adds yet another level of stress that Joshi and I don't need.
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Don't beat yourself up.... you got her bg up and your doing great!
 
Okay, I think we will be okay. She's at 154 PMPS +3.5. Thankfully she didn't show any symptoms of hypo, but I wasn't going to risk it.
 
Lara,

I am glad you got a pre shot this morning. It looks like a bounce from those lower numbers last night. If you can't be around, you might try 2.5 for this red and see how it works. Then, it looks like you need a lower dose for a yellow pre shot next time. (With Vetsulin you can use a sliding scale and shoot a different amount for different pre shots). With most insulins, the low number that triggers a new lower dose is 50. But since you are using Vetsulin, and her drop was fast and harsh, I'd move with caution and give her less on a yellow.

My thinking here is that you can always raise the dose the next cycle if it proved to be too low, but trying to deal with a low number after a dose that was too high is scary, as you found out. It is difficult to decide how much to lower a dose; home testing makes it much easier to decide how much to add if needed.
 
Sue and Oliver (GA) said:
Lara,

I am glad you got a pre shot this morning. It looks like a bounce from those lower numbers last night. If you can't be around, you might try 2.5 for this red and see how it works. Then, it looks like you need a lower dose for a yellow pre shot next time. (With Vetsulin you can use a sliding scale and shoot a different amount for different pre shots). With most insulins, the low number that triggers a new lower dose is 50. But since you are using Vetsulin, and her drop was fast and harsh, I'd move with caution and give her less on a yellow.

My thinking here is that you can always raise the dose the next cycle if it proved to be too low, but trying to deal with a low number after a dose that was too high is scary, as you found out. It is difficult to decide how much to lower a dose; home testing makes it much easier to decide how much to add if needed.
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Yeah, I know now that I won't shoot 2.5u for sure with a PMPS of less than 200. :confused: Here shot is supposed to be at 7:30 this morning, so my mom probably gave her the normal 3u.

The Vetsulin was the original vial we got back in December - could it possibly have gotten more concentrated? We do have a new one ready, so perhaps we should start using it. I worry that having to modify her schedule temporarily may have thrown her system off a bit, too. Needless to say, I'll be doing a BG curve this weekend to see what's changed.
 
It'll be good to see your curve.

I have not heard of insulin getting more concentrated. It usually gets less effective as it gets older. The better numbers could just reflect that her body is adjusting to the insulin and "learning to use it better". Or the transition to wet low carb can often make a shift downward.
 
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