Kitty 3/22 amps 370
- Thread starter kse
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Sue and Oliver (GA)
Very Active Member
At least we are out of the 400-500s. We'll take it, right? :mrgreen:
You can try a .5 raise (or lower) when you need to so it isn't so big a jump next time.
You can try a .5 raise (or lower) when you need to so it isn't so big a jump next time.
kse
Very Active Member
Yes, we will take it! I know ideally I want the lowest numbers possible, but due to the DKA recently , I am actually more comfortable shooting in the mid 300 range. I feel, at least I am getting enough insulin in to keep the ketones away and I think the preshot number is very workable. Mid 300s mimic her earlier numbers.
She feels really good this morning.
She feels really good this morning.
Kelly & Oscar
Very Active Member
Great yellow preshot last night! I agree with adjusting by 0.5u when you get a lower number like that. So glad not to see those pesky 500s! *anti jinx*
kse
Very Active Member
Someone please help me understand something regarding the numbers.
I know I am over simplifying--but, assume I shoot 3 units on a 500 preshot and I get a drop to 250. Then assume the next preshot my test was 280. Is it fair to assume that if I shot 3 units again, I am in danger of that same 250 drop or is it based more on percentages? I am just trying to understand the adjustment phase of this.
Thanks!
I know I am over simplifying--but, assume I shoot 3 units on a 500 preshot and I get a drop to 250. Then assume the next preshot my test was 280. Is it fair to assume that if I shot 3 units again, I am in danger of that same 250 drop or is it based more on percentages? I am just trying to understand the adjustment phase of this.
Thanks!
Kelly & Oscar
Very Active Member
No, it doesn't always equal to the same drop if you have a change in preshot numbers. Usually also, there is a bit of an increase in the first few hours after a shot too that needs to be taken into account. I can't explain why the drop isn't always consistent.
The PZI sliding dose protocol tries to account for lower preshots by giving a lower dose, but the lower dose will also usually not last as long as the higher dose in the beginning too. Each kitty has an optimal dose. Slightly higher than that optimal dose, you will usually see a late nadir and more toward a 12 to 14 hour duration. Slightly lower than that optimal dose, you will see an earlier nadir and a duration more like 10-12 hours. Finding the goldilocks dose usually means oscillating between those two until you zero in on it. It takes time and lots of data collection. Very few can just zero right it on it from the beginning.
With a lower preshot, a dose reduction judgment can also be based on if you were able to get spot checks in during that cycle. If the nadir is at or around +12 or the number is still slightly dropping, a reduced dose is definitely warranted. If the number is rising, then you have the possibility of shooting the full dose. The first time you do this though, make sure you will be around to test and monitor. Instances like this are data collection for you, so you know what a full dose will do with a lower preshot. Hope this makes sense
The PZI sliding dose protocol tries to account for lower preshots by giving a lower dose, but the lower dose will also usually not last as long as the higher dose in the beginning too. Each kitty has an optimal dose. Slightly higher than that optimal dose, you will usually see a late nadir and more toward a 12 to 14 hour duration. Slightly lower than that optimal dose, you will see an earlier nadir and a duration more like 10-12 hours. Finding the goldilocks dose usually means oscillating between those two until you zero in on it. It takes time and lots of data collection. Very few can just zero right it on it from the beginning.
With a lower preshot, a dose reduction judgment can also be based on if you were able to get spot checks in during that cycle. If the nadir is at or around +12 or the number is still slightly dropping, a reduced dose is definitely warranted. If the number is rising, then you have the possibility of shooting the full dose. The first time you do this though, make sure you will be around to test and monitor. Instances like this are data collection for you, so you know what a full dose will do with a lower preshot. Hope this makes sense
Sue and Oliver (GA)
Very Active Member
Good explanation Kelly. Although I would argue that just when you find that Goldilocks dose, things may change within a few cycles and you may have to go looking for it again. :mrgreen:
Joanna & Bix (GA)
Very Active Member
Kelly put it great!
To some extent you can go by the % drop. You are generally looking for something in the 60-65% drop range, though ECID applies. Bigger than that is usually too steep, shallower than that and you likely won't get a very good nadir. On a lower PS there is typically more upward pressure on the BGs so to speak, so from a higher PS sometimes they will sort of free fall down to the nadir, vs. on a lower PS the insulin is countering that upward pressure rather than really dropping the #s down all that far (varies by the zoom rate they are having). That's kind of made up, but that's how I picture it, if it makes any sense.
I would lower slightly on a lower PS as you collect data, but not by a lot. Shoot the most you feel safe shooting and then get some spot tests in, and then if it isn't enough you will know you can increase for next time you see a similar PS.
To some extent you can go by the % drop. You are generally looking for something in the 60-65% drop range, though ECID applies. Bigger than that is usually too steep, shallower than that and you likely won't get a very good nadir. On a lower PS there is typically more upward pressure on the BGs so to speak, so from a higher PS sometimes they will sort of free fall down to the nadir, vs. on a lower PS the insulin is countering that upward pressure rather than really dropping the #s down all that far (varies by the zoom rate they are having). That's kind of made up, but that's how I picture it, if it makes any sense.
I would lower slightly on a lower PS as you collect data, but not by a lot. Shoot the most you feel safe shooting and then get some spot tests in, and then if it isn't enough you will know you can increase for next time you see a similar PS.
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