Re: Kitty 6/26 amps +4 pmps
I would keep at it with the dose. You are seeing good U-curves, and there were a few where you got a good drop. If you hit a point where the drops are too steep then you consider a longer-acting insulin. Since the nadirs are high though, there is oodles of room for a higher dose.
Other options are to shoot TID - that has worked really well for Wombat, but is difficult to manage from a scheduling & cost standpoint.
You could also try a different insulin if you wanted. That can be trading one set of problems for another, but you might find the protocol and wealth of advice on the Lantus board (not sure how the Lev board runs) helps you get the dose. They are pretty rigorous I think about the approach, we are more laid-back here, which can be a problem even if it is more comfy.
Or you can try adding a fast-acting insulin like R. Also comes with more testing though, and if you are struggling with feeling scared to shoot, I'm not sure that's a good solution for you.
I can tell you what I would do. I would go back to the dose where you got the drops that looked a hair steep and start there, and if the drops are still steep I would try to manage it with food. Then if the nadirs are still above 50 (which they surely will be), I would increase in 0.2 increments every 3rd day (work schedule permitting) until I was seeing the nadirs I want. Then if they are coming with steep drops I would reevaluate either shooting early, or switching insulins.
My guess is that if you can get her in better numbers she will be on a dose reduction path. We see it all the time that they get sort of "stuck" in higher #s and need more insulin to bring them down, but once in good #s, don't need as much insulin to sustain it. Just a guess though.