Morning Surprise! When to Shoot and How Much?

[Blamethecats and Hannah]

Well, just when I think I have my little girlie figured out, she gives me a morning surprise -- an AMPS number of 229 on the AlphaTrak. One hour later, right after her morning meal, it's 211. I know that's still an up-there number, but for Hannie, it's lower and something new. That has never happened and has left me pretty much happy but wondering what to do, next. As you can see on her spreadsheet, she's usually in the blacks, reds, and pinks at 7:30 AM, so there is no hesitation to go ahead with her shot. I read somewhere on this forum that the cutoff for insulin, for beginners, on the AlphaTrak, is 230. Therefore, no shot this morning, especially after that 211. Thought about giving her a very small dose, but then chickened out. My question is this: Do I let her go all day without insulin? I expect her numbers will increase throughout the day and I will be monitoring. Do I wait until her evening dose at 8:30 PM, and then how much do I give her? She usually gets 0.8 U in the morning (ProZinc), then 0.4 U in the evening. I expect by this evening, she will need more than the 0.4 U? Last evening, I increased her dose, slightly, giving her a nice, fat 0.4 U. Maybe that explains the lower number this morning? She also vomited a large hairball sometime, early this morning, before we got out of bed. Suggestions will be so very much appreciated, as I am so uncertain about all of this. You folks on this board are so helpful and experienced and I really trust your advice.

 

[Sue and Oliver (GA)]

You can shoot when she is at a number you are comfortable with IF you can wait 12 hours to shoot again. You can wait till the regular time, but yes, she will be likely high. (If you do that, I wouldn't increase). Or you can shoot a smaller dose (maybe .2) when she is above 230 and check at the regular time. If it's been at least 8 hours by your regular pumps and she is clearly rising, you could shoot then, but maybe less than usual. With any option besides the skip one, I'd plan to monitor

 

[Blamethecats and Hannah]

Sue, thanks for your reply and suggestions. I felt better after hearing what you had to say. I chose to not give her any insulin until it was time for her evening shoot, as had a very busy day and didn't have time to do the proper monitoring. By 8:30 PM, her BG was very high, as we figured it would be. Gosh, I wish I was better at this dosing/timing/decision thing! I am just so afraid that I will make the wrong choice and make matters worse. I am hoping I will eventually get better at this (sigh). All in all, other than that high evening number, she had a very good day and acted like her old self. We will see what tomorrow brings. Thanks for being here for us!

 

[Sue and Oliver (GA)]

You'll get it. it's hard. Next time, you'll know your options when you get a little lower number. Remember that you can always stall, waiting 30 minutes without feeding (because food can raise bg levels) and retest. Then if the number is up, shoot but maybe a smidge less. That's always the easiest and best choice if you get a little lower preshot.