? Nala hypo again

[Mancat]

She came in with a late blue so I reduced her dose by half but she's going hypo again. I'm working on getting more nadirs with my new work schedule but I'm really struggling with regulating her. Her highs and lows are all over the place. I'm worried and I feel terrible because I'm not intentionally putting her in a hypo position but it seems to keep happening now. The last time she came in with a blue like this I gave her the same half dose and she was fine. She's ok right now. She dipped low enough to warrant syrup over food (51) so I gave her some. She's wide awake and playful (number is now 163 and rising) but this is not good. I feel like it was ok for awhile but I feel like I can't get a handle on it. I want to get some nadirs and possible skinny shots in but I'm having a hard time finding a base point to work with.

 

[Sue and Oliver (GA)]

So those numbers aren't on the spreadsheet? What was amps? Dose? When was the 51?

 

[Rachel]

Hmmm...it's hard to tell what happened to cause that preshot. As for why it has worked before but not now...well it could be anything. Did she eat well? It could just be that she's feeling better so the insulin was able to help bring her lower than last time. It could be that she was still dropping at preshot and then the insulin added to it. Maybe if you get that lower number stall...even 10 or 15 minutes without food...and then retest to be sure she is rising?

If she was mine, I think I'd try to grab a curve this afternoon. See if that will help you figure out what's going on.

 

[Mancat]

Sorry, Sue. I was worried about making sure she was ok and forgot to put the numbers on the spreadsheet. I updated it now. It was her PMPS which came in at 157 and I reduced the dose to 1. I had previously shot blues with a reduced dose and had no issue but this time was different. The 51 was at +2.5 and then tested her again at +3.5 and it was 163.

Perfect timing, Rachel. I was just replying to the original message. She ate fine. She's always had a great appetite except the issue a couple weeks ago with the tummy bug. She buries her face in the food and ends up with it all over her nose. Appetite is no issue lol. Fortunately I am working from home today so I'll grab a +7 curve and see where she's at. I haven't gotten many in the 6-8 range.

 

[Sue and Oliver (GA)]

Great. I wasn't sure "where" we were. I had been interested in the last two pmps lows when you shot and he went up. That's not usual. Last night's numbers are more common. I'm with Rachel. Before shooting a lower pre shot, stall without feeding and make sure it is going up, not still falling. This amps is definitely a response to the low last night.

So, looking back 2 units looks good for the mid to higher 300s. It may give you a lower pmps but stall and shoot later. Getting the later cycle numbers Rachel suggested should help you see if there is a low late nadir in there or whether the pmps is the nadir. (Shooting +13 at night and +11 in the am may work well for you on cycles like that. Give a tiny snack and stretch the feeding/shooting for an hour if necessary. Catch the amps before it gets too high.)

My thinking is that if you work with the lower pmps and compensate with an earlier shot am, it may balance things out on those cycles and continue the downward trend. That's what I see - a general downward trend with the resulting bounces. But a downward trend is good. It's good that you are needing to reduce the dose. Things are starting to work!