Need Help With Tonight's Dosing Amount

[Blamethecats and Hannah]

It was quite a day for Hannah. For starters, she didn't want to eat. Stuck her nose up at her breakfast, but that's not all that unusual. She acted quite normal, so I assumed her appetite would kick in after her usual dose of Cypro. It usually works that way, but today it didn't. I gave her a fat .8U after her AMPS of 342, even though she was still dropping from the previous night's dose. That was probably a BIG mistake, although I've done it before when her numbers are high and have had no noticeable issues with that type of dosing.

By +3, she still wasn't eating, so I gave another small scrap of Cypro. She still acted good, and by then, she had dropped to 97. That got my attention!!! By +3.5, 90. By +4.5, 83. That sent me into near-panic mode and I broke open a can of FF Gravy Lovers. The last time she did this back in June, we ended up at the ER. Gave her about 1/2 can and she licked up the gravy, leaving most of the sliced stuff. At +5, she had risen to 91, kept rising, and is now at 460 at +9. I am at a total loss as to how much insulin to give her this PM (less than 2 hours from now). We sure could use some advice from those of you in the know. Do I lessen the dose because of today's unusually low numbers? I am so confused and nervous right now, my head is spinning... plus I don't expect her to eat much of her PMPS meal. Suggestions... and hand holding, please.

 

[BJM]

What I think may be helpful is to review her numbers to see how much of a food spike she gets when she eats regular food, vs higher carb food. See what you come up with after doing that.

She's likely to be high tonight with that half can of high carb food and may do fine with her regular dose. Typically, you want to use measured amounts of high carb when you think she might be diving down too low, maybe just a couple of teaspoons, every 30 minutes until it slows down the drop and levels out. We call it steering the curve.

Also, when the glucose leaves the blood stream, it tends to provoke some hunger just from that, so you may have the option of doing a couple of mini-meals of low to medium carb, rather than a full half can of high carb You'll just have to make observations to see what works for her.

Also, take a look at ranges of pre-shot glucose, dose given, and amount of drop. It may be possible to work out a sliding scale where based on her data, a higher pre-shot gets a slightly higher dose.

 

[Sue and Oliver (GA)]

I think .8 might be okay. Might be a little too little but because it's probably partly the high carb and partly a bounce, I don't think I'd increase. She seems to take a fully day to come down off a higher cycle so I think I'd just wait it out.

I would guess your lows today are probably because she didn't eat. Sometimes that can really reduce the numbers.

 

[Blamethecats and Hannah]

Okay, thanks so much, BJM and Sue!! Was relieved and a little less stressed when you both replied to my post. As you suggested, I went ahead with the usual 0.8U. If she goes rapidly "green" on me again and keeps dropping, I will give her the suggested 2 tsp. every half-hour until she starts to rise. I sort of panicked this afternoon and had no idea how much to give her to steer her out of it. What bothered me most was that she hadn't eaten much in about 12 hours and I knew I had to get her eating... somehow. Tried her regular FF, but she wouldn't eat it, so went for the gold. Wow, did she ever love that Gravy Lovers FF.

Tonight's PMPS meal of FF Chicken pate went well. She ate all of what I gave her, then went back for a little more. Her number was high at 470, but only went up 10 points since the previous reading 2 1/2 hours earlier.