Need info about switching to TR

[Lisa and Witn (GA)]

Charlie has been giving me a few great numbers lately, but some of them are occurring at shot time and are too low to shoot. This morning was a 48 at AMPS. He ate and I am stalling for a while to see if it comes up enough to give a reduced dose. He does get another meal around PM+4 each night.

Because of this, I think I may need to consider switching from SLGS to TR. Can someone explain how TR works, including how you decide how much insulin to give the BG are at a certain level?

Thanks.

 

[Sienne and Gabby (GA)]

With TR, you don't use a sliding scale for the dose (if I'm understanding your question about how much insulin to give). Essentially, the dose is the dose unless the numbers are too low to shoot. Dosing with Semglee is based on the nadir, not on the pre-shot number and this is the case with SLGS as well as TR it's just that the points for a dose reduction differ.

Do you know if Charlie was diagnosed more than a year ago? I'm double checking since it's not in your signature and your SS says July 2021. If so, the dose reduction point differs than if he's within of year from diagnosis.

• Dose reduction occurs if numbers drop below 50 if within the first year; reductions occur if numbers drop below 40 if more than a year post-diagnosis.
• Doses are held for 3 - 5 days and evaluated to gauge if a dose increase is needed. (It's a week with SLGS.)
• With TR, you work your way down to shooting any number that's over 50. (So when you skipped the PM shot on 9/23, with TR would would have likely coached you to shoot.)
• With both methods, you need to get at least a "before bed" test every night.
• In the vast majority of situations, dose changes are in 0.25u increments.

Let me know if there are other specific questions.

Remember to reduce Charlie's dose given the AMPS of 48.

 

[Lisa and Witn (GA)]

Yes, I plan to reduce his dose. Just checked him at +2 and it is only up to 107 so no insulin this morning. Years ago in 2006 when Witn and Spot were on Lantus, they would do something similar on Lantus. At least once a week, they would have a low PS number that was too low to shoot. My vet at the time thought I was crazy when I noticed this pattern until she saw the data herself, especially since I had two diabetic cats at the same time doing that. I don't remember if TR was known about at that time, I was using what is now SLSG.

 

[Sienne and Gabby (GA)]

TR was popular when I joined in 2009. You might take a look at Jill & Alex's SS. It's still linked. I think she was the first to use TR.