Need Spreadsheet 101! What should I look for?

[MikeysMom]

Hello! I recently introduced myself and Mikey, That's him, on the right ->

I have started a spreadsheet for Mikey, who has been on Lantus for a week. We were supposed to the first full curve Friday, but he was under 180, so we didn't inject. Ditto Saturday. I'm sure the curve will help answer some questions. He did get an injection tonight, so I'm going to test a few times before bed, and hopefully a 12-hour curve tomorrow.

However, I'm in need of a little spreadsheet 101. I've looked at some other people's, and I'm not sure what I'm looking for. I mean, I know how to read it, so I guess I'm asking what SHOULD it look like if Mikey is improving? What numbers should I be looking for at what times? I read the hourly expectations for Lantus as far as the curve itself, but what specific numbers am I looking for?

I've read the info on the protocol for tight regulation with Lantus, and I know I'm not ready for that yet. I'm still learning the basics! But I will gladly take any advice anyone can give on what I'm looking at and how to improve even more over time.

 

[ohbell]

You will be able to test a few times tonite right? I would think +2,4,6,8...
His numbers look great! thank gosh you are testing!
And it looks like you got your hypo kit just in case.

 

[Ann & Tess GA]

One of the main reasons we do curves is to determine when the nadir is. This is especially needed for Lantus because the dose adjustments are adjusted depending on the nadir, not the preshot number. the nadir isn't a fixed time, it will typically be at about a 2 or 3 hour range. Curves give you a good idea of when to look for the nadir. But don't count on it staying there. :? :roll:

With Lantus you want to see a gentle curve. A little bump between preshot and onset, a slow drop to nadir and a gentle climb to the next preshot. Lantus tpically has some carryover through the next shot time. When we get it right this carryover fades just as the next onset begins

Quite frankly , it is very possible that Mikey will be bouncing from his 40 tonight and I'm not sure how accurate a curve you will get tomorrow. It may take a few days for him to settle down in his new dose.

 

[MikeysMom]

Thank you. That's a good point about the bounce. If things go well on the new dose, I will do the curve on Tuesday before our Wednesday vet visit.

I guess what I'm confused about is what kind of numbers I should expect at different times if the dose is right, so that I will eventually be able to regulate more tightly.

 

[Ann & Tess GA]

You can't look for specific numbers, what you are looking to see is the trend. w/ Lantus you need to hold every dose change for at least 6 cycles. As you gather more data you will start to be able to predict where Mikey is headed. Then is you see a setup for a drop like tonight, you can give a little extra or a little higher carb food early to slow things down,

Once you start to keep trck of the nadir you can determine increases and decreases as per the protocol:

Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Reducing the dose:
If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
If an attempted reduction fails, go right back up to the last good dose.
Try to go from 0.25u to 0.1u before stopping insulin completely.