? Needing education on why some members increase when in greens?

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Lando demando

Lando demando

Member Since 2021
I am wondering if anyone can explain to me why i see a few spreadsheets where the cats are in the greens, but dosage is increased?
Is this because they are on TR?
I am only asking because i assumed the goal of insulin treatment was to get our cats in the 70-120 range consistently.
This is obviously not an urgent question, i really want to know the WHY of the process.
My guy Lando is SLGS btw

thanks!
 
With TR you hold a dose for 10 cycles minimum after you see green. At that point, you have the option to increase if there's room for nadir to move closer to 50 on human meter (68 on pet meter). Alternatively, you can increase after 14 cycles of mostly green, again only if nadir has room to move closer to 50 on human meter (68 on pet meter). There's no harm in holding a dose in those numbers, but if aiming for true Tight Regulation and/or remission sometimes it's needed to bring numbers down overall (like if preshots are still blue/high)
 
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FrostD said:
With TR you hold a dose for 10 cycles minimum after you see green. At that point, you have the option to increase if there's room for nadir to move closer to 50. Alternatively, you can increase after 14 cycles of mostly green, again only if nadir has room to move closer to 50.
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@Lando demando (and any other readers who might be lurking) Please note that the reference to 50 applies ONLY when using a human meter. This would be a higher number if using an AlphaTrak or other pet meter (as it appears you do).
 
FrostD said:
With TR you hold a dose for 10 cycles minimum after you see green. At that point, you have the option to increase if there's room for nadir to move closer to 50. Alternatively, you can increase after 14 cycles of mostly green, again only if nadir has room to move closer to 50. There's no harm in holding a dose in those numbers, but if aiming for true Tight Regulation and/or remission sometimes it's needed to bring numbers down overall (like if preshots are still blue/high)
Click to expand...
Ok i think this makes sense to me ( that the goal is to be closest to 50)?
So would i be incorrect to assume that getting Lando in the 70-120 with the lowest insulin possible for SLGL is NOT the goal?
 
JL and Chip said:
@Lando demando (and any other readers who might be lurking) Please note that the reference to 50 applies ONLY when using a human meter. This would be a higher number if using an AlphaTrak or other pet meter (as it appears you do).
Click to expand...
Thank you for that clarification! As of yesterday, Lando is now on a human meter.
Great distinction
 
Im not sure why i cant wrap my head around all of this! Ive read all the posts on SLGS and TR and the steps to regulation and remission! Should i just stop worrying about end goals?
 
Lando demando said:
Im not sure why i cant wrap my head around all of this! Ive read all the posts on SLGS and TR and the steps to regulation and remission! Should i just stop worrying about end goals?
Click to expand...
With SLGS you reduce under 90, regardless of meter. You can customize it if you like reductions at something like 70 better (human meter); you can not customize TR (unless there are some other underlying conditions like acromegaly or IAA). Some people find reductions at 90 mean preshots are still too high, but a number like 70 puts them in ideal place.

Another reason people choose SLGS is it's a bigger buffer for safety and generally a little less stressful - some find the lower numbers on TR more stressful to manage, or they're unable to test during day or night should the BG go low, or the middle of the night broken sleep is too much. That can also happen sometimes on SLGS but more infrequently
 
FrostD said:
With SLGS you reduce under 90, regardless of meter. You can customize it if you like reductions at something like 70 better (human meter); you can not customize TR (unless there are some other underlying conditions like acromegaly or IAA). Some people find reductions at 90 mean preshots are still too high, but a number like 70 puts them in ideal place.

Another reason people choose SLGS is it's a bigger buffer for safety and generally a little less stressful - some find the lower numbers on TR more stressful to manage, or they're unable to test during day or night should the BG go low, or the middle of the night broken sleep is too much. That can also happen sometimes on SLGS but more infrequently
Click to expand...
This is so helpful! Thank you!! It really helps me begin to see some things clearer.
 
Lando demando said:
Sure! I didnt want to call anyone out ;) - getting link
https://docs.google.com/file/d/1ji0...MBe4GB/edit?usp=docslist_api&filetype=msexcel
But according to this sheet, i would have guessed the latest numbers were good to hold at
Click to expand...

It has to do with the experience level of the caretaker, their ability to test and the dosing protocol they're using. In the case you're looking at, the "greens" you see are still "higher" greens (like 90's). Those of us doing TR try to get them to be under 120 at Pre-shot (preferably under 100) and in the 60-70 range (with a human meter) at nadir.

There are 2 ways to "earn" reductions...by dropping below 50 on a human meter (68 on a pet meter) on TR or dropping below 90 on either meter on SLGS.

The second way is to be in normal numbers for a full 7 days...for human meter's that's 50-120 (preferably with most under 100) and on a pet meter, 68-150 (with most under about 120)

With Lantus, the saying is "Shoot low to stay low". Take a look at China's spreadsheets. She was a good example of that saying
 
Chris & China (GA) said:
It has to do with the experience level of the caretaker, their ability to test and the dosing protocol they're using. In the case you're looking at, the "greens" you see are still "higher" greens (like 90's). Those of us doing TR try to get them to be under 120 at Pre-shot (preferably under 100) and in the 60-70 range (with a human meter) at nadir.

There are 2 ways to "earn" reductions...by dropping below 50 on a human meter (68 on a pet meter) on TR or dropping below 90 on either meter on SLGS.

The second way is to be in normal numbers for a full 7 days...for human meter's that's 50-120 (preferably with most under 100) and on a pet meter, 68-150 (with most under about 120)

With Lantus, the saying is "Shoot low to stay low". Take a look at China's spreadsheets. She was a good example of that saying
Click to expand...
I am screen grabbing this explanation! Thank you! Obviously i would ultimately love for lando to be in remission, but normal numbers while eating his beloved kibble ( satans tic tacs) would work as well.

thanks again!
 
Lando demando said:
I am screen grabbing this explanation! Thank you! Obviously i would ultimately love for lando to be in remission, but normal numbers while eating his beloved kibble ( satans tic tacs) would work as well.

thanks again!
Click to expand...
I always say normal numbers (or at least under renal threshold) should be goal #1. Get to that point first, then see where to go from there. Remission isn't possible for every cat, but there's no way to know until you try, if your situation allows for it!
 
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