New Scale for Lucy?

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123joan

123joan

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I went a teeny bit down (just .2) from the scale I've been using, based on yesterday's idea
I'm thinking the scale needs to be adjusted "down".
Click to expand...
Today 9/3/12
AMPS 384
1.4 units
Should I be looking at a revised scale? I just revised it on my own for a one-time-only. It was so EASY having the scale to work with. Then her super green numbers yesterday threw me for a loop.
 
Do you mean this one time only adjustment, then go forward with the normal scale? Ha! NORMAL.
 
Normal. What a laugh, eh? Especially when it comes to feline diabetes! ohmygod_smile

Yes, I would scale back .2 on the whole scale.

Remember seeing the term "bounce"? On August 29th, see how Lucy started with 344 then dropped to 175 then jumped up to 435 for PMPS? I'd bet that was a bounce. :smile:
 
I like lowering the scale, but maybe keep the top two doses the same and lower for the lower ranges?

200-250 .4
250-300 .8
300 - 350. 1.4
350+ 1.6

It is hard to tell because of the two pmps numbers we are missing with the petsitter. She went low after the second one. You may be able to tell tonight after giving the 1.4 for the 384 to see if it was enough. One thing that seems to complicate things for Lucy is that sometimes she seems to react to a little more agressive dose on the second cycle, not the first. And anytime you can get a night time number, it helps you see the complete picture. The lowest numbers we have seen are amps; I just wonder if it's because she goes low at night or because she has less food or less excercise....

Teresa has a good point. If she is high after a green midcycle, you abandon the scale because you don't want to shoot a higher dose into a number that is bouncing. That's the time to be more conservative.

Let's see what others think.
 
Here she is PMPS and she is 192. What to do? Of course I'm going to wait a half hour and test her again.
 
I've quit feeding them in the middle of the day. So now they are eating twice in the first hour after am shot, then right after the second shot, then again at +3 or so after the night shot. So they are eating three times a day (including their extended breakfast). Been doing this for one week now.

I do not understand the bouncing concept. I can't get it.
 
That answers that question! So you will want to lower all the scale by .2

192 is very close to 200. I would try waiting without feeding to see if she starts up.
 
I waited a half hour and it went DOWN to 159. I had to feed them as we are leaving for 2 hours
 
So this is VERY good news. It means her pancreas has decided to work, at least part time. (Sometimes it joins the party and helps lower the numbers for awhile, when the insulin should be long gone and then rests for a while and then comes back. So I would definitely skip tonight.

When you get home from your evening out, you could look at this bouncing info:

Bouncing is a hard concept to get your head around. I stole this from Carl in an earlier post:

"Sebastian's body, over the time he's been diabetic, has gotten used to BG numbers that are way above normal. When you shoot insulin, it pushes the BG down like it is supposed to. His body has built-in self-preservation systems in place to protect him from BG numbers that are too low. Now, these numbers don't have to be "hypoglycemia-like" too low. They are just much lower than he's become used to.
What happens is that his pancreas and his liver sense a falling BG, and they produce "sugar" in simple terms, that goes into the blood and makes the numbers rise. Because his systems are so messed up, due to the diabetes, sometimes they overreact, and we call this "bouncing". The numbers go fairly high within the next few hours.
What you end up seeing is a high number at shot time, but it is primarily caused by this "bouncing" process, and we tell people not to react by shooting the bounce. In other words, don't increase the dose just based on the high number, when it looks like the high number was caused by a low number from the previous 12 hour cycle."

If you are still unsure, we can ask him to give us some more "science stuff" to explain it. :mrgreen:
 
How about this for a revised scale?

Above 350 1.2
300-349 .8
251-299 .6
200-250 .2
You could, if you are comfortable doing so, probably shoot that .2 on a lower number than 200, like maybe 175?

The 445 last night was due to the green AMBG number, and at some point she may have been even lower than that. So, she "bounced". Also, she had gone 24 hours with no insulin, so the high number makes logical sense. You did right by not shooting a higher dose on that higher number.

One more thing about bounces. Sometimes it can take a day or two for them to go away. In addition to the "sugar" (glycogen and glucagon) that her pancreas and liver dump, there are also "counter-regulatory hormones" that are produced, and those can take a couple of days to go away. The 384 you saw this morning could have been part of a "long" bounce. Tonight's PMPS number looks to me like the bounce has "cleared".

Normally, I don't suggest adjusting all of the numbers in a scale either up or down all at the same time. Because in some cases, you will not have had a chance to try every dose because her numbers haven't forced you to. (in other words, you don't change a dose until you see data that shows it doesn't work). But in this case, it looks to me like less insulin overall seems to be what the numbers are saying.

Carl
 
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