That's some climb. Interesting when you look at it on the spreadsheet it really looks like it's continual rebound from the 98 on Sunday. He pretty much kept going up and up. He had enough shed on Sunday to keep it level, but I have seen this delayed rebound myself. It's very confusing because when it comes after a dose reduction it makes you think you shouldn't have lowered the dose.
Despite how it looks, he could have also had a low Monday AM between +5 and +11 which would compound the problem. I see no other reason for the 500.
I don't recall where we're at with his overall health. Sorry. If you can get a couple ketone tests in during this period, that would be good. Are teeth an issue? Urinary issues? I suspect not because he's getting good action from the Lev.
If you can hold the 1U through at least tomorrow, that would help. You're good at getting frequent tests and that's very helpful. What we're looking for is for his cycles to level off, maybe in the 250s, 300s, but level. That may take well more than 3 days. As I look down your dose columns I wonder if the constant dose changes aren't a huge factor right now. In May you did a good job staying on dose, then I see 5.28/5.29 where it looks like he had a several day cycle similar to the current one where he had an AM green then kept climbing.
The very frustrating thing is that Levemir works so well it is not going to cause full blown hypos on possibly even double the best dose! We see this a lot. But the body thinks it could, so up and down the bounce mobile we go. Gandalf had a 65 that I caught yesterday because he's not eating well and by shot time he was over 300!
I say that because I'm sure you're wondering why if 2.25U was too high of dose why didn't he have truly low numbers. You can think of this like a tug-of-war between Levemir and the liver. Levemir wants to maintain a level blood glucose. Too much means it's going to want a pretty low level, but the liver responds to that as if Levemir is putting the body in danger. Then Levemir says, Oh no you don't, so it tries to gain a foot hold, but the liver tugs back and then you have high BGs for a while because Levemir can't keep up.
And when you've been using it for a long while under these conditions, it takes even longer to get the liver comfortable with reasonably low numbers. That's why he's having bounces off 80s and 90s. The liver has tipped the scales so high, it only feels comfortable in the 300s!
The past few weeks illustrate this very well. He was doing well on 1U, but because he began having lower preshots, you lowered the dose to .75U which couldn't keep up, but once you got up to 1.5U his liver went bonkers. So you go back to last best dose, which was 1U, to get things under control again.
easier said than done 'cause I know those 500s are hard to see. :YMHUG:
