? Please help review spreadsheet

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Gouda Cat

Gouda Cat

Member Since 2016
Hello. My Gouda started lantus January 10 after his N stopped working after a nasty uti. He's had two dose decreases because of dropping too low. Now he's high on this new dose. It is very new though so I don't know if he's still adjusting. Please keep in mind I have MS pretty bad and super tight regulation is nearly impossible for me. I'm more of a start slow go slow approach. What do you think of his spreadsheet?
 

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Not a spreadsheet expert by any means, but it looks to me like you are on the right track now. I think the Lantus was probably increased a bit fast (esp. given where you were on the N), my guess is that his numbers were elevated a bit due to the UTI for a while, and then of course it always takes time for the Lantus depot to settle in, so it looked like he needed increases. You even increased from 1.75 to 2.0 despite him earning a decrease (under SLGS) on 2/12, bringing him even higher in dose. It's clear that the 2.0U was too much, so it's good you are stepping down from that. He's even technically already earned another decrease from 1.5U on the 25th (but I agree with the decision not to take it, given that you'd just stepped down from 2-1.75-1.5 in the previous couple days-- could've just been the depot talking).

I would just stick with the SLGS approach for now-- keep getting those mid-cycle numbers, and decrease (or increase, if that happens) by 0.25U depending on what those numbers tell you. Gouda was pretty well regulated on N, which isn't easy to do, so I'm guessing that once you find the right dose of Lantus, he'll be well-regulated on that, too.

Beautiful kitty, by the way!
 
Nan & Amber said:
Not a spreadsheet expert by any means, but it looks to me like you are on the right track now. I think the Lantus was probably increased a bit fast (esp. given where you were on the N), my guess is that his numbers were elevated a bit due to the UTI for a while, and then of course it always takes time for the Lantus depot to settle in, so it looked like he needed increases. You even increased from 1.75 to 2.0 despite him earning a decrease (under SLGS) on 2/12, bringing him even higher in dose. It's clear that the 2.0U was too much, so it's good you are stepping down from that. He's even technically already earned another decrease from 1.5U on the 25th (but I agree with the decision not to take it, given that you'd just stepped down from 2-1.75-1.5 in the previous couple days-- could've just been the depot talking).

I would just stick with the SLGS approach for now-- keep getting those mid-cycle numbers, and decrease (or increase, if that happens) by 0.25U depending on what those numbers tell you. Gouda was pretty well regulated on N, which isn't easy to do, so I'm guessing that once you find the right dose of Lantus, he'll be well-regulated on that, too.

Beautiful kitty, by the way!
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Ok so you think I should I stick with the 1.5 for now even though he's been higher recently? This insulin is sooooooo new to me. I seriously need a mentor.
 
I do think you should stick with the 1.5U for a while-- under SLGS, you hold doses for a week (unless BG drops below 90 during that time, in which case you take an immediate reduction), then do a curve to determine what to do next.

There are two things that make Lantus different from what you are used to. First, there's the depot-- you really need to give Lantus at least a few days on any particular dose before you can really see what that dose can do, because the depot needs to fill (if you've just gone up in dose) or drain (if you've gone down). Changing doses rapidly can make it more difficult to figure out patterns.

Second (relatedly), we don't determine doses based on the pre-shot number on a given day-- we only use the pre-shot number for basic safety, making sure the number is high enough to shoot. We assess the dose based on how low the numbers go in a cycle (the "nadir"). The weekly curve and mid-cycle spot-checks are therefore critical. High pre-shot numbers, on the other hand-- well, we don't like them, but they aren't the most important numbers for assessing the dose and deciding whether to change.
 
Ok thank you SO MUCH!!! I've been so lost and I think I've irritated my mentor with all my questions so I came here. I'll stick with 1.5 then for a while. I'm doing his nadir pretty soon. Yesterday's wasn't so good, but the dose is new. I'll see how things go after a week or so. Can the curves be every 3 hours?
 
Thank you so much. It's hard with my illness to stay up that long but if I don't have to do it often it's ok
 
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