PMPS tends to be lower than AMPS??

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cellosmom

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Just started 1U BID using PZI on my cat. (see spreadsheet) 7am and 7pm shots. Gets fed at 7am, 5pm and 10pm. Mix of fancy feast and DM and always a bit lying around for grazing between meals.

For 3 out of the 4 days I've been doing it his PMPS has been in the yellows (200-300) yet his AMPS seems to be magenta (300+)
I am not able to test at nadir during the day, but at night he is dipping into the blues and greens at +6-+8 so I don't want to up his insulin.

Should I give a shot earlier in the morning?
Any idea's why this might be? Is it OK?
 
Very interesting spreadsheet...
Okay, those couple of cycles where he has dipped into the greens at nadir? Notice that those were on PMPS numbers that were right on the traditional "don't shoot" line, near 200. So on one unit, he's dropping 125 points or so. I am willing to guess that he's dropping about the same amount on the nights you don't have the mid-cycle tests on. Just the PMPS numbers are a little higher on those nights to start with. So, I think that 1 unit looks to be the "right" dose on yellow PS results. More than that and he might go a little too low. For some reason, in the morning he just likes to be 100 points higher. But he's probably getting about the same bang for the buck on 1 unit during the day time too.


BUT, before changing anything, let's talk about his eating schedule. You are shooting at 7AM, which is when he eats. Then you said he eats at 5PM. And again at 10PM? OK. What that should mean is that the 7PM reading you are getting is influenced by the 5PM meal. The number you are getting is (absent of food) probably even lower than you think it is. And then the insulin starts to kick in probably a hour or two after shot time. Then he's eating 3 hours after the shot, which boosts him a little more. But his nadirs are green sometimes at night. That's odd because the way he eats, he should be higher at night and lower at +6 during the day.

I don't think his morning number is higher in the morning because of his meal schedule. His last meal is at 10 pm, which is 9 hours away from the AMPS. Do you leave food out overnight? If so, then maybe he's eating it mostly at like 5 or 6 AM, and that's bumping up his AMPS?

How much does he eat each meal? You said there's leftovers for grazing between meals, right? Does he eat most of it when you put it out, or a little and then back for more multiple times? You might be able to tweak his numbers with food rather than with insulin, if you can figure out when the food is bumping up his sugar.

Another alternative is to either make his doses not equal AM and PM, or maybe consider a "sliding scale" where you adjust his dose based on the PS tests. But let's see if food can be the explanation for his normally higher in the morning readings....

Carl
Carl
 
Hi Carl!

Thanks, that's very interesting.

So it's hard to know exactly how much he is eating each time. I have 2 cats and I have switched the other cat to fancy feast/DM mix as well just to make my life easier. Once I run out of the DM I bought at the vet they will be 100% on FF.

So basically he is a grazer. He will eat a bit when I put it out (I always make sure he eats some right away so I know he is eating, even if I have to warm it to entice him) but then comes back multiple times between meals. Generally there is a tiny bit left each time I go to give a new meal, which I throw out and replace with fresh food.

At each of the three meals I split one 6.6oz can of FF between the cats and give about 1/4 can DM mixed in. But like I said they are generally free to graze. I know he eats a bit at 7,5 and 10 but its hard to say when else during the day/night.

He also gets treats of freeze dried chicken after glucose testing as well as live catnip every so often.

This morning I had to be up early so I tested and shot about 40 minutes earlier than normal and he was only at 253 (see spreadsheet). (around 6:30, usually he gets morning shot just after 7am)

Usually I then test and shoot at 7pm and test again at 12-1am.

I am going to test tonight around 7 like normal, but if he is in the 200 range still I might hold off on his shot for a half hour or so (say give him at 7:30-7:45ish)

And then test again at nadir. and at just before 7am (so the night cycle will be a bit less than 12 hours and the day cycle a bit more) and see if this works??? (ie. shoot 7:00am, 7:45pm)

Does that make sense? so maybe I can gain more control through timing of the shot rather than changing the dose at this point? If you see anything I can do different with his food let me know. I have a 5 compartment automatic feeder
 
weeeell that didn't seem to make any difference. Had two cycles in the magenta so I'm going to try 2-3 cycles of 1.25 and see if that makes any difference
 
If you can get any tests in between shots, that will really help you to make some sense of what's going on
Carl
 
I can only get them at night, I work a minimum of 8 hours a day, usually more, plus getting to/from work I'm out of the house 10+ hours most days and I live alone. I'm doing my best to do middle of the night ones almost everyday, but because of that I've been running on 4-6 hours sleep max. since I've started the insulin so the odd night (last night) I slept through it. Trying on the weekends as best I can as well. Haven't been going out or doing anything, but it's pretty tough when you're on your own. I also have a lot of work trips coming up so I'm getting a bit stresseed. I have a vet assistant willing to help with the morning shots and I'm meeting some people I found on the internet to see if they will do evening shots :(
 
Not criticism. We all just do what we can and keep on dancing! With all you have on your plate, you're doing a super job!
Carl
 
thanks.
going to stay home all day saturday and will try to get daytime numbers, maybe +4,+6 and +8? Just super overwhelmed with it all as it seems to happen
 
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