Prozinc Dosing Advice

[Hshray]

(This is my previous FDMB thread: https://www.felinediabetes.com/FDMB...am0PJC_o7d33gsTyILx9uhr39z16sIpWGJxz05_b_5JQs)

I posted on Facebook and got some responses regarding George’s inconsistent numbers. I have some specific questions based on that:

1 - should I stick with 3.25 units for a few days or go back up to 3.5 (with MPM a dose decrease wasn’t technically warranted although he did get to 71).

2 - even if he’s in the yellows and blues at pm should I stick with that dose? It seems like a lot considering it can bring him down 300 points, but you all know best.

3 - do you think that MPM is the best dosing method for George? Previously on SLGS it seemed like we were spending a lot of time making not very much progress, spending at least 10 cycles on each dose, but maybe that’s ok and he needs more time than that? I don’t know.

 

[Chris & China (GA)]

1 - should I stick with 3.25 units for a few days or go back up to 3.5 (with MPM a dose decrease wasn’t technically warranted although he did get to 71).

As long as you're getting nadirs less than 300 (pink), your dose increases should be in .25 unit increments, so I'd go ahead and try the 3.25 for at least 6 cycles.

2 - even if he’s in the yellows and blues at pm should I stick with that dose? It seems like a lot considering it can bring him down 300 points, but you all know best.

If he's over 200, shoot the scheduled dose. Remember, you're going to be feeding him next which will usually bring that number up some before the insulin even has a chance to start working, but if you're concerned, get a +1 and +2 to start with. If you get a number you're unsure about, you can always Stall, DON'T feed and test again in 20-30 minutes to see if the number goes up without the influence of food. That's a pretty good indication that the last shot is wearing off and it's going to be OK to shoot the scheduled dose. Also use that time to post here with a good subject line like "STALLING! NEED HELP!" to get somebody's attention. Once you have that, you can go back and edit your subject line and just keep the latest test results in it like "Date, Name, PMPS ###, +1 ###, +2 ###....etc"

As you gain more experience and get more data, that "stall point" starts to come down. You gradually learn to shoot lower and lower Pre-shot numbers.

3 - do you think that MPM is the best dosing method for George? Previously on SLGS it seemed like we were spending a lot of time making not very much progress, spending at least 10 cycles on each dose, but maybe that’s ok and he needs more time than that? I don’t know.

The MPM method offers you the chance to change his dose more often....if after 6 cycles he's still not getting the results you want, you can increase so while it IS a more aggressive method, it also means having a better chance of getting George's numbers under control sooner as well as less chance of developing glucose toxicity. The MPM has built in controls too...if his nadirs start to be in the lower blues/greens, you would hold the dose a few cycles longer.

If you try the MPM and decide later it's just not for you, you can always go back to SLGS. You're not locked in.

 

[Hshray]

As long as you're getting nadirs less than 300 (pink), your dose increases should be in .25 unit increments, so I'd go ahead and try the 3.25 for at least 6 cycles.



If he's over 200, shoot the scheduled dose. Remember, you're going to be feeding him next which will usually bring that number up some before the insulin even has a chance to start working, but if you're concerned, get a +1 and +2 to start with. If you get a number you're unsure about, you can always Stall, DON'T feed and test again in 20-30 minutes to see if the number goes up without the influence of food. That's a pretty good indication that the last shot is wearing off and it's going to be OK to shoot the scheduled dose. Also use that time to post here with a good subject line like "STALLING! NEED HELP!" to get somebody's attention. Once you have that, you can go back and edit your subject line and just keep the latest test results in it like "Date, Name, PMPS ###, +1 ###, +2 ###....etc"

As you gain more experience and get more data, that "stall point" starts to come down. You gradually learn to shoot lower and lower Pre-shot numbers.



The MPM method offers you the chance to change his dose more often....if after 6 cycles he's still not getting the results you want, you can increase so while it IS a more aggressive method, it also means having a better chance of getting George's numbers under control sooner as well as less chance of developing glucose toxicity. The MPM has built in controls too...if his nadirs start to be in the lower blues/greens, you would hold the dose a few cycles longer.

If you try the MPM and decide later it's just not for you, you can always go back to SLGS. You're not locked in.

Thank you! Based on previous discussions on the board I was doing .5 unit increases if no blues for several cycles. I will keep in mind that .25 is ok if I’m at least getting into the yellows.

I just tested him again and it looks like he’s still (verrrrrry slowly) coming down for the day so we may be in yellows for pm shot today. I will do 3.25!

 

[Hshray]

I just tested him again and it looks like he’s still (verrrrrry slowly) coming down for the day so we may be in yellows for pm shot today. I will do 3.25!

It’s also numbers like this that don’t make sense to me though...3.25 units brought him down over 300 points in 5 hours yesterday but the same dose brought him down less than 100 points in 10 hours today.

 

[Chris & China (GA)]

It’s also numbers like this that don’t make sense to me though...3.25 units brought him down over 300 points in 5 hours yesterday but the same dose brought him down less than 100 points in 10 hours today.

He's a cat....it's in the rules "confuse the hoomin as much as possible so they don't ever quite know what's going on".

Insulin is a hormone....it's not like you take 2 aspirin and your headache goes away so the next time you have a headache, it's pretty sure that the same 2 aspirin are going to help again. With hormones, there are 1000 different things going on inside the body that can change how the hormones work.

I don't know how old you are, but do you have (or have you ever been) a teenager? Giggling and laughing one minute, slamming doors and screaming "I HATE YOU" the next? Yeah, that's hormones.

It was a good 5-6 months before I started to see something even vaguely resembling a pattern. There is one thing this disease will teach you.....patience

 

[Hshray]

He's a cat....it's in the rules "confuse the hoomin as much as possible so they don't ever quite know what's going on".

We’re at 75 +5 today. I’m going to continue to test him every hour until he starts going up, but assuming that’s his nadir, do you think we should reduce to 3 units next shot? I know that’s not strictly following MPM (like my last reduction) but thinking it may make sense.