? Question about SLGS and remission

Hey guys! I am becoming more experienced and understanding how to handle Cooper and his numbers and what not.

I do have one question that I have been wondering about and hopefully I’m asking in the right part of the forum.

I know the rule is to reduce the dose immediately after getting a 90 BG reading but how do you ever find the “right” dose if that’s the case? In my thought process 90 is on the upper part of “normal” so say if Cooper’s nadir ends up being between 60-80 on a dose but then rises back up as we reach the end of his cycle wouldn’t it be smart to try to hold that same dose to see if that ends up being the case each time through the cycle?

I do know TR is supposed to be a better method but unfortunately for my situation that isn’t possible right now because my work schedule rotates and my fiancé isn’t able to test yet (she can give insulin).

Maybe I am just overthinking it but I sometimes worry if I’ll ever find the right dose or be doing the right thing for Cooper.

 

It really depends on the cat. Some cats fall nicely into a 90-ish to 120 range, and caregivers are comfortable with that.

Now, some cats prefer to make things interesting for us. When you're first starting out, yes you'll probably see more swings like you've been seeing, but for safety's sake it's best to take the reduction just in case especially if you can't be around to test. He should "settle in" eventually, it just can take months sometimes.

That said...some people do find reductions at 90 don't work for their cat because then they just go right back up, and choose to customize SLGS with a reduction at 70 or 80...but I'd caution against that for now. Not quite enough data on reductions, and a lower threshold without being able to test at least a little more is a bit risky.

 

Due to the extra safety factors figured into the SLGS method (and especially since you're skipping so many PMPS tests and blindly shooting, there's really no choice but to stick with the SLGS.

As for your question, let's say he's on 1U and on one cycle his BG's are AMPS 189, +3, 120, +6 84, +9 118, PMPS 158....because he dropped below 90, he "earns" a reduction and you'd reduce to .75.

Over the next week, you get cycles all over the place, but never drop below 90 again....so that means .75 isn't enough at this point in time, so you'd go back to 1U.

Over the next week he drops to 72 one cycle at nadir, thus earning a reduction again to .75.....but this time, over the next week, he drops below 90 again...so he "earns" another reduction down to .5....during the next week, he drops below 90 again...so he earns a reduction to .25...etc. etc.

The whole idea is to have him "earn" his reductions by dropping below 90 at nadir. Cat's often go up and down in dose (some for months or years). You just follow the rules for the numbers you're getting!.....and HOPE that at some point, he keeps dropping below 90 enough times that he earns his way down to zero insulin at all.

 

@Chris & China (GA)
@FrostD

Thank you for such good and detailed explanations!! I read through the dosing methods thread again before posting this and it didn’t seem to explain why a reduction is earned at 90 so that’s where my question pretty much came from. Both of your answers make it make a lot more sense now! I’m hoping soon my fiancé will be able to test since she is not working at the moment.