Skipping a dose

NancyJH

NancyJH

Member
Lenny was in the ER from December 1-5 for DKA and pancreatitis. He’s home and doing fine but I have a concert this Saturday night that makes it impossible to give his evening dose. It would either be 4 hours early (but I’m not comfortable because I won’t be home to check his numbers) or 4 hours late. Is it too soon to stray from his schedule? I don’t want him to get sick again. I‘m fine with missing the concert if I have to. Any thoughts? Thanks
 
I am really sorry to hear that your Lenny was in the hospital with DKA and pancreatitis. I went through a very serious extended hospital stay with my boy in DKA, so I understand. Are you testing for ketones. This, apart from doing regular BG testing (of course,) would be my number one recommendation. I used a blood ketone meter after Darcy got out of the hospital because I wasn't willing to missing risk any ketones after that. I purchased a Nova Max Plus blood ketone meter from ADW Diabetes Supply. Strips are expensive, but a lot cheaper than a DKA (in more ways than one.) Have you been doing regular testing on Lenny? I don't see any BG numbers on your spreadsheet for a really long time, so I can't comment right now on whether I think it would be safe to skip a dose. Do you have data that you can input for Lenny so that we can look at it and see what's been going on? I'm hoping maybe that you have a log book with BG numbers in it? Otherwise, how will you know if it's safe to give him insulin or how to decide upon a dose (if you don't know nadir numbers or even preshot numbers.) Anyway, I'll wait for you to reply and will check back in later.
 
Suzanne & Darcy said:
I am really sorry to hear that your Lenny was in the hospital with DKA and pancreatitis. I went through a very serious extended hospital stay with my boy in DKA, so I understand. Are you testing for ketones. This, apart from doing regular BG testing (of course,) would be my number one recommendation. I used a blood ketone meter after Darcy got out of the hospital because I wasn't willing to missing risk any ketones after that. I purchased a Nova Max Plus blood ketone meter from ADW Diabetes Supply. Strips are expensive, but a lot cheaper than a DKA (in more ways than one.) Have you been doing regular testing on Lenny? I don't see any BG numbers on your spreadsheet for a really long time, so I can't comment right now on whether I think it would be safe to skip a dose. Do you have data that you can input for Lenny so that we can look at it and see what's been going on? I'm hoping maybe that you have a log book with BG numbers in it? Otherwise, how will you know if it's safe to give him insulin or how to decide upon a dose (if you don't know nadir numbers or even preshot numbers.) Anyway, I'll wait for you to reply and will check back in later.
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Suzanne & Darcy said:
I am really sorry to hear that your Lenny was in the hospital with DKA and pancreatitis. I went through a very serious extended hospital stay with my boy in DKA, so I understand. Are you testing for ketones. This, apart from doing regular BG testing (of course,) would be my number one recommendation. I used a blood ketone meter after Darcy got out of the hospital because I wasn't willing to missing risk any ketones after that. I purchased a Nova Max Plus blood ketone meter from ADW Diabetes Supply. Strips are expensive, but a lot cheaper than a DKA (in more ways than one.) Have you been doing regular testing on Lenny? I don't see any BG numbers on your spreadsheet for a really long time, so I can't comment right now on whether I think it would be safe to skip a dose. Do you have data that you can input for Lenny so that we can look at it and see what's been going on? I'm hoping maybe that you have a log book with BG numbers in it? Otherwise, how will you know if it's safe to give him insulin or how to decide upon a dose (if you don't know nadir numbers or even preshot numbers.) Anyway, I'll wait for you to reply and will check back in later.
Click to expand...

I haven’t been keeping the spreadsheet up to date but I test him regularly and I did a urine test for ketones and that’s how I noticed he had them. His Prescott numbers are usually in the low 300s and it drops to the 200 or 100 at nadir. I’m just concerned if I don’t give him his evening shot on Saturday that it will mess up his system. Had he not just been hospitalized I would feel comfortable skipping a dose but I don’t know if two weeks is enough time to fully recover
 
Unfortunately I can't give much advice either without the spreadsheet - and there's a big difference between 100 and 200. One of your options is a reduced dose, if he's high enough to shoot (make sure his BG is also rising). Skipping a dose with such recent DKA is a last resort, but safety first.
 
Hi. The problem is that we have no data (no spreadsheet) for your sweet boy. We want to help, but we are hindered by lack of information. You should really consider keeping a spreadsheet if only for yourself— to see trends in blood glucose and how he responds to food interventions, etc. Most people find they do not want to do without their spreadsheets.
 
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