Somebody help me with the math

[Carl & Polly & Bob (GA)]

I'm a numbers/math geek, so please help me out.

How many drops of Lantus are in 1.0u?

Define "fat" and "skinny". In terms of what's the difference between a "f1.0", "1.0", and "s1.0". Are we talking a drop? Two drops?

What is the difference between a "fat 1.25u" and a "skinny 1.5u" dose? Is there a difference? Or is it like "a B flat is the same thing as an A sharp"?

Speaking purely from a "math" standpoint, it would seem to me that the larger the dose, the less of an effect a "fat" or "skinny" dose is going to have? In terms of "what percentage of the dose is being increased or decreased". Take a drop off a .5u dose, and it's likely to really matter. Take a drop off of a 2.5u dose, and it should matter a heck of a lot less, right?

 

[Marje and Gracie]

Depends on how big your drops are...it's an EBID thing but many use ten drops to the unit.

The skinnys and fats are also individual. My skinny does not have to look like yours and probably doesn't. My skinny might be two drops....yours might be one. The more important thing is that I am consistent with my skinnys and fats.

Since I started using calipers, I quite using skinnys and fats and started dosing in tenths of a unit. 0.1u makes a difference in Gracie regardless of whether she is at a higher dose or lower. I think your logic is good that the higher the dose, the less effect a drop would have but I don't think that is an absolute.

 

[Carl & Polly & Bob (GA)]

Marje,
Thanks. I know with calipers, you're going to have a higher degree of accuracy in measuring (which is why you use them).

Ok, just using 10 drops per unit as a "standard", now I can do the math...

1.0u = 10 drops
.75u = 7 1/2 drops
0.5u = 5 drops

So if you squeeze a drop out of 1.0u, you would have a "skinny" 1.0u? (9 drops)
And if you squeeze two drops out, you'd have 8 drops, and you could call that a fat .75u?
I'd say you could squeeze a drop and a half out, but "half a drop" is sort of like "half a hole". Either it's a drop/hole, or it isn't. You can't cut a hole in half. It's still a hole.

So a drop of insulin, on a one unit dose, is 10% of the total dose. 10% matters. A drop out of 3u is only 3%, which should matter a lot less. I know ECID, and you find that a drop matters on a high or low dose.

But that's where the "other variable" comes into play, in my mind at least. You have a meter that is far from a precise tool. Even if you don't go to the extreme of "=/- 20%" that gets tossed around all the time. The exact number on the meter really doesn't matter, except when it comes to the line in the sand where you make a dose reduction based on the numbers. If you get a 50, you don't reduce. But you do on a 49 or a 48. Because when it comes to reducing, you have to take the numbers at face value. The difference between a 49 and a 50 is just 2%, but you take it as accurate. If you don't, and instead you start thinking "well, the meter is only accurate as much as 20%", then there's no point in defining "50" as a "line in the sand". You'd have people rationalizing about whether or not they were going to take a reduction. "Well, that 48 is close enough to 50, so I think I'll hold the dose", or "Well, that 53 could be a 49 so I'll take a reduction". That sort of makes the "50" pointless, right?

It seems to me that the "reduce" standard, which I think is great, is so much easier than the "increase" decision is. That's the part I see more people struggle with. When to increase. Or when to determine "the reduction failed".

Anyway, thanks for the the input.

 

[Marje and Gracie]

Your last point is well taken and is true. If you reduce and see a bounce and that bounce lasts six cycles, you can't tell whether the reduction holds or not until the dose clears. If someone is experienced and they know their cats patterns and can monitor, they will likely increase the dose back up during a bounce. But you have to have data and really know your cat and be sure if the "last good dose" was into the one that put the cat in the 30s.