Starbuck AMPS 117, +4 53, +8 64, PMPS 87, advice about shooting low numbers

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SarahNOLA

SarahNOLA

Member Since 2017
Last week...

Starbuck has been on .1 units of insulin for a week now and is doing great!! And I've started to get green preshot numbers! So far I've been too scared to give her the shot at night when she is under 100, but I think I probably need to bite the bullet and start doing it.

I was going to say anything over 90 and I'll give the shot. Is that a good place to start? Do I have enough data now to start doing that? Advice?

So far I have noticed that if she is at a good place at +4 that's usually the lowest she goes. So I have been getting a +4 before bedtime.

Edited to add: I had been doing SLGS but I have not been giving her reductions since she got down to .1, even though she goes down in the 50s. Because she stays low all day but hasn't gone under 50, but also I think it'll be super hard to reduce to less than .1.
 
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A lot of dealing with shooting low depends on your developing a comfort level and the confidence to do so. Frankly, you're testing a sufficient amount to think in terms of TR rather than SLGS. One of the places the two approaches differ is shooting low numbers. Basically, those of us who are experienced with TR would shoot anything above 50. That said, the first time I saw a green pre-shot number I was a wreck! It's truly a matter of deciding what you feel safe doing and working your way down. Right now, you're seeing great numbers but with skipping the PM shot, there's a greater probability of a higher AMPS.

To be honest, shooting a 99 isn't terribly different than shooting an 80 given that meter variance is +/- 20%. You saw a flat PM cycle when you shot the 99. That's great information! The only thing I might do differently is that when you shoot lower numbers, do a bit more testing so you have a solid handle on where numbers are heading early in the cycle. It's the way you build your confidence, have a sense of what is going on with Starbuck's numbers, and by getting early tests, you don't get a big surprise.

The AMPS is typically the last number to fall into line. In all likelihood, this is due to the dawn phenomenon. (The body's natural biorhythm causes a release of of stress hormones in the early morning which helps to prepare for the day ahead and raises BG.)

I think Darrah is asking how you draw up 0.1u. If you want to dose "some" insulin, you can depress the plunger as hard as you can and once the needle is in the Lantus, release the pressure. This will give you about a drop of insulin. Right now, with the blue AMPS, I'd consider keep doing what you've been doing.



 
Girlie's mom said:
I'll be curious to hear what more experienced people say. Do you go to the "some"insulin line as in the pic on this post? http://www.felinediabetes.com/FDMB/...insulin-info-handling-drawing-fine-doses.151/

I have trouble getting 0.25 right: these low, low doses are a challenge to get just right, for sure! :)
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I've been doing it so I just touch the bottom of the 0 line, and so if I tilt it I can see a sliver of daylight? It might not be exactly .1 but I've been trying to be consistent.
 
Sienne and Gabby (GA) said:
A lot of dealing with shooting low depends on your developing a comfort level and the confidence to do so. Frankly, you're testing a sufficient amount to think in terms of TR rather than SLGS. One of the places the two approaches differ is shooting low numbers. Basically, those of us who are experienced with TR would shoot anything above 50. That said, the first time I saw a green pre-shot number I was a wreck! It's truly a matter of deciding what you feel safe doing and working your way down. Right now, you're seeing great numbers but with skipping the PM shot, there's a greater probability of a higher AMPS.

To be honest, shooting a 99 isn't terribly different than shooting an 80 given that meter variance is +/- 20%. You saw a flat PM cycle when you shot the 99. That's great information! The only thing I might do differently is that when you shoot lower numbers, do a bit more testing so you have a solid handle on where numbers are heading early in the cycle. It's the way you build your confidence, have a sense of what is going on with Starbuck's numbers, and by getting early tests, you don't get a big surprise.

The AMPS is typically the last number to fall into line. In all likelihood, this is due to the dawn phenomenon. (The body's natural biorhythm causes a release of of stress hormones in the early morning which helps to prepare for the day ahead and raises BG.)

I think Darrah is asking how you draw up 0.1u. If you want to dose "some" insulin, you can depress the plunger as hard as you can and once the needle is in the Lantus, release the pressure. This will give you about a drop of insulin. Right now, with the blue AMPS, I'd consider keep doing what you've been doing.


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Thank you!! This is super helpful. My vet originally started her out too high, and I had planned to do SLGS but as you can see from her chart, she dropped REALLY fast once I changed her diet. So I've felt like I needed to test all the time anyway, because of how her dose dropped so frequently. I guess I am doing TR now! Because with everything going so well, I want to get her in green all day long and hopefully get her into remission. So it seems to me TR is the way to do that because--like you said--when I shot lower than 100 she didn't hypo. I felt bad not shooting when I got that 91 the other night--because of how she bumped back up when I didn't give the shot.

So do you suggest getting a +2 as well as a +4 before I go to bed? I haven't been testing that early. And that's really interesting about the AM numbers being high! Early on I was assuming it was because the dose was too high. But that's not the case anymore. So it's reassuring to hear that's normal!
 
SarahNOLA said:
I've been doing it so I just touch the bottom of the 0 line, and so if I tilt it I can see a sliver of daylight? It might not be exactly .1 but I've been trying to be consistent.
Click to expand...

Sienne and Gabby (GA) said:
I think Darrah is asking how you draw up 0.1u. If you want to dose "some" insulin, you can depress the plunger as hard as you can and once the needle is in the Lantus, release the pressure. This will give you about a drop of insulin. Right now, with the blue AMPS, I'd consider keep doing what you've been doing.
Click to expand...

Thanks so much. I'm nowhere near the tiny "some" insulin dose yet, but have been curious for a while about how people actually draw that dose up. Those tips are great for future reference. :-)
 
SarahNOLA said:
So do you suggest getting a +2 as well as a +4 before I go to bed?
Click to expand...

We usually suggest the first several times (at least) that you shoot a low PS number, you get a +1 and +2

This allows you to intervene early if they start dropping early instead of waiting until there's a crisis.

Getting an occasional +1 is a good idea anyway.....It's good information to have to see what kind of "food bump" she usually gets!

It's nice to know that after you feed a normal meal, your cat usually gets a food bump of XXX points.....so if you don't get something similar, you can be more watchful
 
Susan&Felix said:
I'm too new at this to have advice, but ohmeowgosh your spreadsheet is inspiring! Love and best wishes to Starbuck.
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Aw, I think I lucked out! We caught it pretty early. The only thing I can say is my vet prescribed prescription dry food, but I went online and did research and decided to switch to wet. She dropped from 300s to 100s in 24 hours when she got off dry food and her dose dropped scary fast. I see your signature says "won't eat canned food yet"... my 2 boy cats are really giving me trouble right now about canned food, but luckily my diabetic cat loves it! I think she's a best case scenario honestly. So far anyway!
 
Chris & China said:
We usually suggest the first several times (at least) that you shoot a low PS number, you get a +1 and +2

This allows you to intervene early if they start dropping early instead of waiting until there's a crisis.

Getting an occasional +1 is a good idea anyway.....It's good information to have to see what kind of "food bump" she usually gets!

It's nice to know that after you feed a normal meal, your cat usually gets a food bump of XXX points.....so if you don't get something similar, you can be more watchful
Click to expand...

OK that makes sense! I was focusing more on testing in the middle when I knew she would drop. I will try to grab some early numbers tonight & tomorrow. I plan to shoot if she's green tonight even though it scares me!
 
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