Update: one day of low #'s

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Plugbait

Plugbait

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Haven't posted much in the last few days. Needed a break. The work week was a little tough to get tests done like I wanted, but I did my best. I've updated Pixie's spreadsheet and everything seems pretty normal like life is falling into a routine finally except for ONE day when his blood sugar was a little lower than usual. I had to work of course so I did my best to measure down to .25 units but I wasn't sure what to do the next day when his numbers were back up to "normal" so I went back to .5u.

Here is the day in question:

6/4/10 amps 93 .25u hastily measured
+8 69
pmps 102 .25u

Then the next day he was back to his normal numbers:

6/5/10 amps 174 .5u
+5 62
pmps 132 .5u

Not sure why he was low on the 4th. Does this mean I need to watch him closely as I may have to lower his dose soon? He has 8 more days worth of Purina DM to go through then he gets switched to Fancy Feast low carb wheat gluten free varieties. I'm going to try to watch him as closely as I can when his diet changes but it's going to be difficult. My work schedule leaves me working a lot of 10-8 and 11-8. Will try to have girlfriend test him when she comes home on her lunch break.

Thanks for reading!

-Mike 'n' Pixie
 
Just tested him this morning. We have another low number. It's 97. May try to measure .25u again as I will be at work all day until 8PM. Am I doing the right thing by backing off the dose?

-M
 
I am of the conservative dose camp. I prefer to offer shallow curves ( not high highs and low lows) and dose accordingly.

Though levemir is thought of as a "safe" insulin where hypos rarely happen, they can and do. So if you are gone long hours- if it were me, I'd cut back.

They next day after the initial cutback was really not that bad of numbers, so it is my opinion that you have room to "play" a little.

there are others here who prefer to be more aggresive and may likely advise that those lower numbers were the best thing....ECID.

I'm not sure why the purina DM has 8 more days ( is that what you have left or something?) but if it were me, I would start now working the transition now....75% DM and 25% FF for a few days, then 50/50, then 75% FF and 25% DM and then all FF.

This will ease the transition on the tummy and allow for less tummy upset, runny poos etc and will also acclimate Pixie to the FF slowly in case she decided she doesn't like a cold switch from DM to FF.

See what others say about the dose and diet and then use what works best for you!
 
Mike, I think you were right in backing off the dose because you have no data to show how he will react if you gave the full dose on low numbers. However, it looks like you may need to shoot a skinny .5u and be consistent. Something more than .25u and less than .5u. I am thinking that .4u would be good to try. Do you think you can do that with the instructions I posted last week (or was it the week before?). If not then move the top of the stopper just above the .5u line (assuming needle is up). The difference is about half the depth of the stopper top - and watch where your zero line is. I always check if the stopper is even with the top of that line or can fit above it before I draw the dose. If the whole stopper top fits above the zero line that is .15u to .2u of extra insulin if you don't take it into consideration - and that could cause the lows you saw.

The change from DM to FF will make some difference, and I agree about phasing it in to minimize tummy upset. That way maybe you can time it so when he goes to FF 100% it will be a weekend when you can get some spot checks in. The main bad thing about DM is the crappy proteins (all organ meats and by products) and expense. The canned isn't too bad for carbs.
 
Plugbait said:
Haven't posted much in the last few days. Needed a break. The work week was a little tough to get tests done like I wanted, but I did my best. I've updated Pixie's spreadsheet and everything seems pretty normal like life is falling into a routine finally except for ONE day when his blood sugar was a little lower than usual. I had to work of course so I did my best to measure down to .25 units but I wasn't sure what to do the next day when his numbers were back up to "normal" so I went back to .5u.
Click to expand...

So .5U filled his shed. That's why the lower preshot number and also why the lesser dose didn't bring him "too" low.

Plugbait said:
Here is the day in question:

6/4/10 amps 93 .25u hastily measured
+8 69
pmps 102 .25u
Click to expand...

Then with lesser dose for 2 cycles the shed gets drained, causing a higher AMPS the next cycle.

Plugbait said:
Then the next day he was back to his normal numbers:

6/5/10 amps 174 .5u
+5 62
pmps 132 .5u

Not sure why he was low on the 4th. Does this mean I need to watch him closely as I may have to lower his dose soon? He has 8 more days worth of Purina DM to go through then he gets switched to Fancy Feast low carb wheat gluten free varieties. I'm going to try to watch him as closely as I can when his diet changes but it's going to be difficult. My work schedule leaves me working a lot of 10-8 and 11-8. Will try to have girlfriend test him when she comes home on her lunch break.

Thanks for reading!

-Mike 'n' Pixie
Click to expand...

The +5 on .5U is a little lower than the +8 on .25U, shed is built back up again. The conclusion is that .5U is just about right but has the potential to tip him over the edge, resulting in a lower nadir than you may be comfortable with. So, yes, you are correct, he's probably going to need lower dose soon. .25U is not quite enough though, I like Sheila's suggestion of .4U as it is a lesser percentage decrease - going from .5U to .25U is a 50% drop. From .5U to .4U is only 20% decrease.

The key is to balance the decreases with where you want BG to be. A .25U actually brought him down where he should be, but did not keep him there, resulting in the higher 174 preshot. So the optimum dose at this point is somewhere between .25U and .5U.

I've been with 2 rambling people for the past 30 hours, so that may not have been the most cohesive of explanations. Sorry! Congrats on getting some very good, mostly stable numbers!
 
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