What do dosing experts think?

[Lucy and Julian]

Today is the third night in a row that I haven't shot Julian. He gets 2 units in the morning, then by PMPS he has dropped too low to shoot. Beth from Levemir suggested that I maybe go to 1 unit and hold that for 4 days to see what happens, but she wanted to make sure I get the ok from the dosing experts in Lantus.
It also seems from his chart so far that overall he has lower numbers at night. All shots are done between 6-6:30 am/pm.

 

[Sienne and Gabby (GA)]

I posted in your Friday condo.

 

[Marje and Gracie]

Lucy: Here is what Sienne said this morning on your other condo

I think there are a couple of issues at hand. First and foremost, you need to get more spot checks during the PM cycle. Even if you don't shoot, you still need to get some tests in. It will help you to understand Lantus' duration of action. You want to be able to see when numbers start to rise.

Ordinarily, if you're not able to shoot twice a day we lower the dose to a level where you can shoot. If you want to lower Julian's dose, that's fine. Just please make sure you can test. It looks like you are not home during the week. Especially if this is the case, you need to be able to collect data in the evenings.

You state that his shots are done "between 6-6:30 am/pm". Lantus really needs the consistency of shooting within the same 15 minute timeframe each day or else you are constantly giving him dose reductions and increases. So it is best to pick either 6, 6:15, or 6:30 and shoot at that same time am and pm with as little variance as possible. A late shot is the same as a reduction and an early shot is the same as an increase so if you aren't shooting at the same time, you are giving him "mixed signals".

I know there is such a steep learning curve but just a friendly reminder that we do just one condo a day so when you have any questions...just keep posting to the same condo so that we can follow what others have suggested. Luckily, I saw both condos and found Sienne's earlier response.

Bottom line is, it looks like Sienne believes it is absolutely fine to lower his dose as long as you (1) test especially during the PM cycle and (2) stay consistent with the dose. If you can't test, you might consider lowering him more but it may give you some really high numbers...

Hope that helps You may also get some good input from others!