5/15 Sebastian AMPS 304 +6 312 +9 289 PMPS 275

Discussion in 'Lantus / Levemir / Biosimilars' started by Justin & Sebastian, May 15, 2019.

  1. Justin & Sebastian

    Justin & Sebastian Well-Known Member

    Joined:
    Feb 1, 2019
    Yesterday

    AMPS 304. Blood ketones: 0.8. Diarrhea in the box overnight. Step backwards on all fronts. Going to increase dose at PM to 3.5, maybe even 4.
     
  2. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    Hope Sebastian starts going forward again.
     
  3. Sonia & Leo

    Sonia & Leo Well-Known Member

    Joined:
    May 24, 2018
    Poor Sebastian and you, I hope this turns around soon. :bighug:
     
  4. Justin & Sebastian

    Justin & Sebastian Well-Known Member

    Joined:
    Feb 1, 2019
    312@+6. Don't have anything nice to say about that. Blood ketones 0.5, at least that is decent. Going to increase dosage tonight, pretty much thinking to 4u. I know it's a big jump but we got to get this down and we saw no difference between 2u and 3u so I'm not expecting a .5u only increase to do enough. Doesn't really make much sense since a few weeks ago we saw 3u and 4u giving limes but the only thing I can figure is those were still coming off the 5u depot and/or the vomiting and/or diarrhea were giving him artificially low BGs.
     
  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    I would use caution. It wasn’t that long ago since you saw a bunch of lime green on 3.5 units. 3.25 units is a safer dose. TR has safety mechanisms built into it. You already increased too fast from 2.0 to 3.0 without giving the depot time to stabilize. It’s possible you have already gone past a good dose.
     
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  6. Justin & Sebastian

    Justin & Sebastian Well-Known Member

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    Feb 1, 2019
    If we went past the right dose why is he purple today?
     
  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hard to say. There weren't any tests past a +2 last night. Could also be from whatever is causing his diarrhea. Also remember that we don't base dosing decisions on just one cycle. They are allowed to have an off cycle once in a while.
     
  8. Justin & Sebastian

    Justin & Sebastian Well-Known Member

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    Feb 1, 2019
  9. Justin & Sebastian

    Justin & Sebastian Well-Known Member

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    Feb 1, 2019
    Well unfortunately I need to sleep for more than 3 hours at a time and can't get a +6 every single night, so if he's somehow picking those specific nights I'm not getting the +6 to somehow bounce down to 50 and back up again real fast, guess I'll just have to deal with that and do a little steering when I increase the dose to much.
     
  10. Justin & Sebastian

    Justin & Sebastian Well-Known Member

    Joined:
    Feb 1, 2019
    Also, I'm not basing my increase decision off one cycle. He's been upper 200s for a week now. How does the dose being too high explain that? Other than the last two nights, when he was rising around 50 points off the PMPS , which everyone has said indicates it's not going to be an active cycle, I've gotten mid-cycle and +11 readings, and everything was yellow or pink.
     
  11. Justin & Sebastian

    Justin & Sebastian Well-Known Member

    Joined:
    Feb 1, 2019
    PMPS 275. Blood ketones: 0.6
     
  12. Justin & Sebastian

    Justin & Sebastian Well-Known Member

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    Feb 1, 2019
    BM right on schedule at PM+0, pretty solid, just about back to normal.
     
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  13. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    I agree with Wendy, with Sebastian seeing all those lime greens on the 3.5u, fairly recently, I would have taken him up to 3.25u if at all. Especially as ketones were back down in the evening.
    The worry is being able to keep him safe by steering when he has got the tummy issues going on.

    With all the fast changes in dose from 2 to 3u, you won't have seen the true effect of each increase as the depot didn't have a chance to settle, and you may have needed a cycle or two more at 3u to allow the depot to catch up.

    They can just have off cycles if they're not feeling well, and with all that's been going on with his tummy troubles, that seems at least possible.

    Looks like he is dropping tonight into low yellows, if he is low yellow or blue in the morning I'd be looking to monitor closely as he may just be giving you advance warning of a pretty active cycle.
     
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