Oliver 10/23 AMPS 88, +2 65, +2.25 40, +2.5 50, +8 115

Discussion in 'Lantus / Levemir / Biosimilars' started by Bec and Oliver, Oct 22, 2018.

  1. Bec and Oliver

    Bec and Oliver Member

    Joined:
    Oct 21, 2018
    Yesterday
    I decided to go ahead with the new 0.5 units even though he's a *tiny* bit lower than yesterday.

    Not giving insulin last night, I would have expected him to be much higher this morning, it's almost like he barely changed overnight.

    Hoping to get a consistent dosage started instead of all these skipped shots.
     
  2. Bec and Oliver

    Bec and Oliver Member

    Joined:
    Oct 21, 2018
    We've just had a little scare. I retested at +2.25 because I wanted to feel confident leaving him to go to work and he was down to 40 (2.2). I have re-tested after giving him some meat with gravy and kibble and he came back up to 50 (2.8) quickly.

    I am feeding him up on short and longer acting food but I won't be able to check him +4 to +7.

    He is looking alert and happy. Very happy with extra attention and food.
     
  3. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Bec,
    Just wanted to comment your last post on yesterday's thread, which you wrote this morning, where you said "at this stage I am not too worried because his AMPS is only 0.2 lower than yesterday , and he received a whole unit then, but I will keep an eye on him."

    It is looking like Oliver's pancreas is healing nicely with those lovely green numbers even after 12 hours without insulin. This could mean he is needing even less insulin than the 0.5 units....... but the only way to tell is to get some mid cycle tests.
    88 doesn't leave much room for error.
    @Bec and Oliver .......I've just looked at his SS and seen he has dropped to 2.2. Did you give some honey?. That is a very low number and you will need to bring him up higher.
    Also with that he has earned a reduction to 0.25 units.
    We are worry warts here ( when the BSLs drop very low) so please keep us updated
    Bron
     
    Last edited: Oct 22, 2018
    Reason for edit: clarifying point
  4. Christie & Maverick

    Christie & Maverick Well-Known Member

    Joined:
    Aug 1, 2017
    Hi Bec and welcome! I'm thinking you may need to go down to 0.25u...you had one shot 24 hours ago.,.and your 0.5u got you to 40 very early in the cycle. It is suggested that those that feed kibble follow SLGS...earning reductions under 90...and not shooting under 90...

    @Bobbie And Bubba what do you think about the last few cycles?
     
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  5. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    I don't think it would be safe for you to leave for work at this stage. Can you stay home until he is in better numbers?
     
  6. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    I agree, I think you need to stay with him until he has held above 50 for 2 hours from the last food needed to prop him.

    And I would reduce to .25 units so that hopefully you will be able to shoot 2 shots 12 hours apart.

    Please post and let us know what the next test was. We are all co concerned.
     
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  7. Bec and Oliver

    Bec and Oliver Member

    Joined:
    Oct 21, 2018
    Have just tested 52 (2.9) at +3. A family member will be able to stay to feed him during that time (I am a 23 year old uni student who lives with parents), just no tests :(
     
  8. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    That's good. I'd get them to give him some of the food you've just been feeding him a few times until you get back home to test as the nadir ( lowest point) won't be until +5 to +8.
    Well done catching the 2.2
     
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  9. Bec and Oliver

    Bec and Oliver Member

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    Oct 21, 2018
    He was up to 115 (6.4) at +8 after what sounds like a pleasant afternoon of snacking.

    I don't currently have syringes with half unit markings so I'm not confident that I could give him 0.25 units until I am able to get some. Given that 0.5 units isn't right, and his numbers have been pretty stable even when only getting 1 unit/24 hrs, I'm tempted to trial him without insulin. Is there another reasonable mid-way step without having half unit syringes?
     
  10. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    It would be much better to give him some insulin than not give it. He is doing very well and looks like he will most likely go into remission BUT you want the remission to be strong. And the way to do that is support the pancreas with insulin until it has healed.
    I used to give 1/4 unit doses often and I only had 1 unit syringes. What you need to do it divide the 1 unit marking by 4 (with your eye) and just give the 1/4. I used to eyeball it with the help of a magnifying glass. Try practicing drawing up water in an old syringe a few times. It is very doable. It may not be exactly 1/4 unit but if you stick to the same amount each time that is fine.
    You will gain confidence after a few goes.
    What about that?
     
  11. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
  12. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    @Bec and Oliver
    Don't worry about Olivers BSL being a bit higher today on the 0.25 units. Some of that is from no insulin last night and it takes up to 6 cycles for the depot to fill. Then you will see how the 0.25 is working for Oliver. Just continue with the 0.25 units twice a day and test when you can.
    Was really happy to see you managed to give the 0.25 units.:)
     
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  13. Bec and Oliver

    Bec and Oliver Member

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    Oct 21, 2018
    Thanks Bron. It's the first time in a while we'll be able to give two even doses in a day, so that is a good start!
     
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  14. PussCatPrince - GA

    PussCatPrince - GA Well-Known Member

    Joined:
    Nov 25, 2017
    Meant to say @Bec and Oliver
    The syringes should be on their way. Hopefully they reach you quite quickly and tide you over for the time being.
     
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  15. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    @Bec and Oliver
    Oliver seems determined to want to come off insulin. But he would get a stronger remission if you could continue with some micro doses for a week or two.
    I have no experience with micro dosing but I will tag a couple of people who might be able to help you.
    @Marje and Gracie @Wendy&Neko
    Bron
     
  16. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    This condo is a couple days old but I don’t see a new one so I’ll post.

    Since I don’t know if she is following SLGS or TR, I don’t know what the reduction point is for her. However, if we assume TR, he hasn’t actually earned a reduction from 0.25u. The BGs she has gotten are above the reduction point for TR and she could have been shooting these numbers with that dose unless he dropped below 50. Of course, if she is following SLGS, he earned a reduction during the morning cycle of 10/25 and the new dose would have been 0.1u. He was fairly flat during the cycle and the 58 at PMPS should have been a shootable number with 0.1u.

    My recommendation going forward at this time is to shoot the 0.1u until he earns a reduction. If he’s on SLGS, that reduction point would be a drop below 90. If he’s on TR, it would be below 50 or a week in normal numbers. If he’s not all in green, or mostly in green after the next reduction, then we should talk about further microdosing and how to determine if/when he’s ready for an OTJ trial.

    Thanks, Bron :bighug::bighug::bighug::bighug::bighug::bighug::bighug::kiss:
     
    Last edited: Oct 25, 2018
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  17. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    @Marje and Gracie
    Bec has only posted twice and during that time we were finding a dose that would allow shooting AM and PM, then Oliver had a BSL of 22, so TR and SLGS have not been talked about yet.
    Thanks for your help with microdosing.
    Bron
     
  18. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    As I know you’ve seen, the dose was started too high. We could still be seeing some depot effects even with the skipped shots but it’s not likely much, if any.
     
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  19. Bec and Oliver

    Bec and Oliver Member

    Joined:
    Oct 21, 2018
    Sorry for being a bit sporadic with replying! I am away this weekend but I will update on where we are at after the weekend. I really appreciate the extra info about microdosing.

    ETA: From what I have read, and since Oliver had kibble in his diet until very recently, I think I am following SLGS.
     
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  20. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Great! I didn't want you to just stop the insulin, thinking it was OK to do so now Oliver is in low numbers.
    You will get a much stronger remission if you do it slowly and we have a 2 week "program" when they finally go off insulin where you monitor the BSLs to ensure it is the correct course of action.

    In the meantime you need to look at the TR and SLGS protocols to choose one to follow even though Oliver is in good numbers
     

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