2/19 GrayGray 56 @ +3.5

Discussion in 'Lantus / Levemir / Biosimilars' started by Becky and Gray-Gray, Feb 19, 2020.

  1. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Hi,

    the last two mornings I’ve had lower than normal amps and have been scared to shoot. I resulted in stalling and feeding and shooting.... this morning I was particularly worried as she was hovering at 129 @ 5:30am, 142 @ 5:40am, 134 @ 5:50am, 127 @ 6:00am, and 124 @ 6:10am. I’ve never had preshot number this low! This evening I hit my first two greens with 78 @ +3 and 56 @ +3.5 She just had her evening snack @ +3.5 and shot 58 @ +4. I AM so scared of shooting her anymore now that I transitioned to Lantus! I’ve never had numbers this low and I am afraid of her going hypo while I am away at work ALL day during her am cycle. I just don’t know what to do in the morning? I know the stickies say no shoot under 150, but all honesty I’m afraid to shoot anything under 200! Please may I have anybody help advice me on how to handle my morning preshots? With two back to back morning of an amps in the blues, and each day her number are dropping lower and lower! I get up at 5:30am TFS her and am out the door for work by 6:30 am the latest..... I have no time in the morning to redo what happened this morning testing every ten minutes, I literally didn’t shower and got dressed running out the door in 20 minutes. It was so stressful because of my inexperience and how low my confidence level is.... So, this is why I am reaching out to you all tonight. I am trying to prepare to figure out what to do in the morning so I’m not running around like a chicken with my head cut off panicking. GrayGray is currently receiving 0.5u am & pm. Do you think I should continue with dose or should I decrease it? Please advise‼️ She does have a food timer that gives her two snacks at +3.5 & +7.5. I will not be back home from work tomorrow morning until +9.5 to test her.

    previous post this morning
    http://www.felinediabetes.com/FDMB/threads/2-19-graygray-amps-129.225891/
     
  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Have you decided which dosing method you would like to follow? That will determine whether or not a reduction has been earned.

    How many slots does the autofeeder have? I think maybe the feeding schedule should be changed so she gets food earlier, like just before onset (when she seems to drop hard) and nadir,
     
  3. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    I thought I wanted to start low and go slow? But idk what I should do:arghh:.... I’m so inexperienced and much more unsure and not confident in myself of this Basaglar than I thought I would be.

    The SLGS says hold insulin for 7 days. It’s only been 5 days and her nadir was 52 this evening. Is it too soon to drop her dose 0.25u? I think I should drop it but the sticky says to hold dosage for 7 days.

    The feeder has 4 slots. She gets 2.5oz at meal, and two 1 oz snacks. I could adjust the feeder...

    Option 1: give GrayGray less at meal & 3 snacks
    Option 2: give same amount at meal & a snack at +2 (a little bit sooner) & +7.

    what'd you think?
     
    Last edited: Feb 20, 2020
    Si am cat mom likes this.
  4. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019

    Reductions are always taken immediately when earned. The only thing that is on a certain timeline are the increases to doses.

    FROM STICKY:
    Hold the dose for at least a week:
    • Unless your cat won’t eat or you suspect hypoglycemia
    • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
     
    Becky and Gray-Gray likes this.
  5. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    TY!
    Based on this evenings numbers I’m going to most likely shoot 0.25u. If I start shooting 0.25u do I hold it for three days?
     
  6. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    @Si am cat mom does “Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately” mean at nadir or preshot?
     
  7. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019
    anytime you get a number below the set threshold, you reduce.
     
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  8. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019
    I don't see a (52) on your spreadsheet, did you mean (56) ? Just making sure they weren't more test and that the numbers perhaps didn't come up as much as It seemed like they had.

    I don't know if you had read the TR (tight regulation) dosing method, but you do seem to test enough to follow that over SLGS when you are comfortable....
    Feel free to ask questions about the differences between the two if you have any apprehensions about TR vs. SLGS.
    TR gives you a lower threshold for taking reductions (50 for TR, 90 for SLGS), but TR is more intense approach and does ask that you shoot much lower numbers and adjust/assess the doses you are shooting every 3-5 days (6-10 cycles or 12 hour periods).

    Just FYI, just in case- You also might need to watch for another similar drop in Gray-Gray since the depot from the 0.50 dose could still affect the BG. It takes a few cycles for the depot from the previous dose to drain.
     
    LilTurkey likes this.
  9. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    I scrolled back thru the meter and your right, it was 56, not 52. The biggest reason I am hesitant to follow tight regulations and shoot at lower numbers is because their is absolutely no way for me to monitor BG during am cycles during weekdays. Some days I can come home by +9 if I completely rush out early otherwise I typically come home by +11. I’m super scared of her hyping whileI’m away at work:(. For my peace of mind I think I’m going to reduce to 0.25 IF she is low again this morning, however I’m trying to monitor her tonight (totally not getting any sleep :banghead:) so I can be better prepared when amps comes. How many cycles does it take the depot to affect a given shot?
     
  10. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019
    I would definitely take the reduction....

    I wouldn't count out TR completely because of that, but I totally get your point. Some kitties see more action and lower numbers overnight, so it just depends. If you had an automatic and could leave MC to HC snacks when needed on the weekends, it could work. We can revisit that when you have a bit more data and feel more comfortable handling some of these lower BG numbers :)
    The depot from the previous dose can affect a BG for a number of cycles...my cat it seems to be about 2-3 - so a day and a half. I think that's a ECID , but the important thing it just to be aware that if CAN affect future BGs even after you reduce. We don't want people to think that if their cat drops into the 40s one night, he's in the clear the next 12-24 hours because they reduced the next dose appropriately.
     
    Becky and Gray-Gray likes this.
  11. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Soooooo, I’m thinking to shout 0.25u tonight? Just checked her PMPS and she is @ 200. What are your thoughts?
     
    Si am cat mom likes this.
  12. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019
    start a new post for today :)

    just so we aren't rambling on this one ! I know technically I started it so- my fault

    let me check your SS again and I will comment on the new post for 2/20
     
    Last edited: Feb 20, 2020
  13. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    That’s what I’m thinking!
     
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  14. Si am cat mom

    Si am cat mom Well-Known Member

    Joined:
    Nov 11, 2019
    yes to the reduced dose by the way - you had it right

    you can always go back up if need be but it's safer to take reductions at this stage when they come and get more data to handle future BGs
     
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