1/13 Akila AMPS 153, +2 96, +4 121, +6 109, +8 81, +10 139, PMPS 271

Discussion in 'Lantus / Levemir / Biosimilars' started by penni, Jan 13, 2018.

Thread Status:
Not open for further replies.
  1. penni

    penni Member

    Joined:
    Dec 23, 2017
    Prior: http://www.felinediabetes.com/FDMB/...124-4-148-6-148-8-174-10-274-pmps-235.189288/

    Our 2nd curve and I'm happy overall, but the data did surprise me. Up and down (more a squiggle than a curve?) and, after being so clustered in the early hours, such jumps in the later!

    Where do we go from here? As I'm following SLGS, this curve tells me it might be time for a reduced dose. I feel really conflicted about it! First, there's only one nadir under 90 not "nadirs" under 90 as the SLGS instructions say. And, second, I guess because her curve today doesn't look so traditional, I'm less inclined to make decisions on it. I mean, in addition to above, what's with the nadir at +8, not to mention the mini-peak at +4, when she should have been going steadily down - weird, right? Maybe I should just hang in at 1u for another week before making a decision?

    On the other hand, I definitely do not want to risk pushing her numbers too low! She already was barely snatched back from the jaws of death in her first week after Dx due to a hypo episode. Also, I was sort of hoping I would meet the rules to reduce because there were 3 times this week that I had to wait and recheck at PS due to low-ish BG. Maybe with a lower dose, we won't do that very often? She would be so happy about that, and so would I. She does NOT like waiting for meals. Lately her meows have turned into more like screams and loud, sustained screaming at 6am will, I'm afraid, someday result in calls to the police or angry knocking from neighbors!

    So two places I would appreciate feedback:
    1. Did we really meet the qualifications to reduce per SLGS? Is there anything you would caution me on?
    2. My no shoot threshold: I'm not quite at the point that I auto-shoot anything above a 90. The three times I retested she was above 90 at the *first* test, but I just didn't feel we had graduated to that level of SLGS yet! I still feel so new, that I actually feel like a rebel for feeling comfy shooting at 120. What are your thoughts on a wait and recheck number given what you can see and our newness to this? (And, that number may be different depending on the answer to question #1, yeah?)
     
  2. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I don't think I've stopped by before today, so welcome!

    Since Akila dropped below 90, if you're following SLGS, then a reduction is indicated. You would drop her dose to 1.75u. There's really nothing I can think about as a caution since you're reducing the dose.

    Most people who are new to managing their cat's diabetes aren't comfortable shooting lower numbers. Decide on where you'd be comfortable shooting and work your way down to lower numbers. I was using TR and would shoot anything above 50 -- but I had tons of data. It is important to have the data in order to guide your decisions and when you're still getting your bearings, you don't have the accumulated data. You've shot a 120. Would you be comfortable shooting at 100? There's no "rule" here. We want you to be comfortable and Akila to be safe.

    It's also fine to stall and see if pre-shot numbers are rising if you get a lower than expected pre-shot test result. Just don't feed your kitty if you're stalling. If you feed Akila, the numbers will rise in response to food vs rising on their own. Get your pre-shot test, and then re-test in 20 - 30 min. If numbers are where you're comfortable, then shoot. If not, continue to stall. Just remember, your PM shot will be12 hrs from whenever you shoot so stalling can play havoc with your schedule.


     
  3. penni

    penni Member

    Joined:
    Dec 23, 2017
    Thank you! Yeah, I've pretty much decided, due to scheduling issues, that if I don't feel comfortable shooting at first, then I make the final decision at the 30 minute re-test. I usually am not able to spend further time testing, and even if I did, it would throw future schedules off each time, such that eventually I would be shooting her AM shot (and feeding!) at like 10am or something and neither my work nor she would stand for that!

    I think if I reduce the dose, I ought to simultaneously feel more comfortable shooting a slightly lower number, like 100 or 110 this next week. Then she's getting the more consistent dosing like we want, but since it's a smaller dose, I have a proportionately smaller fear of hypo. I'd probably move to shooting 110, and doing a 30 min retest at anything lower. No harm in that and no rush in forcing myself to shoot far lower numbers, right? With a 30 min retest, I can at least see if her BG is on the way up or on the way down, which is how I made the shoot/no-shoot decision this last week, and it felt like a good way to decide to me. But I will also slowly get myself comfortably with shooting slightly lower and lower numbers as I also accumulate more data over time. It sounds like a good plan. If only things always went according to plan!
     
  4. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    You don't need to rush anything. This is a learning process. It sounds like you have a solid plan in place.
     
Thread Status:
Not open for further replies.

Share This Page