2/19 Silver AMPS 178 +8=112 PMPS 88

http://www.felinediabetes.com/FDMB/threads/2-18-silver-amps-76-4-173-7-173-8-137.191329/

Not such a nice start today. Holding dose for another week. Not reducing as I am only going to reduce when he goes below 90 on the Accucheck. Not quite there yet but close. The 58 was 95 on Accucheck.

 

Not a bad start. I hope Silver heads down for you.

 

Silver, slide on down today. Momma bean needs to see some green!

 

I left you a comment on this post but I figured you might not have known I was asking you.

http://www.felinediabetes.com/FDMB/...questions-for-the-switch.191360/#post-2134687

 

Today’s pic of my gorgeous boy. Not disturbing him for testing today. Giving him a break.

 

I actually enjoy the late nadir. I usually get home from work at +10 so I am catching the lower part of the cycle. With lantus and a nadir of +5, I could never catch a low point when working.

If her pre shot was lower, I test at +1.5 when I am leaving the house. She usually has quite a food bump, but if she doesn't and I am nervous, I just put out an extra can of LC before leaving for work (she gobbles it up immediately, but it is the best I can do)

Like you, I was really unsure if I would like how Levemir works, but I have a lot more confidence when leaving because she doesn't drastically dive and bounce like she did on Lantus.

Hope this helps!

 

Unfortunately I’m not home until preshot. I leave right after AMPS and not home til PMPS. The late nadir scares me as any extra food I may leave out at AMPS is long gone. I. And use a timed feeder either. His preshots seem to be his lowest but shooting those low preshots is a little scary. Only 58 a couple days ago.

 

I get it....everything with this dance is anxiety provoking. All I can say is from my experience, Levemir has flattened my girl out a ton and I feel much safer with her on this as opposed to Lantus. Silver is pretty flat on Lantus compared to how my girl was. You can see on my SS that before June of 2017, Osha bounced and dove all over the place on Lantus. There is nothing wrong with sticking with Lantus and what you know.

 

He used to dive a lot but with the dose increases he’s flattened quite a bit.

 

Fed him at +8. Had I not, he likely would have had a lower PMPS. For some odd reason his preshots are his lowest. Anyone else seen that? He food spikes and starts to come down off that at +4. I want to bring his mid curve numbers down but that’s risky as it means shooting lower and lower preshots. Then what if he changes up and goes lower during cycle than preshot?

 

From the mid cycle data you have, it looks more like the nadir is in the +8 to +10 range and he goes back up a bit by PMPS, that's what I'm seeing anyway. The only thing we don't know is if that is true at night and is he going lower in the +8 to +10 there as well? On Lantus, Asia's am and pm nadirs were different, closer to +4 in the am cycle and closer to +6 in the pm cycle,

Shooting lower preshots on days where you can do a curve (like you have done) should give you a better idea of what he is doing in a cycle so that you know what the limits are during the week days. The biggest problem is if he is bouncing from those greens, it will look different than when he starts to get comfortable in them and it's an active cycle on a low preshot (like the 2/16 pm cycle). I think your greatest challenge will be figuring out how you can keep him safe when you are sleeping or at work knowing that his numbers may come down when you can't test or feed him and trying to keep him at a dose that hopefully won't let him drop that low.

 

So what do you suggest? I’m asking for some help here but no one responds. I don’t see signs of bouncing. The one day he landed up in yellows and pinks was my reduced shot.

 

It's tricky. I don't think people know what to suggest to help because you can't do so many of the things that we know to do to figure these things out. It requires some out of the box thinking, that's for sure.

Some things I can think of right now, and if you can't do them, that's fine, but just throwing these out there since you asked:

I would try to get some tests overnight, once a night in different places in the cycle to try to figure out where his pm nadir is (start in the +8 to +10 range since that's the best guess we have) and how low he goes at night. You'd have to figure out the logistics that work for you to do that, perhaps on the weekend when you don't have to be out of the house early the next day? If you need a block of undisturbed sleep, maybe try to go to bed super early and wake up around +8? Or set an alarm for +8 one night and +9 a different night, etc.

Figure out your reduction number on the meter you are testing with, I know you double check the greens with your other meter, and that's fine, but the problem with using a meter you don't regularly test with for dosing decisions is consistency. It's not like a 50 on one will always be a 98 on the other, do you know what I mean? But if given the amount of tests comparing both, you find a comfortable number on the meter you are using and decide that is your reduction point, you have the consistency of it being in line with the other numbers on your SS with the same meter and it's much safer that way.

Once you have that reduction number, as much as it sucks to lose momentum, you have to make some compromises and reduce and/or skip shots when faced with that number so you can keep him safe. Others might shoot lower and leave food out, but you can't so you have to find another way to make sure he stays safe when you can't feed or monitor him.

Another possible option is to find a higher carb food he likes, how high would depend on how carb sensitive he is, you'd have to play around with that, but anyway, find a higher carb food he likes and feed that on the days you have lower shots and are worried about him being safe. Or like Osha's bean does, give him an extra helping of food. Hopefully it will give him a higher number come onset and keep him out of unsafe numbers. Not fun to make him higher on purpose, but again, there are compromises that you will have to make in light of your situation. I've had to make Asia's number high on purpose too when I know I can't monitor her during the lowest parts of her cycle. It's not ideal, but I'd rather have the peace of mind to do what I have to do and not worry like crazy about her the whole time.

That's all I can think of for right now, have you had any thoughts or ideas about what you can do to keep him safe when you start seeing lower numbers consistently? The little stinker sure has given you plenty of time to mull that over, hasn't he?

 

I can’t get overnight tests. As I’ve said before I must get sleep at night. I will just have to make my own judgement calls I guess I’m on my own.

 

Try to focus on what you can do instead of what you can't. I wrote more ideas besides try to get pm cycle nadir tests.

 

Thanks. I already do do those other things you mentioned.