? 1/8 Jenks AMPS 79 +3 45 +4 54 +7 108 PMPS 170 +7 150

1/6

I'm getting nervous. If you look at the spreadsheet, you'll see why.

Jenks is now regularly rebounding into the blues (sometimes high blues) at PMPS after 100ish point drops overnight. I'm worried this is a sign that we're starting to regress, and once these yo-yo cycles start, things tend to go off of the rails.

But I'm conflicted about how to deal with this and could use advice.

One option is to reduce the dose to 6.0U. He's dropped below 50 enough times to earn it. The theory is that if we stop the early morning drop with less insulin, then maybe we can avert the later day bounce. The counterargument is that if he's not getting enough insulin to keep the later cycle numbers in check, does it really make sense to give him even less?

The other option is to hold the dose and give him a depot draining 3.0U in the morning. The theory is that draining the depot and interrupting the cycle may help him reset. If we take the depot momentum away, perhaps we can stop the early cycle dive without depriving him of the extra insulin that the PMPS numbers seem to indicate that he needs. I can't think of much of a counterargument here, except that one cycle may not be enough and he'll just get right back on track, and that we have to continue to monitor for morning lows. Neither is really persuasive enough to take this off the table.

I don't see why they have to be mutually exclusive. We could start by trying the second option. If that turned out not to work, then we could move to the first. That may be the most conservative move.

Thoughts?

 

I think option 2 is worth a try with option 1 in the background if it doesn't work

As we all know, Jenks has his own rules in this dance, so I really don't think there's a "wrong" answer

 

He wasn't bouncing like that from the same types of numbers at the end of December on 6.5. He did have a couple bounces, but it wasn't an every day blue PMPS situation. 1/3 looks like a bounce and today as well, the rest look like something else.

Any new or interesting things happening in the latter half of the am cycles that differs from the latter of the pm ones? Foods, meds, is he typically sleeping or active in those hours?

 

I pick option 1. Clearly 6.25 is too much insulin, cause he's hitting 40's all the time and did get a 37. Remember, we dose by the nadirs primarily. I'm a little concerned there are little early PM tests, whereas in the AM cycle, that's when he hits his lows.

 

To me it looks like Jenks needs a reduction. You can always go back up if his numbers start creeping up.