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? 11/10 Lilly AMPS = 398 Time for increase??

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Kelsey & Lilly, Nov 10, 2019 at 5:04 AM.

  1. Kelsey & Lilly

    Kelsey & Lilly Member

    Joined:
    Mar 23, 2019
    I'm trying out TR (and using a pet meter). We got a green pre shot number, and I chose to give a reduced dose (maybe should've kept the 2u but, I think she's gonna shoot up regardless when she sees green). Anyway, I held the dose for 10 cycles because I had seen a few numbers below 200. But by and large she's been in pinks and red. I'll also admit there may be some blues missed because she usually doesnt stay in red so much which makes me think it could be bouncing? Thoughts? Am I off base?

    My question: now what do I do after I've held for 10 cycles? do I increase by .25 now again??
     
    Sonia & Leo likes this.
  2. Bellasmom

    Bellasmom Well-Known Member

    Joined:
    Feb 12, 2018
    I would definitely agree time for an increase
    Have a great day Kelsey
     
  3. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    I agree with @Bellasmom - it's time for an increase...yes, increase by .25 - this morning would have been a good time, but tonight will do. If you're doing TR you can increase every 6 cycles until you start to see better numbers - then hold the dose as long as Lilly is hitting the greens daily - the AM and PM are usually the highest numbers of the day and are not the best indicator of the nadir (lowest number of the day) Hope you'll see some better numbers soon.
     
    Bellasmom likes this.
  4. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I noticed in your signature that you are using Freestyle strips in an AT meter. We truly discourage this practice. I know the cost of the AT strips is ridiculously high but there's no way to know if the FS strips are reliable when used in a different meter. One of the other moderators was in touch with Abbott who indicated that the strips are not interchangeable. There is a thread in Think Tank on this topic. You might want to consider using the FS or a different human meter if cost is a concern.

    With TR, you typically are increasing every 3 days/6 cycles. You hold the dose for 5 days/10 cycles once you start seeing a majority of numbers, initially nadirs but ultimately the numbers throughout the cycle, in blues then greens. You don't want to hold the dose for 10 cycles if there's just a scattered blue or green number. Given the pattern of numbers on Lily's spreadsheet (SS), I'd suggest holding the dose for no more than 3 days until there's a shift to lower numbers so to answer your question, it's time for an increase. (Having said that, Lily will read this thread and probably drop into dose reduction territory today. Cats!)

    I think you were OK with shooting a reduced dose on 11/5. You're doing a good job of collecting data when you run into a lower than expected pre-shot number. I try to encourage people to think about what the next lowest PS number will be that they feel like they can shoot. Ultimately, the goal is to shoot any number above 50 (providing it's safe to do so) but it takes a while to develop that confidence.
     
    Sue and Luci likes this.
  5. Kelsey & Lilly

    Kelsey & Lilly Member

    Joined:
    Mar 23, 2019
    Thanks for the feedback. I'm on the same page. But my reading of the TR was when I see a nadir below 200 to hold for 8-10 cycles, so I did that. How do I know when to hold for more than 6 cycles? Lilly isnt a cat that's going to give a lot of blues and greens, at least right now, because she shoots up as soon as she sees those numbers.

    I did my own comparisons with the FS strips in the AT, and they were pretty much on par. I've been considering switching to a human meter anyway, because of the cost and because I initially kept an alpha track because of the vet I had and have since stopped really going to or communicating with a vet. I'll have to do some research. Also I'm concerned about losing all this data i have right now since there really isnt a comparison btw the two.
     
  6. Kelsey & Lilly

    Kelsey & Lilly Member

    Joined:
    Mar 23, 2019
    Thanks for the feedback. I'm on the same page. But my reading of the TR was when I see a nadir below 200 to hold for 8-10 cycles, so I did that. How do I know when to hold for more than 6 cycles? Lilly isnt a cat that's going to give a lot of blues and greens, at least right now, because she shoots up as soon as she sees those numbers.

    I did my own comparisons with the FS strips in the AT, and they were pretty much on par. I've been considering switching to a human meter anyway, because of the cost and because I initially kept an alpha track because of the vet I had and have since stopped really going to or communicating with a vet. I'll have to do some research. Also I'm concerned about losing all this data i have right now since there really isnt a comparison btw the two.
     
  7. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I agree -- the way the TR information is written isn't terribly clear. I look at it this way. If your cat touches blue numbers once or twice in a cycle, I would not hold the dose for 10 cycles. If you're starting to see the middle portion of the cycle -- several hour of the cycle in blue numbers -- and you're starting to see that on an increasing basis, then hold the dose for 10 cycles. I'm going to do some backchannel consulting to see what a few others think.
     
    Kelsey & Lilly likes this.
  8. Kelsey & Lilly

    Kelsey & Lilly Member

    Joined:
    Mar 23, 2019
    Thanks for your help! I'm trying my best to wrap my head around the protocol and appreciate the help!
     
  9. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Well, in talking to my "fact checkers," we concluded that the way the instructions are written is not clear. Going back to the original version of TR, there are some differences between what the German Lantus board does and what we do. For now, if you stick with what I suggested above (post #7) and keep chipping away at Lily's numbers by increasing the dose every. 3 days/6 cycles until you start seeing more numbers under 200, you'll be good to go.
     
    Kelsey & Lilly likes this.
  10. Kelsey & Lilly

    Kelsey & Lilly Member

    Joined:
    Mar 23, 2019
    Thank you!!

    I'll just keep posting for guidance then
     

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