12/17/2019 Mowgli AMPS 292 +11 196 PMPS 218

Discussion in 'Lantus / Levemir / Biosimilars' started by AmandaE, Dec 17, 2019.

  1. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    12/16/2019

    Hello!

    I’m wondering, how many cycles do you give a dose before you consider it a failed reduction... typically?

    I’ve typically been giving 6 cycles if Mowgli went below 50 on a dose before calling a failed reduction when numbers keep rising. I feel like 0.87u could be a failed reduction but I don’t really have a good sense on if it’s too soon to tell. Especially since he just went to 48.6 4cycles ago. But that could have been some of the previous 1u depot at play. Would you consider this a failed reduction?

    Tomorrow is Mowgli’s first dental. They told me it’s ok to give him his full dose and to feed him his breakfast as long as it’s wet food. They asked me to bring him in at 10am but his cleaning won’t be until 1pm.

    These are my questions:
    1. Is the 0.87u dose a failed reduction? If it isn’t how long would it be before I know it’s failed?
    2. If it is a failed reduction should I keep the 0.87u dose for Mowgli’s dental appointment tomorrow? Or should I increase to 1u tonight for the PM dose?
    Any advice welcome :)
     
  2. Penelope and Mačka

    Penelope and Mačka Well-Known Member

    Joined:
    Jun 13, 2019
    Good luck with the dental tomorrow!
    For the rest, I am not sure ^^;
    :bighug:
     
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  3. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    No, you don’t want to hold a dose that long if the reduction has obviously failed sooner. For example, let’s say on 1u, he dropped below 50, you reduced to 0.75u, he bounced for two cycles and on the third, he cleared the bounce but only came down to 140 and you know that’s as low as he got. That’s a failed reduction and so you need to increase the dose back to the last good dose remembering that if he dropped into the 30s or lower, the last good dose is not 1u but somewhere in between 0.75u and 1u.

    So..I bet you know what I’m going to say already ;):) He dropped to 31 on 1u on 12/14 pm cycle. The dose absolutely should have been reduced to 0.75u the next morning. We don’t shave doses with a drop in the 30s. If the dose had been dropped to 0.75u and not 0.87u, you would have had a place to increase to with a failed reduction, as long as you knew it was failed by knowing how low the 0.87u dose took him.

    Because I don’t know how much lower he might have gone last night and the last good dose right now is not 1u, I wouldn’t increase the dose.

    Does all that make sense? Good luck with the dental tomorrow!!
     
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  4. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    I'd wait until after the dental for sure to make any changes. Sometimes having their teeth cleaned can make a big difference in those BG's. I support Marje's comment about shaving the dose - I'm not a big fan after a drop that low of shaved doses - I'd just take the .25 reduction and see what happens.

    I hope he settles out for you once the dental is done...hope he can get some better numbers with his dose soon...if not and you're doing TR, you can increase soon...
     
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  5. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    It makes sense! I didn’t realize you have to do the full 0.25u reduction in the 30s I just thought you had to for sure do a reduction. Maybe it’s common sense but I don’t really have common sense for TR yet, for some reason it feels like I’m struggling to catch on to it. I’ll hold the 0.87u for a couple more cycles. I’m home this weekend so I can monitor if he does need an increase.

    last night I’m fairly sure Mowgli didn’t go to much further down, his typical nadir is +4 - +5 of course I can never be 100% sure because I wasn’t awake, but based on yesterday’s PMPS and today’s AMPS I would be surprised if he went below 100. I should be able to get more data this weekend so we will see how he’s doing on 0.87u.
    Thanks Sue!

    I personally am still a fan of shaving doses but I understand that the other night was not the time to do it. I will start saving it for increases after failed reductions (when appropriate) It’s been said before but I really need to follow one method. If I’m using three drops below 50 I definitely shouldn’t be shaving doses.

    I will have to try and check in more often for advice, but it has been hard since work blocked the site.

    I hope you’re right about the dental, it feels like Mowgli really doesn’t need that much insulin so maybe there is something going on with his teeth that is keeping him from flattening out. We will see :)
     
  6. Sandra And Buddy (GA)

    Sandra And Buddy (GA) Well-Known Member

    Joined:
    Oct 4, 2019
    Good luck with the dental, I hope it helps some. :bighug: I had to get my head out of shaved doses real quick I tried to do that in the beginning, but I think it was because he was all over the place from the mis marked syringes. as soon as I started using calipers he straightened right out.
     
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  7. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    Thanks Sandra! Ive noticed improvement since I started callipers too, I still find Mowgli doesn't stick to his reducies :| hopefully the dental will help!
     
  8. Sonia & Leo

    Sonia & Leo Well-Known Member

    Joined:
    May 24, 2018
    Good luck with Mowgli's dental tomorrow Amanda. :bighug::bighug::bighug:
     
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