2/13 Yoyo AMPS 284,+4 261,PMPS 331,+3 174,+4 143,+5 126,+10 156

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Debra and Yoyo, Feb 13, 2019.

  1. Debra and Yoyo

    Debra and Yoyo Well-Known Member

    Joined:
    Nov 10, 2018
  2. carfurby

    carfurby Well-Known Member

    Joined:
    Feb 19, 2012
    You're getting some nice blues, but not seeing green again. I think @Marje and Gracie was suggesting you increase if you didn't see more green. Hopefully she'll see the tag and weigh in. I hope Yoyo heads down today.
     
  3. Debra and Yoyo

    Debra and Yoyo Well-Known Member

    Joined:
    Nov 10, 2018
    Ok...thanks
     
  4. Bellasmom

    Bellasmom Well-Known Member

    Joined:
    Feb 12, 2018
    Come on down Yoyo :D:D:D
     
  5. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Again, it depends on whether you are doing SLGS or TR. If you are doing SLGS, his nadirs are right where you want them to be to hold the dose. If you are doing TR, his dose needs to be increased by 0.25u.
     
  6. Debra and Yoyo

    Debra and Yoyo Well-Known Member

    Joined:
    Nov 10, 2018
    Thank you for checking in on Yoyo. With SLGS you are telling me his nadirs are good to hold the dose. But last time when he was on .40 units his nadirs were similar, they were between 150 and 90 within the 7 day guide line rules and yet I was informed to increase - which I did:cat:. If he was in the guide lines at .40 units for SLGS, why did I increase his dose? Did you feel he was stalled on the .40 unit dose? I'm just trying to understand the guide line rules or are there exceptions when you feel the dose is not taking the kitty where it should? I look forward to hearing back from you because I really want to understand why I increased Yoyo from .40 units to .50 units if he was in the guide lines for SLGS.
    Please explain when you have the time.

    I am so happy that you are reviewing Yoyo's progress and I appreciate your help. I did order the meter that you recommended and it should arive soon. I'll keep track of his BG on both the pet meter and the human meter until I get used to the readings. It will take some adjustment on my end seeing different numbers/colors.
    I haven't ruled out TR. If I do change to TR and I don't want to take a reduction that is earned, can I hold his current dose until I am ready to take his earned reduction?

    Thank you again for your advise, I really appreciate it.
     
  7. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Excellent question!

    Under SLGS, you increase the dose by 0.25u if nadirs are above 150. If you remember, he was getting few nadirs below 150 so we initially took him up to 0.5u to just get to an easier number to dose and then we would adjust from there but then he started to actually do better and have more nadirs below 150.

    Even under TR, we hold the dose 8-10 cycles if we are seeing nadirs under 200 and he was getting into blue quite a few cycles. It made sense to hold the dose for entire week because he was doing better and your goal was SLGS.

    On 0.4u, he had one green BG and went right back up. On the 0.5u, he got into green, went up a bit, but came back down. On 0.4u, he had four BGs below 120. On 0.5u, he had 7 BGs below 120. On 0.4u 15 out of 30 cycles...half of them...saw only pinks/ yellows. On 0.5u, only 8 of 22 cycles have been only pink/ yellow; the others have had blue or green. He’s had improvement. I wouldn’t have expected much improvement just over a 0.1u increase but he’s done better.

    If you switch to TR, you should take the reductions when they are earned. You might want to read my post on Reductions where you can see what can happen when you miss taking one. If we found YoYo was routinely failing reductions, then we could try allowing him to hold a dose until he falls between 40-50 on three different days and then reducing. However, that’s for cats that fail reductions and have to have the dose go back up.

    I think he could be doing better but it’s a good idea for you to be comfortable with the numbers after the switch. There is no advantage to testing with both meters because you won’t be able to make any correlations. Look at my Gracie’s SS and there’s a tab comparing the AT with the Micro. You’ll see the numbers are all over the place.

    It’s best to just switch to the new meter and use the guidelines to determine when to change the dose. Just let me know when you are ready to switch and I’ll fix the SS.

    Does that answer your question and help?
     
  8. Debra and Yoyo

    Debra and Yoyo Well-Known Member

    Joined:
    Nov 10, 2018
    Thank you for explaining in such detail, greatly appreciated!

    I guess I am still a little confused about how one decides if a dose increase is warranted in SLGS. I understand everything that you wrote and I assuming only an experienced person like yourself can make that call if an increase is warranted in SLGS.

    In TR you have explained that you hold the dose for 8-10 cycles if nadirs are less than 200 and 10 cycles if nadirs are below 100 before deciding if a dose increase is warranted. It seems in TR the guide line rules are more flexible. That I understand:)

    Again, thank you for putting up with all my questions.
    Please keep checking in on Yoyo. For now I will stay with SLGS, but I may change to TR if I can handle it. I need a little more time.:bighug:
     
  9. Debra and Yoyo

    Debra and Yoyo Well-Known Member

    Joined:
    Nov 10, 2018
    I forgot to mention that I wrote the complete opposite when I asked about not taking reductions. I meant to ask if a dose increase is warranted do I have to take it when following TR?
     

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