? 25-Jan Mav AMPS 293|+2 270|+4 126|+5.5 92|PMPS 248 question on late nadirs

Yesterday

I'm still not sure what happened with his cycles yesterday, but at least Mav stayed in blues for a while. We also had another nice play before bedtime , he does feel pretty good in these blues. Hoping to see a more "normal" curve today . Happy Thursday

 

I hope Mav heads down and surfs for you. I love hearing how playful he is.

 

Glad he's feeling good and playing!
The date in your title is wrong.

 

+3=171, getting on this drop from +2 with 1 tsp 9% and about 1/4 can FF

 

Whoa that's a big drop!

Glad he's coming down for you, but no need to rush, Mav, nice flat blues, you can do it!

 

+5.5=92

 

For those of you who have seen late nadirs with your kitties, was there anything earlier in the cycle that looked to indicate that this would occur? I'm still stumped about Mav's higher +2 after AMPS yesterday, only to then drop by PMPS. I suppose starting to get those +10s might be helpful?

 

PMPS = 248

 

@Bobbie And Bubba, when Bubba was a late nadir cat, how did you know if it would be an active cycle versus a flat cycle?

 

Thanks, Mandy, I didn't know who I might be able to tag

 

Good question. Looking back on Bubba's SS from 2015 in Dec. we switched from ProZinc to Lantus Dec 1 . He had ketones unbeknownst to me until I discovered them around 12/4. Jill and Libby helped me use R to pull him down and then he became less flat and started moving down. That is when they realized he was a late nadir cat. His lowest numbers were at the Pre shots at both ends of the day. So if the pre shots were the nadirs , or +4 -+7 for other cats, his numbers would start climbing back up from that point . If he got to about +4 and his numbers were going down I knew he was going to see movement. Or, if he didn't give me a big 40 -50 point food hike I knew also he was going to drop. ( see 2016 also )


Now this rodeo, he's an early nadir cat.

 

Glad to see Bubba's mixing things up . Thanks, Bobbie, that's a very interesting experience, I think Mav is usually an earlier nadir cat, but yesterday he did exactly what you mentioned, only it wasn't both ends, just at PMPS...looking back, Mav may have done it on the 21st...ugh I have such a hard time understanding patterns when he is consistent, these oddities now and again are even more confusing. I appreciate the feedback.

 

Our cats & patterns

 

LOL ... the best is when you think you have a pattern, but you really don't

 

He does have quite a few cycles where his lowest number is at the beginning of the cycle. Is it late nadirs or is the insulin hanging longer? Maybe get a few +10's and +11 's during some cycles to see if that sheds any light on the cycle.

I thought the following might help you . Even though it's more about shooting lower numbers, the concept of why get +10;s and +11 test is helpful. Taken from the stickie Lantus and Lev:

Shooting and Handling Low Numbers


Why the +10s and +11s? These spot checks will help keep you out of trouble. Again, let’s say that you have a lower than usual preshot. If your preshot is higher than +10 or +11, you know the insulin from that cycle is waning, the cat is on his way up, and the number is probably shootable. If you have a preshot that is much lower than your +10 or +11, knowing why will help you decide whether or not to shoot. Some Lantus and Levemir users notice a dip at the end of the cycle, meaning that the preshot is always a bit lower than +10 or +11 (but usually still higher than the nadir – the cat dips to a nadir at mid-cycle, then rises, then dips again). If this is your cat’s pattern, then this type of dip is not a reason to delay a shot. On the other hand, if your cat has a bounce clearing and is still careening downhill at shot time (usually characterized by numbers that drop for the whole cycle, without a clear nadir), then you will want to take that into consideration as you make a decision about shooting. Know thy cat.

Knowing whether your cat is one that dips at the end of the cycle can also help you with dose increases. If your nadirs are not that great and you are considering an increase, but then he dips again at the end of the cycle, you might be tempted to delay the increase. If you know that this is a usual pattern for your cat, you will know that you can ignore that dip and go ahead with the increase.

Do not forget the “neglected spot checks.” They are more useful than most realize.

Know thy cat. Be data ready to handle the situation.

 

Neko was a late nadir cat too. On Lantus, the +2 test told me not much, unless it was close to the preshot, in which case I could see more action. But I seldom got a +2. I got more +3 and +4 tests as her onset was later too, and th later testsbwere better indicator. There were a couple times I saw a higher +3 than the preshot, followed by a reduction earned later on that cycle. I really liked the +9 test. If she was going up or down into preshot, I got a heads up on what might happen next cycle. It also helps to look back a few cycles, and see if you can see longer patterns. Is the cycle a bounce breaking cycle? That one often has a later nadir.