5/21 Maxi AMPS 352

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by bambinaki, May 21, 2020.

  1. bambinaki

    bambinaki Member

    Joined:
    Jan 22, 2010
  2. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    I should have caught that as well yesterday so I’m glad Wendy did.

    It’s a good idea to go back and review the stipulations Wendy and Sandy gave you when you started using R especially regarding when in the cycle to use it and when not to. One of the times you don’t want to give it is when the Lantus and R nadirs overlap. If you figure the L nadirs at +6 and the R and +4, then they overlapped yesterday. Again, my bad for not pointing it out but I was just checking in and saw the green.

    You did a good job of controlling it, though. As an alternative, if you had given it at L+6 or a little later, it would have set him up for a decent PMPS. Using R is a learning curve; some “rules” trump others so that means just because he’s in the R scale “zone”, doesn’t mean you want to overlook overlapping nadirs.

    Every cycle, we learn something :)

    In the mornings when you post his link to the previous condo, we would love to know how he’s doing :)
     
  3. bambinaki

    bambinaki Member

    Joined:
    Jan 22, 2010
    Thank you
     
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  4. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    You’re welcome.
     
  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    There are a couple basic situations you want to avoid R. One is avoiding overlapping nadirs. The main reason for that is you want to avoid large drops. Large drops cause bounces, so we try to limit the amount that R takes down the numbers to about 100 points. If you have the L taking the insulin down strongly at nadir, and R doing the same, you set yourself up for a big drop. Yesterday that was 174 points.

    To figure out when you can give R, I found it helpful for me to graph or draw "typical" Neko Levemir curves. So I knew at what point in the cycle the insulin would start to take effect (onset), the lowest points (nadirs), and when she's start drifting back up again. I would do the same thing with the R insulin. Then I would overlay overlay the two, to try to figure out when it was safe, and more important when not, to give R. For me it was a bit trickier because Neko onset both her Lev and her R later than typical cats. In general, unless your cat has weird cycles, R at preshot is safe, as well as R after nadir when they've started to rise and are at a safe number to give R.
    That's what I would have guessed. When Neko first started seeing green numbers, she didn't like them either and would hide under the spare bed.
     
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  6. bambinaki

    bambinaki Member

    Joined:
    Jan 22, 2010
    OK, thank you
     
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