? 6/16 - Noodle AMPS 190 PMPS 41 (NS) - Dosing Question + Rambling Within

Patricia & Noodle

Member Since 2015
Last Condo

Thanks to @Sienne and Gabby (GA) and @Wendy&Neko for your thoughts on the BD syringes on my last condo. I ended up working with what I have and not trying to find a replacement. I figured out a way to measure lower doses better with the calipers.

Work has continued to be absolutely insane the past few weeks. Noodle has dipped into the 40s a couple times, I lowered her dose with her 33 on 6/14 around AM +6. I was thinking that was very likely influenced by my inconsistency with her PS times the previous days. I reduced because she hit 33, but did wonder if I'd eventually work back up since she may not have truly "earned" the decrease. Today at PMPS she threw me with a 41 (after another 12 hour day for me at my laptop :blackeye:) and I'm stumped. I skipped to drain her depot and gave her a drop of Karo with her meal because, of course, I am low on strips and ADW is late with my shipment that was due a week ago. I did not time my autoship schedule for my increased testing. :banghead:

Sidenote: I still use the Arkay Glucocard strips in the discontinued Relion Micro, but am now rethinking that strongly after the past couple days. I know the new Relion meters are a larger sample size, but it might be worth being able to get them at a 24/7 store. I plan to check out the archives from when Walmart discontinued the old meters, but if anyone has thoughts handy I'm all ears.

My main questions, though, are about what my next steps should be:
- Should I decrease further right away? We are nearing drop territory, for what it's worth. Her current dose is below the 0 line on (most of) the BD Ultrafines we use.
- I think there are ways I could adjust her meal cycle to help, too. She currently gets 1oz at PS, +2-3, and +6-7 (we use the 2 bowl autofeeder for those and it's just a dial timer). I could divide that into 4 meals and add a later cycle meal, I was thinking +9?
- Spreadsheet-wise, it looks like I need more data in the +4-8 range (and just, more data...).
- Plus, this is all assuming I am following TR, is SLGS more appropriate at this point and with insulin doses this low? She'd have decreased to no dose at this point on the main SLGS rules based on her lows and that doesn't seem appropriate given the regular yellows she gets.

She, of course, is happy as a clam--unless I go out on the porch where she is *not* allowed after trying to make a break for it through the railing... We aren't telling her that the dog lived her dream and got a mouthful of bird feathers the other day when he chased one! This, from the little dog who acts like he can't even jump on the couch without a boost. I swore the bird would fly away when he went to pounce, but it must have been the world's slowest bird. At least the only things I had to pull from his mouth were feathers. :eek::eek:
 
You only reduced 0.07mm on that last reduction. How does that compare to 0.25 units for you? Just trying to figure out if you made too small a reduction after that 33. Knowing the mm vs. dose size will also help me understand how close she is to being able to benefit from a +9 meal.

Yes on the more data, those second tests each cycle are really important when she likes to play with lime greens.
Plus, this is all assuming I am following TR, is SLGS more appropriate at this point and with insulin doses this low? She'd have decreased to no dose at this point on the main SLGS rules based on her lows and that doesn't seem appropriate given the regular yellows she gets.
You are right, her spreadsheet does not look like a cat ready to go off the juice. It should be pretty solid green. Especially with a longer term diabetic.
 
You only reduced 0.07mm on that last reduction. How does that compare to 0.25 units for you? Just trying to figure out if you made too small a reduction after that 33. Knowing the mm vs. dose size will also help me understand how close she is to being able to benefit from a +9 meal.
So - I just checked the calipers and updated the measurement in my SS, it’s .32mm. The .32mm dose is on the bottom edge of the “zero” line on the BDs (on the side of the bottom of the syringe not the 1u line), which still leaves quite a bit of insulin like you mentioned in my last condo. It’s so hard to explain the volume in text, but I would say it’s (very roughly) 2x the amount you get when you draw up a drop by pressing the plunger hard and releasing. I can try to measure in smaller, half turn drops tomorrow if that would help, but I couldn’t get a syringe to cooperate tonight!

I do think it’s quite possible/probable I did not reduce enough after the 33. Maybe I could try .2mm - half the dose of that day?
 
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