? 88 PMPS, +2 98 how much should I reduce?

Hello,
Apologies, as I Haven't filled the introduction part yet, been an observer for the past month or so.
Eti (short of etienne) , female, Dx beginning of May (fructosamine 850, fasting glucose 290), immediately switched to canned high-protein, low carb food, attempted one month on acarbose only, no success (fructosamine down to 750). Preexisting condition eosinophilic gastritis - intermittent steroids as as a treatment. Last occurence >0.5year ago. Mildly elevated AST and ALT (2x upper limit), USG didn't reveal any inflammation, vet assured nothing to loose sleep about.
June 4 started on Lantus 1u b.i.d + 25mg b.i,d. acarbose, link to spreadsheet:
https://docs.google.com/spreadsheets/d/1Z5SLIhbT3__1c__oxHnxCVYdFQFdJDRJiIfJXgW4Es4/edit?usp=sharing (Two weeks flying blind)

Trying "start low, go slow" protocol. Using Juniorstar pen (half units increments, one unit minimum).
She's currently on 2units twice daily . I started tread as dosing advice would be greatly appreciated:
1) today's +11 values is 66, PMPS +88. After meal at shot time (30min after pmps) it was 201, after much deliberation with partner we shot 1.5u and will observe into +2 (before sleep time), should it be <120-150 intend to give small amounts of high carb dry food . Is it appropriate reduction or should it we slash it lower?
2) As PMPS values are getting lower, what dose reduction strategy might be better? Slashing PM dose to 1.5u or going wholly back to 1.5u ? Yesterday's daily curve was almost reference one.

Thanks!

 

Hi Geordie I would go back and preface this post with a "? dose advice" to get attention to your post. When you go in to write your post there's a drop down box that gives you a ? or 911.

 

With SLGS, you skip if under 90.

Any chance you can change your spreadsheet order so that the newest data is on the bottom? It's the opposite of what we do here, so hard to read and see patterns.

One more thing, today's numbers earned a reduction down to 1.75 units. You will need to get 1/2 unit marked syringes to get the smaller doses.

 

Thanks , i amended the original post in the meantime and flipped the spreadsheet order.
At shot time it was 201, so we went ahead with 1.5u - we shot with pen (0.5u increments).
But i'm at a cross on how to reduce, starting tomorrow - > both doses or only PM one?
To get the 1.75u 2 times daily, would it be ok with 2u AM, 1.5u PM?

 

You want to shoot the same dose every 12 hours. You can get syringes and use the pen like a vial so that you can shoot in between doses. We usually increase/decrease in .25 increments. You should be able to get u100 insulin syringes at any pharmacy. Walmart sells them with half unit markings.

Here’s some info on using syringes with the pen.

http://www.felinediabetes.com/FDMB/threads/syringe-insulin-info-handling-drawing-fine-doses.151/

 

We'd like to stick with pen and 0.5u increments as long as it's possible.
As for Wallmart, we're across the Pond, in Poland.
+2 PM shot came out as 98.

 

It’s risky to increase in .5 increments because you might bypass a good dose. Can you get U100 insulin syringes there? Even if you can’t get them with half unit markings you can make a paper sample or use digital calipers. I used digital calipers and often increased and decreased in 1/8 increments.

 

Ask the pharmacy if they have insulin syringes for children. You should be able to get BD Microfine syringes that have half unit markings. If not, we've had people order them on line from the UK. @Gill & George

 

Some of our members in finlaFi ordered their Syringes he's from here
https://www.vetuk.co.uk/veterinary-...-0-3ml-u100-insulin-syringes-box-of-100-p-296
As they were very expensive in Finland.

Have a look on amazon for them, they are available there.

My local pharmacist ordered them in for me, iIhad to show here a picture of the product, she was super helpful and got me the syringes the following day. So I would try your pharmacy first as it might be easier, here in spSpa at least it was just the same price as ordering on line.