another pm no shoot.. what am I doing wrong?

Can someone look at Thai's numbers and tell me what I'm doing wrong? I can't get two shoots in one day. I thought she was doing great today but still too low at night.

She is at 144 right now.

 

On a morning pre-shot of 262, 0.8 units resulted in an unshootable evening number.
The glucose dropped 205 mg/dL to a low of 57 by +6, an average of 34 mg/hour.
The recovery up to the next pre-shot only came up about 40 mg/dL to 98, suggesting too high a dose.
So, on a pre-shot between maybe 250-300, maybe cut back to 0.4 and see what happens.
Maybe on a pre-shot of 200-249, test out 0.2 units.

He may be trying to go off the juice.

 

I like the sound of that....

@BJM I did .2 today when it was a little over 200.. still too low tonight

 

I would love to have those numbers right about now! I used to but my boy has gone way up. Can't wait to get a new insulin and see if I can get him to be more stable and in low healthy area. As far as your numbers go, BJM is right and that maybe cut back half of what you are giving him to see if you can get 2 shots a day in. Can't complain though that he is doing well and below renal threshold.

 

Go Thaiger! You aren't doing anything wrong! You're doing great!

 

@Stacym20 I wish it would just be regular! I thought surely with only doing .2 this morning when she was at 208 that I would be able to do a pm shot but she is only at 144 8 hours later!? I'll recheck at 10 - looks like she is telling me that she'll make her own stinkin' schedule and not adhere to mine!

 

Also - should i line up the AMPS in the correct column even if they are happening at different times? For example, yesterday's AM shot was at 8am (which is when i would like it to be) but today's shot was at 1030 because she was too low at 8. Is there any value in knowing that she was too low 12 hours later or should i follow exactly what the column says?

 

ProZinc can have a duration of 12 hours, so maybe that's what we are seeing here. If she's around or over 200 at +12, it sounds like 0.2 is a great dose actually. I'm assuming you ultimately need to be at a 8am/8pm shot schedule? If so, even if she does get over 200 tonight, maybe you could skip tonight and start over at 8 tomorrow morning? Does that make sense?

 

If I have to shoot early or late, I'll put that pre-shot value in the AMPS or PMPS column so that the +1, +2 etc are applicable to that pre-shot value and then in the notes I'll put "gave shot hour early" or whatever, so you could just record the what would have been AMPS in the notes. Whatever makes the most sense to you is how I would do it.

 

Wouldn't her AM number be much higher than the 208 I started with for the .2 dose today if I skip tonight? Even if it is, would I still just give the .2 with the hopes that tomorrow night she levels out?

 

Some people will change the color of the pre-shot number box (like gray) if it's early or late I think to easily identify something was different at that time.

 

She might be higher in the morning. It'll be interesting to see. I'd say the dose would depend on wether or not you're going to be around to test. If you won't be, 0.2 might be good just to be on the safe side so you wouldn't have to worry much while you were gone. That's just what I would do only because we don't have a lot of data yet to know what different doses will do at different pre-shot values.

 

I'll give her another night off of ear poking then and see what we are at in the morning. Thanks for the advice.

 

Are you on central standard time? I was thinking you were. I am. I will try to check in on here around 8 to see where Thaiger is at in the morning!

 

Eastern time! Atlanta, GA.

 

Well that works out better for me then cause I leave for work at 8! I get up at 7 so I'll check in then.

 

Can you eyeball 0.1 units?

Have you heard of drop dosing?

Drop dosing

Using a colored liquid, so you can see it more easily, fill a syringe to 0.5 units.
Slowly squeeze out equal-sized drops, maybe by twisting the plunger, until you can get the same number of drops per 0.5 units every time.

Now, you can draw up more than the amount you need, and squeeze out drops to the dose you want.
You discharge the excess into the sink.

Decreases may be done a drop at a time.

 

Oh wow... now that sounds advanced! I just learned how to ear prick 5 days ago!

I didn't even know that was possible or if she would sit still enough for me to try and get tiny drops out. Sounds like something fun to try this weekend though.

 

There is definitely a practice effect for drop dosing. Some folks use calipers.

 

I'm having similar issues starting my cat on Lantus. Some days Edwin gets 2 shots, most days 1 shot, some days no shots. The vet tried to tell me to give him a shot no matter what his PS number was. I found that to be a ridiculous idea. No doctor would tell a human patient that.

I'm still new, but it looks like you're doing what you need to; testing often and relying on your test results to let you know when to give a shot. I'm hoping that over time the shot times will become more regular as Edwin gets used to the Lantus or as food changes make a difference. I've found keeping track of food to be helpful too. I see that you are doing a bit of that.

I'm giving 0.25 u of Lantus per shot and I find that using the magnifying glass on the "helping hands" (see Amazon link here, this is usually used for soldering) really helps to eyeball that size of dose since syringes don't have markings that small.

 

@Stacym20 - ahh!! At 173 this morning and I can't wait around 30 minutes to see if it goes up... No shoot till PM?

 

Go Thaiger! Without being able to monitor, it's probably best to skip.

 

If you can't monitor and don't know how low he might go on that tiny of a dose, skip.

 

Stopped at home real quick to get a test in before I head to class... She is at 156 and hasn't had insulin since yesterday morning at 10am (.2u) - it's now 4pm here so no insulin for 31 hours... Is this normal? What the heck is going on?

 

WOW! She's doing great!!!!
Maybe the diet change and the kick from insulin has sent her on her way to remission. Fingers are crossed

 

That's awesome! I'm so happy for you! And not in the least bit jealous....
Keep going with those low numbers Thaiger!

 

184.. climbing but still no shoot i suppose.. Keeping my fingers crossed for the morning!

 

You may need a drop of insulin when she hits 200 mg/dL.