? dose/questions about SLGS. UPDATE: green numbers

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Moms2Tigger&Blu, Sep 15, 2018.

  1. Moms2Tigger&Blu

    Moms2Tigger&Blu Member

    Joined:
    Jul 23, 2018
    I know I'm only supposed to do a message a day but I just realized I am supposed to do a curve tomorrow and decide if we will increase Tigger's dose. I just have a question about the rules of SLGS

    "After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours:
    Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
    • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
    • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
    • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit"
    It says nadirs . . . so multiple. But what if he has had a recent nadir of 100 . . . but on day of curve its 185 . . . which numberS do you listen to . . .how many times should he have a nadir of >150 in order to increase? and/or how many out of the week should be 90-149 in order to maintain current dose. Do you consider atleast one nadir of 100 as a reason not to increase? so confused.

    UPDATE: Tigger plunged into greens at only +4 - never done that before! Since he went under 90 I am supposed to decrease . . . he was supposed to have a curve tomorrow . . . and this will surely give him the bouncies . . . . so now what do I do - why is this so complicated?!?!
     
    Last edited: Sep 15, 2018
  2. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    Good question. That 100 was the lowest he has seen in a while . So he should clear that by tonight's cycle. ( 6 cycles or 3 days) He has not seen a green number since 9/3 PM cycle. So I am thinking an increase is in order but since your testing is better in the PM cycle, I would do the curve tomorrow. If he does not make it back into green during tomorrow's AM cycle, I would increase the dose to 1.75.
     
  3. Moms2Tigger&Blu

    Moms2Tigger&Blu Member

    Joined:
    Jul 23, 2018
    Well I asked a question and Tig answered it himself. He's blue at +3 - something he's never done before. o_O
     
  4. Moms2Tigger&Blu

    Moms2Tigger&Blu Member

    Joined:
    Jul 23, 2018
    and here's the green . . . . . time to stay calm
     
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  5. Moms2Tigger&Blu

    Moms2Tigger&Blu Member

    Joined:
    Jul 23, 2018
    Why would he go so low so early? Was a bounce breaking? Could be my fault - I never noticed he only ate about half his dinner tonight. Usually I feed 1/2 can FF, shoot, then feed the other half. He's a slow grazer and this way I can tell when he has finished half a can and feel comfy shooting. Well now that its windows open time (versus air conditioning season) he gets distracted even easier and followed me and his brother - who eats like a pig! - back to the living room and window seats. He's finished his LC food now and I put a few spoonfuls of gravy on top after I checked at +4. How long does the boost from food last?
     
  6. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    Sorry, I was in bed by the time you posted last but forgot to sign off .

    Looks like a bounce breaking cycle and it could have been that he didn't eat quite enough dinner. The boost from HC food wears off quickly which is why it is important to test again in about 30 minutes. The way you did it with adding the HC gravy on top of the low carb food allows the boost to hang with him longer.

    Well, Tigger answered your dose increase question! Glad you were monitoring closely to catch the drop. It was a big drop from the PMPS to the +2.5 which in itself can cause a bounce not to mention that he did hit green. Without the HC food, he would have no doubt gone lower.

    ETA: If you are following SLGS method, he earned a reduction by going to 70 @ +4. His new dose will be 1.25 and I wouldn't bother to do a curve while he is bouncing. With last night's cycle, he gave you all the information you needed for the 1.5 dose. Good job Tigger! :)
     
    Last edited: Sep 16, 2018
  7. Moms2Tigger&Blu

    Moms2Tigger&Blu Member

    Joined:
    Jul 23, 2018
    No problem! It feels like the whole world is in bed when I'm up with this guy. He is so lucky I'm a crazy cat lady :cat: I'm just surprised I noticed his behavior was slightly off, which made me test in the first place. He woke up from post dinner nap all wobbly - not something entirely weird as he's old and arthritic - but he couldn't settle down again. He just kept walking to a few favorite spots and looking like he was gonna sit, even doin a spin, then moving to a different spot. I was like, heck, lets see what his BG is doing and sure enough! I knew the minute I saw the 148 at +2.5 it was going to be an interesting night, but I held off on giving anything until that 70 . . . Though I really wanted to at the 97 he hit 30 min earlier.

    This has got to be the scariest disease in the world. Both treating it and not treating it can kill you! I hate seeing these really anomalous cycles because I can't stop thinking about "what if this had been during a work day . . . . . " And worrying how low he may have gone had I not tested until +4 like I was planning. Anyway, I am about to shoot 1.25, and as we knew, his AMPS is thru the roof. Sometimes it actually gives some peace of mind knowing he won't go really low again for a few days lol. Thanks for your advice!!!
     
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