Question about dose

I have been reflecting on Lucy's glucose levels at the current dose and according to Roomp/Rand guidelines I could increase the dose from 1.75 units to 2 units. But we got green numbers again today so not sure if I should hold the dose for a while yet. My thinking has changed in recent weeks especially given my own health issues and the fact that it is now over one year since Lucy was diagnosed with diabetes. If we could achieve a bit more weight loss it would be beneficial to Lucy's chances of her diabetes going into remission the vet said. But both I and the vet are very happy with Lucy's quality of life and with having lost our precious Rosie to lymphoma it puts things into perspective for me in that I am so thankful to have my Lucy with me and that she is happy and content and so if we don't get remission so be it. Whilst remission of Lucy's diabetes would be wonderful regulation is fine too. Our recent experience with a reading of 1.7/31 was scary and so I am anxious about increasing back to 2 units as that is the dose we got that very low glucose level but I know insulin needs change and 2 units might be fine now. My own health issues have at times interfered with being able to give Lucy her insulin on time as I have to go to hospital regularly for treatments and have had many surgeries in recent years in order to manage my health issues. So consequently we have missed doses and I have probably been too cautious with dose increases given my limited ability to monitor Lucy's glucose levels at times. I have been recovering from surgery the past few weeks so I have not increased Lucy's insulin dose as I probably should have as I have been afraid I might sleep through the alarm at night which I have done when I am fatigued because of my health issues. So I am not sure how long to hold the current dose seeing as we have had green numbers again today at this dose. I delayed this morning's dose by two hours according to Roomp/Rand guidelines as I am not confident giving insulin with a falling green AMPS or PMPS under 4/72. In addition I thought if I gave insulin at 3.7/67 we might earn a dose decrease and I don't think we need a decrease in dose. I understand about the change in guidelines for long term diabetes in that you decrease when glucose levels go under 2.8/50 three times but at this point with my own health issues I would probably take the reduction if we got a glucose level of under 2.8/50 once. I hope everyone is well and their kitties are well too. Thank you again.
My previous post:
http://www.felinediabetes.com/FDMB/...13-amps-239-8-130-10-128.142357/#post-1472455

 

I was just looking at your spreadsheet yesterday as it happens and wondering if she might need an increase soon. That 67 last night says no

In regard to following Roomp/rand guidelines for stalling though I think maybe you should have another read. The guidelines say to initially try reducing/stalling or splitting but if those methods lead to increased BG you should give the full dose and observe closely and note that the best results occur when the full insulin dose is given at the regular time. If that results in a reduction that means that she did need it - something for you to ponder.

I think you do do a marvelous job managing your Lucy in your circumstances Voula and I think that continuing to take reductions for once under 50 for her is fine too.

Sending vines for your health.

 

Thank you so much Serryn. I value your opinion and we will stay with the current dose. I really appreciate your support and your wisdom and experience. Yes I could have reduced the dose by 0.25 units according to the Roomp/Rand guidelines and I have done that to stay on schedule before when we have had a falling green number at AMPS or PMPS if I couldn't monitor as closely as I thought was needed. Good point too about if we earnt a reduction it means it was needed and I will keep that in mind though I delayed today because I felt anxious giving insulin with the falling green number under the limit I feel confident doing so and also so I could change our schedule by a few hours for this week and took advantage of the falling green AMPS to do so. Thank you again.

 

yes, I agree, I'd just hold the dose for now.

You always have the choice of taking reductions whenever you want to - there are 2 of you to consider, and you have some significant issues that are good reasons for being more conservative with Lucy. Sounds like she has a very good quality of life!

So good to see you!!

 

Thank you so much Julie. Lucy seems happy in herself and that makes me happy too.

 

I hope you're on the mend.

I tend to look at how low a current dose is bringing numbers and knowing that, how much room to go lower do you have if you increase the dose. With a 67, you don't have that much room. It also looks like Lucy is bouncing.

There are points in all of our lives when we don't push as hard with keeping numbers in line. It may be a health issue, family emergency, etc. As important as our kitties are, if you don't take care of yourself, you can't take care of Lucy. The only thing I might suggest is seeing if you can get someone in to give Lucy a shot if you're not able to be home.

 

Thank you so much Sienne. Yes Lucy has been having quite a bit of bouncing lately but I have accepted that now. Yes I agree I have to take care of myself so that I can care for Lucy and I can get the vet to come in as I have sometimes done but she needs someone to hold Lucy to give Lucy the insulin injection. I guess she could bring a vet nurse but with two people that Lucy doesn't know well it will probably be two people chasing her to give her the insulin instead of one person. I have gotten the vet to come when I have had to be in hospital overnight or more than one day as my friend stays with Lucy then and Lucy likes and trusts my friend. My friend can't do tests though or give insulin as Lucy won't allow that. The vet is experienced and she can give the insulin injection fast. Thank you I am feeling fine now. Lucy and I had a little holiday at my sister's house after my surgery and that was very nice.