Question about PM testing and insulin

I'm still trying to get a hang of all of this. For the past week, I've been testing Missy twice a day, with occasional spot checks thrown in. The vet has me call her with the readings and tells me whether or not to give insulin. The first couple of days, her PM number was pretty low, so we skipped the evening insulin. Yesterday, when I checked around 5pm she was at 180. I called the vet and she said no insulin. That number seemed high to me considering the past couple of days and I didn't want to go another 12+ hours with no insulin and have her level keep rising. I checked her glucose again 2 hours later and she was at 285. I decided to give her half a dose.

I guess my question is... how do I decide whether or not to give the PM dose if her level is "low" (considering the "don't shoot under 200" rule)? If her number is under 100, should I just wait until morning? If it is over 100, should I recheck in a couple of hours like I did last night and give insulin if it goes over 200? How do I determine if I should give 1/2 a unit versus a whole unit? Tonight I went with a whole unit because she was over 300. I really want to get her regulated and hopefully get her OTJ, but I feel like I have no idea how to adjust the insulin and I'm just making stuff up as I go along. She is currently using ProZinc and I finally received the U40 syringes. I finally figured out the spreadsheets, so if someone could take a look at that and help me out, I would greatly appreciate it.

Thanks,
Krista

 

Your spreadsheet looks great. But you did seem to be getting wonderful numbers at 0.4 units. Why did you increase?

 

Hi Krista,

Generally with people new to insulin the no shoot number is 200 until you get enough data (testing) to see how the insulin is effecting her. When you start seeing the patterns you can lower the no shoot # to 180 and see how that effects her, etc.

Better too high for one day than too low for one minute.

 

The 0.4 was when we were using U100 syringes. We started at the 2.5 line, then bumped down to the 1 line. Once I received the U40 syringes, the vet told me to start with a true 1 unit. Ever since then, her numbers got kinda crazy

 

I think you could lower the dose. It is harder to regulate if you skip shots, and if you are using less insulin, you may be able to skip fewer shots. Each time you skip a shot completely, it sets you back a little because she goes higher for the next cycle. You could do 1/2 unit.

If you get a number around 200, the usual advice is to wait 30 minutes and test again. If she goes up to 200 after 30 minutes, you can then shoot. If she goes up to almost 200, you could shoot a smaller dose than usual.

 

I recommend that you go back to the U100 syringes. As you know they provide finer dosing control. Just make sure, however, that you always give the dose in actual units of insulin and not the markings on the U100 syringe.