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  1. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Just a little refresher course on reductions, primarily for new members, but if it helps experienced members, that's great!

    I've noticed in looking at many SSs, that sometimes reductions are missed.

    FD is time consuming and we all get exhausted and sometimes, we just miss taking the reduction. Other times, we see our kitty finally doing great...getting all those greens and blues and when he/she just slightly drops below 50, we possibly think "oh...meter variance..could have been above 50; I'll hold off on the reduction". I've done it myself.

    Under the modified protocol, reductions are earned when:
    • A newly diabetic cat (dx under one year) drops below 50 once
    • A long term diabetic cat (dx over one year) drops below 40 once
    • A kitty has had normal numbers for a week
    For kitties that tend to fail reductions, many experienced caregivers (CG) follow the Roomp/Rand protocol and will not take a reduction until the kitty's BG has dropped between 40 and 50 three times on different days on that specific dose. The reduction taken should be .25u because this is an aggressive method of earning reductions. However, if the kitty drops below 40 once, a reduction should be taken. Another option for kitties that fail reductions is to shave the dose if the kitty drops below 50 once. But please do not mix and match reduction strategies as you could be compromising your kitty's safety. As an example, it is not recommended to allow kitty to drop between 40-50 on three separate days and then shave the dose.

    And while it is not addressed in the protocol, if the CG is having a cycle where they are working hard to keep numbers up, it is wise to reduce the dose regardless if numbers have not fallen below the thresholds mentioned above.

    Be aware that the depot from a higher dose can affect up to six subsequent cycles. If you reduce the dose per the protocol and the very next cycle or two, kitty gets into the 40s again, you might consider holding the dose as these subsequent low numbers are likely the influence from the depot of the higher dose you reduced from. If you are a new member and not sure whether you should take a back-to-back reduction, it is always good to have an experienced member (or more) help you decide whether to take a back-to-back reduction or hold the dose until the depot drains a bit. In some cats, back-to back reductions will not hold and the dose will need to be increased back to the last good dose.

    It is acceptable on an earned reduction, to shoot through the bounce once and then take the reduction. For kitties who clear bounces quickly (in a cycle), shooting through the bounce may not be the best option and, instead, it might be safer to take the reduction at the next shot time after it is earned. If your kitty clears bounces in one cycle and you decide to shoot through the bounce, it is important to monitor numbers the cycle that the CG shoots through the bounce. If the CG accidentally overlooks the need to reduce, the reduction should be taken as soon as possible; reductions are not "lost".

    The reason it is important to take the reductions when they are earned is due to the cumulative nature of lantus/levemir where one shot builds upon the preceding shot. At some point, when the depot is full and numbers drop to levels warranting a reduction, if the reduction is not taken, the CG could be working feverishly to stay ahead of that depot.

    The best example I can give is when I failed to take a reduction with Gracie and the depot got ahead of me. She had already been into the 40s three times on the c1u dose when she dropped into the 30s on the morning of 5/8. I should have reduced her the PM cycle of 5/7 because her third time into the 40s was the a.m cycle of 5/7. Note the PM cycle of 5/8 below:

    Reductions.jpg

    Even for an experienced CG, this was a scary cycle because we could not keep her out of the 20s even with carbs and karo. I had let the depot get way ahead of me.

    I hope this refresher and example will stress the importance of taking those reductions. Remember...you can always go back up if the reduction fails. It is safer to take a reduction that may fail then to let the depot get the upper hand.
     
    Last edited: Oct 20, 2019
  2. Anne&Muffin (GA)

    Anne&Muffin (GA) Well-Known Member

    Joined:
    Jul 11, 2010
    Re: 10/16 Today's Lesson....Reductions

    This is great Marje, thanks so much!
     
  3. Frosty

    Frosty Well-Known Member

    Joined:
    Aug 27, 2012
    Re: 10/16 TODAY'S LESSON--REDUCTIONS

    Marje, this was very informative. It helped clear a bit of the fog but I'm sure I'll still be posting for advice.
     
  4. Anne & Zener GA

    Anne & Zener GA Well-Known Member

    Joined:
    May 26, 2011
    Re: 10/16 TODAY'S LESSON--REDUCTIONS

    Thank you Marje - it is so great to have this reviewed again and to see it all in one clear and concise post to bookmark!
     
  5. MelanieAndRacci

    MelanieAndRacci Well-Known Member

    Joined:
    May 19, 2010
    Re: 10/16 TODAY'S LESSON--REDUCTIONS

    Thanks for the reminder, Marje. I know I can still use them once in a while. They're helpful for advanced as well as new caregivers.

    Melanie & Racci
     
  6. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Re: 10/16 TODAY'S LESSON--REDUCTIONS

    bump
     
  7. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Re: 10/16 TODAY'S LESSON--REDUCTIONS

    bump
     
  8. Pam & Hoot

    Pam & Hoot Well-Known Member

    Joined:
    Oct 2, 2012
    Re: 10/16 TODAY'S LESSON--REDUCTIONS

    Thanks sooo much! VERY helpful!
     
  9. Teresa and Poopy

    Teresa and Poopy Well-Known Member

    Joined:
    Dec 17, 2011
    Re: 10/16 TODAY'S LESSON--REDUCTIONS

    Great explanation, Marje! Thank you! :YMHUG:
     
  10. tortie58

    tortie58 Well-Known Member

    Joined:
    Jan 3, 2012
    Re: 10/16 TODAY'S LESSON--REDUCTIONS

    Thanks Marje for the reminder! I am a life example of this these 2 days! nailbite_smile
     
  11. Jane & Jack & Karre the Emperor

    Jane & Jack & Karre the Emperor Well-Known Member

    Joined:
    Dec 30, 2009
    Re: 10/16 TODAY'S LESSON--REDUCTIONS

    Bumpity bump bump :smile:
     
  12. Re: 10/16 TODAY'S LESSON--REDUCTIONS

    bippity boppity bump
     
  13. Michelle & Scrabble (GA)

    Michelle & Scrabble (GA) Well-Known Member

    Joined:
    Feb 10, 2010
    Re: 10/16 TODAY'S LESSON--REDUCTIONS

    HI Marje, thanks so much for this, I was wondering just today what I needed to do with Scrabble's reduction and this clarified everything! Thanks!!!!
     
  14. Anne & Zener GA

    Anne & Zener GA Well-Known Member

    Joined:
    May 26, 2011
    Re: 10/16 TODAY'S LESSON--REDUCTIONS

    Lots of wonderful information and I need to review it more often!
     
  15. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Re: 10/16 TODAY'S LESSON--REDUCTIONS

    Bump
     
  16. Re: TODAY'S LESSON--REDUCTIONS

    Bump
     
  17. Doreen and PeePee

    Doreen and PeePee Member

    Joined:
    Dec 30, 2009
    Thank you so much for this explanation. Very helpful. I took a reducie last night. I think you were pointing your finger at me.LOL
     
  18. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    :lol: :lol: I wouldn't have been so subtle :lol: :lol: :lol:
     
  19. Onyx & Klepto

    Onyx & Klepto Member

    Joined:
    Jul 19, 2013
    Thanks, Marje. I was actually wondering when I'd need to start worry about reductions, but you've cleared that all up.

    Thank you.
     
  20. Elizabeth&Julia&Margaret(GA)

    Elizabeth&Julia&Margaret(GA) Member

    Joined:
    Dec 28, 2009
    Talk about bumping this up at the perfect time! Julia earned her reduction today (will update spreadsheet after dinner) and I was wondering if I should shoot through the bounce. I have my answer. :D

    *Bump*
     
  21. Susie and Elian

    Susie and Elian Member

    Joined:
    Jan 11, 2013
    Thank you! I had that "this is all about me" feeling while reading since I missed Elian's reduction yesterday morning and gave it to him last night instead. But then I was reminded that the world revolves around my daughter, not me. :) Really appreciate the information. Thank you.
     
  22. Tigger's Friend

    Tigger's Friend Well-Known Member

    Joined:
    May 23, 2013
    BUMP! Some very important information here!!!
     
  23. Kim & Twice

    Kim & Twice Well-Known Member

    Joined:
    Oct 9, 2013
    Thank you Marje! I bookmark and then also copied & pasted to word and printed off,complete with the pic of Gracie ;-)
     
  24. lovey11

    lovey11 Well-Known Member

    Joined:
    Aug 6, 2013
    Thanks for the helpful information.
     
  25. Frosty

    Frosty Well-Known Member

    Joined:
    Aug 27, 2012
    Thank you Marje.

    Bump
     
  26. Tigger's Friend

    Tigger's Friend Well-Known Member

    Joined:
    May 23, 2013
    Thanks, Marje - this is really great info. Julie reminded me of it, & I read something I hadn't noticed before:

    Marje said: And while it is not add... fallen below the thresholds mentioned above.our sugarbaby would've

    Somehow I missed that, & I think its a critical point. We all have days where we work too hard to keep our kitties above that 'reduction threshold', when we know that without all that effort, our sugarbabies would've dropped below 50 (BIG finger-point ohmygod_smile).
     
  27. Alexis & Nikki (GA)

    Alexis & Nikki (GA) Member

    Joined:
    Apr 24, 2013
  28. Angela & Blackie & 3 Others

    Angela & Blackie & 3 Others Well-Known Member

    Joined:
    Mar 15, 2010
    Bump, and it is very good information to have on hand. Since Blackie is a long term diabetic (LTD), she earns her reductions by giving me 3 #s between 40 and 50.
     
  29. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Thank you for this helpful reminder as I was one that was pondering what to do in the middle of :lol: the night LOL.
     
  30. ChEMom

    ChEMom Member

    Joined:
    Mar 31, 2014
    bump, because I needed to reread this. :D
     
  31. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
    Never read this post... Thank you Marje, good to know!
     
    Marje and Gracie likes this.
  32. Jill & Alex (GA)

    Jill & Alex (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    There's some very good information in Marje's post. However, here's an updated version: Reminder: *earning* reductions and starting OTJ trials with current guidelines for *earning* reductions as well as numbers to look for prior to starting an OTJ trial.

    Look for current "Info" posts marked with a yellow "Info" prefix...
     
  33. Alicia & Maggie (GA)

    Alicia & Maggie (GA) Well-Known Member

    Joined:
    Jun 17, 2017
    This should be a "sticky." Thanks Marje!
     
    TSP and Marje and Gracie like this.
  34. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    You're welcome. It is also important to read the post Jill linked.
     
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