What to do?

Pelles numbers fall so much after his shot in the mornings, så that his pmps is to low to shot on. His amps is then really high and then the same thing happens.
Here are the last 4 days numbers

3 days ago: amps 280, got 0,5 unit, pmps 83, no shot
2 days ago: amps 230, got 0,4 unit, +5 176, pmps 115, no shot since he seems like dropping for more than 12 hours and it is nighttime.
1 days ago: amps 272, got 0,4 unit, pmps 85, no shot, +1½ 101
Today: amps 284, got 0,25 unit, +6 95, pmps 74

We have lowered the dose to prevent him dropping for to many hours, so that it will be possible to give him insulin twice a day as he clearly need since his amps is so high. But he reacts a lot to even a small dose like 0,25 unit.

Is there anything we can do differently to help get Pelles numbers more stable?

Thanks

 

I would try to hold the .25u dose. You just dropped to it and today's pmPS may still be coming off the higher doses.

However, you are right that you want to keep reducing until you find the dose you can give every 12 hours. See how he does over the next two days and if this pattern continues, reduce the dose again to approx .1u. That could be anywhere from .1u to .15u, just be consistent with how that dose is arrived at so you know he is getting the same amount each time.

My hope would be that the amPS numbers would stop being so high, but skipping a shot when he is probably doing a little rebound contributes to them being higher. If they are up for it, they could test hourly after PS time (in the evening) to see if he is rising past 100 and give a reduced shot then. But then test up to at least +4 (+6 would be better) to make sure he doesn't drop too low.

I did find that I had to keep reducing Beau's shot. I could not give even the tiniest insulin if he was below about 150 (130-150, I can't remember). So I would reduce again until he started having low PS and/or a low nadir (below 40-50). Eventually, you do end up shooting "as needed". When I got to that stage with Beau, I would test and shoot when he got above 150. Sometimes I had to skip testing/shooting because I had to be gone for work. When they are at the point where you are shooting as needed, they can need two shots a day or only one, or none, but then need a shot again the next day.

Charlotte, this is looking really good. Pelle is doing very well and so are his parents (with your considerable help). Dare I say it looks like he may be headed OTJ? (Knock wood, anti jinx). :mrgreen:

 

Thanks Sheila
Now at + 17 he is at 120, so still pretty ok number.
The late nights and a lot of testing is not gonna happen i think. They are working a lot and Pelle is sometimes when we are not expecting it dropping hard. We need to play safe since there is not to much testing.
They will keep his dose at 0,25 the next few days and then we hope the possible rebound will stop. Yes and then we all pray for him going OTJ