4/18 Jake's AMPS - 415 PMPS - 354

Hello everyone,

Jake has been on a new dose for about a week now, he's pretty pretty high for the past eight days too... could new dose wonkiness still be in effect? I don't want to up his dose unless I have to, maybe even switch to a different insulin. Thoughts?

-Breayle and Jake

http://spreadsheets.google.com/pub?key=0AgUMsjJc7hILdGNqR0VCRVBGbnI3c0o0U1VzYUdfVmc&output=html

 

New dose wonkiness (NDW) only lasts a day or so. It may not be immediately after you increase the dose but it is relatively brief - usually 24 hours. Here's a bit more info on NDW.

Is there any way you can get a full, 2-hour curve in? What you are referring to as "freaky numbers" on your SS could be interpreted in a couple of ways. Jake may need more insulin in order to bring the numbers down. On the other hand, Jake may be bouncing from yellow (or lower) numbers that are happening mid-cycle. If you increase the dose, this will mask the situation and make the bouncing worse. Having more spot checks will help to sort this out.

 

why don't you want to increase his dose? It looks to me like he needs an increase to bust through those pinks and reds. There's no reason to be afraid of giving more insulin if it's needed.

 

Freaky numbers as in 400's 300's. I get as many tests as I can in, I was told by my vet to do a 4 hour curve test so that's generally what I've been doing on my days off. Last week was a long week with lots of work, and no one else in my house will do spot checks for me. My mom has done it ONCE and now she says she can't get a test out of him 'cos he wont let her. When I'm home I do as many as I can. He's been at 1.75 for a week now so I'm not sure if I should up his dose or what.

 

Well my vet keeps giving me a bit of a hard time about his dose, she keeps telling me to keep the dose for 3 weeks. She wants to get him back in for his BG test but says she can't 'cos I keep changing his dose. I can tell her what his average BG level is, it's in the high 300's to the 400's and has been since he was diagnosed. Maybe a new insulin... dunno... he does react to it he's just not leveling down.

-Breayle and Jake

 

Here's my best guess. Your vet would like to run a fructosamine test. This gives you an average BG over a 2 - 3 week period. From the vet's perspective, I can understand why she would like you to hold the dose. My other best guess is that your vet isn't used to having people who test as regularly as we do. One of the big advantages of having a SS is that your vet should not need to run fructosamine levels since you have hour to hour, day to day data. Fructosamine levels are fineas a means of diagnosing diabetes and if you don't home test. Since you are testing, it's an unnecessary expense. You could offer to send your vet Jake's SS. (My vet was pretty blown away when I sent her Gabby's SS. She stopped asking for fructosamine tests or for me to bring her in for curves. The latter would have given a false reading anyway since Gabby gets very stressed at the vet's office. )

Most vets use a 2-hour interval for a curve. A mini-curve is every 3 hours. A 4-hour curve may be helpful with an insulin other than Lantus. I'd be concerned that you might miss the nadir when getting only 2 tests between AMPS and PMPS.

I didn't see anything on your SS about testing for ketones. With Jake's numbers running this high, I'd encourage you to do so, if you aren't already routinely testing. If you are, could you remember to put a note on your SS?

 

I did send my vet the spreadsheet! She still wanted to take the test, she also basically ignored my emails until she wanted to do that fructosamine test... which lead me to believe that she wants money. My vet wanted a 4 hour interval for the tests... she's pretty green graduated in 09 and I'm a little disappointed in her.

So with all this and that, do you think increasing his dose to 2u a day would be beneficial?

-Breayle and Jake

-Breayle and Jake