10/14 Frip AMBG 40 +2 86 +7 158 +11.5 104 - Dose?

Hello LL,

I’m opening a condo today to have advice for tonight’s dosing. I haven’t posted in a couple of weeks because everything is going well.... but I log in regularly to read others.

Please see Frip’s SS.

I noticed something changed in the last month or so, we get more regular blues and greens. cat_pet_icon Frip has late nadir (around +12).

He’s been doing well more like his younger self (jumps on news paper, sleeps in bed, chases mouse toy, sleeps in laundry basket, etc…)

I already lowered the dose from 2.4U (Sept. 22) to 1.75U (yesterday night). This morning AMBG is 2.2 (40). Decided to skip shot this morning to stay on schedule (11:30 bid).

What dose should I give him tonight/next days?

Re: 10/14 Frip AMBG 40 - Dose question for tonight

Hello! Nice to see you! I can't give advice, but Frip's SS is looking pretty! Good job!

Re: 10/14 Frip AMBG 40 - Dose question for tonight

Hi...can you tell me what his PMPS was last night please?
I think I found your last condo Aug 15th...have you posted since then?: viewtopic.php?f=9&t=22474&p=224359&hilit=Frip#p223841

I am wondering if you have read the dosing guidelines in the stickies at the top of the page.... Tight Regulations: viewtopic.php?f=9&t=1581

"Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further."

I see that on 9/24, Frip was +4=38 and you stayed with that same dose afterward. And actually, we change doses by .25u each time so I am not sure where the 2.40 dose came from. Can you tell me how you arrived at that dose in particular? Were you "shaving his dose"? On 10/11 that 40 would have earned another .25u dose reduction...but I see you only took .10u off his dose. This morning's 40 would mean another .25u reduction was earned.

I will link another post from Libby regarding low preshots.... viewtopic.php?f=9&t=26571
If you have a moment to read that and come to post any questions you may have.

I am so happy to see your condo today Sylvie! Is there any way that you can post daily? It would be very helpful to Frip if you can keep in touch daily with us. I am wondering when Frip was diagnosed. Has he always been on Lantus or did you start with a different insulin?

I am hoping a dosing person can take a look at Frip's SS today and give you some suggestions. Any time you get a low preshot, you are welcome to post here too and someone will walk you through the choices of shooting and doses for each particular situation.

Re: 10/14 Frip AMBG 40 +2 86 - Dose question for tonight

Fed HC FF after AMBG +2 since AMBG is 86.. (not sure how we call that since I din't give a shot...)

Anne, Pat, thanks for your response...

Last evening PMPS was 2.9 (52).

Frip: Date of diabetes dx: April-02-2010
Oral diabetes medications: Diabeta (2 months) before starting Lantus June-01-2010.

I already read all the stickies…I’m used to shooting low numbers now because Frip has late nadir around +12.
I reduced dose slowly since August because he didn’t do well on 0.25 decreases earlier in August – tried twice to go from 2.5U to 2.25U but didn’t get good results..

This is how I adjusted the dose:
Aug 15: AMBG 49 - Reduced dose from 2.5U to 2.25U.
Aug 24: Increased to 2.4U because not getting good numbers.
Sept 23: AMBG 47 - Decreased dose to 2.25U
Sept 24: +4 38: Kept 2.25U because just reduced the dose the day before.
Sept 30: PMPS 56 – Reduced dose to 2.1U because I didn’t want to see another 38…
Oct 11: AMBG 47 – Skipped shot to get back on schedule and reduced dose to 2U.
Oct 13: PMPS 52 (2.9) – Reduced dose last night to 1.75U.
Oct 14: AMBG 40 – Skipped shot this morning to keep schedule.

I already reduced the dose yesterday evening to 1.75U… This morning I got a AMBG 40 – do I keep the dose at 1.75U or reduce again at 1.5U or 1.6U?

I will keep posting more often now that I’m getting lower PS… ;-)

Re: 10/14 Frip AMBG 40 +2 86 - Dose question for tonight

Others will be watching today to see what he does....it's good if you can keep tabs on him and maybe post your +11 number when you get it? Lantus works best when a 12/12 with consistency can be maintained....maybe a lower dose would work better than skipping at these low preshots....so let's see what he does today and where he is at +11.
Can you test him throughout the day?
If you are not able to get many AM cycle checks regularly, then filling in some more data in the PM cycle would at least give a better idea of what he is doing. Is that doable from now on?
Post that +11 number and others will most likely be here to tall it over with you...how does that sound? :razz:

Re: 10/14 Frip AMBG 40 +2 86 - Dose question for tonight

hi sylvie. it looks like frip could be over dose due to some missed reductions. it's hard to tell by how much though.
if it were me, i would probably take the dose down to 1.5u bid, but i would watch carefully for indications that the dose may need to be reduced again.

Re: 10/14 Frip AMBG 40 +2 86 +7 158 - Dose for tonight

+7 is 158, will update again around +11...

It's easier for me to get tests during the day (I work from home).. The shot time is 11:30 so that does not leave much time for the evening cycle... This is the best time for us (after my morning calls/meetings and late enough when we go out at night)..

Jill, I was also thinking of being safer and use 1.5U bid for a while and see how it goes. Amazing, hard to think we were up to 4U for a while...

+11.5 104

Any advice please? I'm thinking 1.5U even if I already reduced to 1.75U yesterday evening...

i'm not a dose person...but i think jill is one of the all time experts...guess what i'm saying is i would go with jill's advice

I agree with Jill, I would take the reduction to 1.5 units BID. Good luck with the reduction!