Oops I posted on yesterday ... Nice string of blues for Do Daa yesterday evening! I'm wondering if his flat yellow cycle today means he's got something planned tonight?
Are we still suppose to wait until next Wednesday on his current does of 3.25u even if he hits lower that 90 tonight? Are we just to ignore the lower numbers until then and keep shooting 3.25u?
Just getting a little conflicting information: "He’s definitely looking better. Be watchful because it’s not unusual for back to back reductions to fail. Unfortunately, under SLGS with Lantus, if he fails a reduction, you would hold the dose a week before you can take it back up. Good luck with the reduction." - I wrote that down on a post it note so I'd remember until next Wednesday.
These are two different situations. Anytime at all, with SLGS, the BG drops below 90, reduce the dose by 0.25u at the next shot. Otherwise, hold the dose a week, run a curve, determine whether the dose needs to be raised, held, or reduced (if he drops below 90 the day of the curve). In the case of Daa, you are testing enough that a curve is not necessary after a week. We just look at the nadirs of the week and decide. Lastly, in what I told you a few days ago, when you reduce the dose, you hold it for a week even if the BG goes back up and it’s evident the reduction failed. At the end of the week, determine what needs to be done with the dose per the guidelines, which, if it looks like the reduction failed, the dose would go back up. This contrasts with TR because if the dose is reduced and then the next cycle, the BG drops below 50 but not into the 30s, we wouldn’t take another reduction because it’s likely due to the depot (same as for SLGS...it’s likely the depot but we are more conservative with SLGS). However, any time after a reduction on TR, if we see it’s failed, we take the dose right back up even if it’s been just a cycle or two. We don’t hold onto doses with failed reductions. Does that make sense?
I'm glad you asked for clarification about what happens if he goes under 90. If you read Marje's post again, it says "you would hold the dose a week before you can take it back up". But that doesn't mean you hold the dose a whole week even if he goes under 90. With SLGS, you hold the dose for a week unless Do Daa goes under 90, then the guideline says you need to reduce immediately. ETA: Marje's response is way better , I'm too sleepy to post in such detail!
