? 03/18 Mowgli AMPS 394 Dose Increase?

Discussion in 'Lantus / Levemir / Biosimilars' started by Jaime & Mowgli, Mar 18, 2021.

  1. Jaime & Mowgli

    Jaime & Mowgli Member

    Joined:
    Jan 5, 2021
    Last Thread

    @Wendy&Neko

    I am very encouraged to see Mowgli's numbers improving significantly over the past week. Considering that he hadn't seen numbers in the 100s (or 200s for that matter!), it's not surprising that he's been bouncing every day. He seems to clear the bounce in one cycle though, so hooray for that!

    I want to ask whether we should increase his Lantus dose based on our recent results. As far as I can see, there have only been a couple of cycles that can be taken as relevant to making this decision considering that many others were bounce cycles and the rest were spent using mid-cycle R to lower the BG back down.

    We had mixed results in the two cycles where no mid-cycle R was given (apart from clear bouncing cycles). The night of 03/14 his preshot was 245, nadir was somewhere in the mid 100s, and ended at 261. The next day-time cycle on the 15th we had the preshot of 261, nadir of around 110, and ended at 354. Unfortunately, I believe we got a bounce on this second example because we gave 0.5R instead of 0.25R which caused a greater than 100 point drop in the first 4 hours. It is clear that 0.5R with 9.0L is a bit too much.

    Anyway, should we work to get the BG down to a lower preshot and give 9L and 0.25R another shot or should we increase the Lantus dose?

    Cheers!
     
  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Your goal is the majority of time under renal threshold including some greens, I would increase. This dose + R isn't quite enough.

    By my counts, around day 68 on insulin. Maybe time to schedule a blood draw for next week?
     
  3. Jaime & Mowgli

    Jaime & Mowgli Member

    Joined:
    Jan 5, 2021
    Got it. We will increase tonight.

    I will look into scheduling that soon, but it will have to be for two weeks from now since I will be on a work trip next week.
     
  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    No rush on the timing, just something to plan in case it takes a while to get an appointment.
     
    Jaime & Mowgli likes this.

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