4/28 - Napoleon - crazy numbers

Wow - what is going on. Yesterday was so great. Is this to be expected as they are adjusting? That 480 scares me :sad:

AMPS - 401
+3 - 259
+5 - 166
+8 - 216
PMPS- 480!!!!

 

As is said frequently around here, "DM is a marathon not a race."

Now, if you could fill out your profile [which will hopefully detail what foods you are feeding exactly - brand AND flavor - as well as giving us a better picture - figuratively - of Napoleon] I know it would help me. Please make sure to note whether Napoleon is indoor out outdoor. The instructions in the Tech Support forum have a guided setup that asks you most of the important questions.

The curve looks nice - you are lucky for that. But the PSs have ticked up the past couple cycles sooo.

Do you think you can muster figuring out 0.25U increments? Usually folks around here raise doses in approx .2U increments which works out to one line in a U100 syringe with U40 insulin. Getting smaller increments is going to be a bit more tricky with the U100 insulin you have, but at 2.5U the change to 2.75U would not be THAT big of a jump. I've written instructions before that you could convert into dosing with U100 insulin that might allow you to even make "0.125"U changes - I think Hope has the link to that topic here in PZI or I can try to find it if you think you might want that.

With the SLGS approach I believe the usual recommendation is to wait approx 4 [3-6] cycles before changing the dose. So you have gone 3 cycles now & I've laid out some ideas for you. :smile:

 

ok lets think...those are some unusual #'s so lets see if we can find an answer to that puzzle. anything freighten him or stress him today? anything unusual, different food?
SOMETHING happened, stress of any kind can add a hundred or more points. so can the wrong food. is he hurting anywhere that you can see?

 

Another odd question to ask - when was his last dental? Any tooth issues can cause the BG's to be funky and spiky.

Any possibility of getting an hourly test even for an 8 hour period. That could give you a lot of data.

Another possibility is going TID for a short period of time. I found the 8 hour schedule helped us to hone in on a good dose a lot quicker and I was much better able to react to weird swings. It's grueling though and you go through test strips like water.

 

I'd want to try a measured [as in small] dose increase before going TID ;-)

Yea, as you are seeing there are all sorts of things that can effect BGs. :smile: But it seems you are getting pretty nice curves so far [besides the PSs going up]. So I'm less suspicious of extraneous factors. Your numbers really aren't that crazy.

So we'll see where Napoleon ends up tomorrow. If things stay high, in the morning then you might think about a small increase if you think you can manage 2.75U. Eventually you will be able to use all the data you collect to guide your future dosing.

 

Gator - just making sure it's an option in case needed . If I remember correctly, they have a short period of being able to test a lot before a new job (that's right, right?)

I've got to say, for us, and a really hard to regulate cat (9 months and 2 times that euthanasia was offered as a option), TID was extremely helpful. I fought against doing it and it was exhausting, but it really did help us keep her in low enough numbers for long enough for everything to start working.

No one ever told me it was an option for the first 6 months of our fight to get Ari regulated and I was open to anything. Heck, if you had said dipping the cat in giraffe urine would help us keep her out of the 400's, you'd have seen wild kingdom in our back yard. Just want to make sure all options are kept open.

 

Gator, my profile is now updated. Hope I did it right, I followed the template from the tech forum and made a Google Doc. Couldn't get it to work the other way. Napoleon is an indoor cat. I can definitely try the 2.75. I think I can try to eyeball it. Thank you for the suggestions ;-)

Lori, nothing stressful that I know of. He put up a little bit of a fight though when I was trying to test him at PMPS.

Hope, he has not had a dental as of yet and that is definitely my next step. He does have a lot of tarter and I have a gut feeling that it may help this situation to get him a cleaning.

 

Good work :smile: OK now just post the link into this topic or put it in your signature like you did for your SS.

EDIT: BTW this link was posted recently by Ele about measuring small doses - there are some pics near the bottom that might help.
viewtopic.php?f=9&t=157
And I think this is for Lantus which is a U100 insulin too so it would have direct applicability to your situation.

 

All set Gator Thanks for the guidance with this.

I will check out the link! Thanks!

 

Ketosis as in keytones in the urine right? That stinks. I'm sorry if I missed this before.

How the the keytones go down? I mean, when did that occur and how did you or have you resolved them. Do you know at what dose they disappear at? Are you currently testing for keytones?

EDIT: Sorry I messed up the other post.

 

Yes. I actually new he had Diabetes before it was confirmed when we went away for a weekend and came back he was not himself. He is a snuggler and I smelled acetone on his breath and knew something was up. I can always smell when he has ketones. I took him to the ER and for sure it was ketones and Diabetes. They were luckily trace to small and he has had them trace to small in the very beginning of his diagnosis. I do test, absolutely. They are why I get alarmed with high numbers.

Not sure what dose causes them to disappear unfortunately.

 

One more question:
When/how long ago did you make the switch to low carb wet only diet?

 

I switched as soon as I found out he was diabetic. At first I tried him on EVO dry to supplement the wet, but it spiked his numbers, so he has been on strictly wet low carb pretty much since 1 to 2 weeks after his diagnosis. Also, I think that I had to possibly change my injection technique. I did some research and although I was always rotating sites, I was not always shooting at a 45 degree angle. I did this tonight and he is getting a nice curve again. His numbers are updated on the spreadsheet and I am updating on the board.