? 4/9 Evey PMPS 106 +1 104 +2 52 +3 56 +4 52 +10 157 +11 203 AMPS 218 +1 185

Discussion in 'Lantus / Levemir / Biosimilars' started by Evey, Apr 8, 2024.

  1. Evey

    Evey Member

    Feb 16, 2024
    Preview thread: https://felinediabetes.com/FDMB/thr...4-8-92-9-104-10-95-11-86.288542/#post-3168256

    Evey had a lower than usual preshot number in the evening of April 8th. I fed her and stalled the shot for about an hour (she was supposed to get insulin at 19:09, but I didn't give it to her until 20:18). This is my first time to give her a shot at a number under 108 and I was really worried that she might have low blood sugar. So I gave her 0.75U instead of 1U even though she didn't earn a reduction.

    I have some questions about shooting her at low preshot number and what happened afterwards.

    1. I was gonna wait for +5 BG number but I was so tired that I fell asleep. Unfortunatelly, I didn't get her +5 or +6 number. I'm not sure if she drop below 2.8 or not. It's kind of hard to see from the curve (this is what the curve looks like Evey's curve). Since I don't know if she drop below 2.8 or not, I gave her 1U this morning. Am I doing this correctly? If I'm wrong, please correct me. Thank you!

    2. I also noticed that she had a big bounce after i gave her insulin at a low preshot number. Her +11 was 203 and AMPS was 218. She doesn't usually go up that high. Can anyone explain it to me why this is happening? Did I do anything wrong?

    3. The sticky notes says "Shooting an hour or two early *could* act like a slight dose increase. Shooting an hour or two late *could* act like a slight dose reduction". Since her shot time was delayed for about an hour last night, I need to move it back to around 7am/pm because of work schedule. If I understand guidance corrrectly, it's ok I gave her a shot 30mins early. Am I right?

    4. I was told the flatter the curve is, the higher chance she coulde get to remission. Recently, her BG curve looks like riding a roller coaster. Is she getting better or worse?

    I'm so sorry I have too many questions. Thank you for your help in advance~
  2. Bandit's Mom

    Bandit's Mom Well-Known Member

    Oct 18, 2019
    You were right to give 1U since she didn't drop below 50 and earn a reduction. We go by the numbers we have and not by what could have been. :)
    In fact, for CGs using the Libre, we suggest verifying any lows with a regular meter since the Libre reads much lower at normal numbers. You want to make sure that you are basing dosing decisions on accurate readings.

    It's possible that her body was reacting to staying in lower numbers for longer. Anyway, those yellows were pretty much blues if you consider meter variance, so I wouldn't worry about it.

    Yes, you can move shot timings by 30 mins a day or 15 mins per cycle.
    Getting back on a 12/12 shot schedule

    Not so much flat curves as much as time spent in normal numbers where the pancreas can heal. She is looking good at this dose. If you aren't doing so already, you want to "feed the curve" and reduce the drops you are seeing at +2 in active cycles. Although, I'm not sure how much of that is Libre wonkiness.
    Staci & Ivy likes this.
  3. Evey

    Evey Member

    Feb 16, 2024
    Thank you Bandit's Mom. I didn't even see post about Getting back on a 12/12 shot schedule. This is really helpful. I am moving her shot time 15mins early each cycle. so hopefully couple days later I don't need to stay up so late for her BG.;)

    I am learning to feed the curve. I give her 25g when I give her insulin. Then I feed her at +2 when her BG starts to drop and feed her more food and more often if her BG drops really fast. But I see a problem with this way of feeding that is the feeding time is not consistent every day. I read that it's better to have set insulin and feeding schedule. But if they want to feef the curve, it's kind of hard to have a set schedule.

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