? 7/13 Max PMPS 668; +3.5 551; +6.5 482. Day 4 on TR and due for an increase w/AMPS- is 0.5U correct?

Discussion in 'Lantus / Levemir / Biosimilars' started by Rebecca & Max (GA), Jul 13, 2020.

  1. Rebecca & Max (GA)

    Rebecca & Max (GA) Member

    Joined:
    May 14, 2020
    7/12 post

    Today (day four on TR) Max earns a dose increase from 1.5U to 2U, I believe, because his nadirs have been above 300 - except for his second cycle after moving to 1.5U (he was 228 @ +6). I'm a bit worried about jumping so much, but I'm also so very tired of the highs. Frustrated that at 1.25U, he was getting more mid-cycle reads in the 300s, but kept spiking high at PS times. The bump to 1.5 gave one low, and then lots of freakouts...come on Max (or Max's liver), help a girl out!!

    If anyone thinks I should only bump up to 1.75U, PLEASE let me know! I'm still new at TR. If I'm correct, the rules are going up 0.5U with nadirs >300...but that one drop to 226 worries me.

    OR do I hold for a few more days? I believe he's too high for a hold...
     
  2. Teri & Disco NoFurNo (GA)

    Teri & Disco NoFurNo (GA) Well-Known Member

    Joined:
    Oct 25, 2019
    I don't have enough experience to advise, but you are reading the Sticky Info correctly. Do you know how to see what members are online? If you go to the Forums Tab, on the upper right hand side it will show you who is online and I will tag the experienced @Diane Tyler's Mom to see if she can advise
     
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  3. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Last edited: Jul 13, 2020
  4. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I would increase to 1.75. At lower doses the increase is .25.
     
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  5. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    I think you're good to go to 2U

    From TR:
    Increasing the dose:
    • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
      • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
      • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
    • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
    • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
    Out of 16 cycles, you've only had 1 yellow nadir so I think we can "throw that one out"

    ETA....if this were my cat, I'd use the human meter instead of the AT....the numbers before that you were getting on the Libre (which is a human meter) had Max getting into yellow more which would mean possibly different answers to your questions
     
    Last edited: Jul 13, 2020
  6. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
  7. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Rebecca --

    You were reading the TR Protocol correctly. Max's numbers warrant a 0.5u increase.
     
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  8. Rebecca & Max (GA)

    Rebecca & Max (GA) Member

    Joined:
    May 14, 2020
    Thank you all!! I had to test and dose him before sitting through rounds of Zoom interviews for high school teachers for my twins’ charter school. Max surprised me and read 427 at his AMPS. I know we shoot for the lows, but I also knew I might get delayed and not be able to test as much today. I didn’t even have time to update his SS with his new numbers, SO, I decided to wait a day. I’m getting ready for a mid-cycle test, and figure I will increase him tomorrow as I don’t want to do it tonight and then not test him much during the night. Hopefully I won’t be messing him up too much!
     
  9. Rebecca & Max (GA)

    Rebecca & Max (GA) Member

    Joined:
    May 14, 2020
    I looked at his numbers from the two reading I got at +3 (3:30 AM) and +8 (8:30 AM)...he was 346 & 293. That made me look back at his other reads and that’s pretty much where he’s been (300s) for his nadirs. Since dose numbers are based off of HUMAN meters, I’m going to start using the Contour first, then the AT if I have enough blood. My only issue is there are a few key times when there’s barely any blood after multiple sticks and one angry kitty) yet it’s enough for an AT read, but not for the human meter. Time to just make the switch and do my best!
     

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