? 7/31 Thelonius 202 AMPS 76@+6. Hold or increase?

Discussion in 'Lantus / Levemir / Biosimilars' started by Thelonius, Jul 31, 2020.

  1. Thelonius

    Thelonius Member

    Joined:
    Nov 15, 2019
    Prior thread

    He's been doing pretty well at this dosage, should I keep him there for a bit longer or try an increase?

    TIA
     
  2. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I would hold a little longer since you are seeing nice nadirs and some bouncing from tge greens. One thing to keep in mind is that he might have gone lower after +6. I would have tested one more time after the 51. See what others think.
     
  3. Thelonius

    Thelonius Member

    Joined:
    Nov 15, 2019
    Well I gave him 1.75 with a PMPS 233 and he was 148@ +3.5, so it wasn't a dangerous increase atleast.

    I think this situation confuses me a bit with respect to the guidelines, but I think he'll probably come back down quickly.
     
    Last edited: Aug 1, 2020
  4. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I think you were in a gray zone with regard to whether to increase. You are correct in that since nadirs were <200 that you hold the dose for 5 days. (Note that the protocol says new to numbers <200 and Thelonius isn't exactly "new" to those numbers.) The decision point is based on how low the current dose is bringing the nadir and if you have enough of a safety margin to increase. If you're comfortable with the amount you're testing, think that you have enough data to support a decision to increase, and will be able to keep an eye on the numbers, then it's fine to increase.

    As detailed at TR is, there are still decision points that are left up to the caregiver. If it were my kitty, I would have likely increased, as well. Elise may be a little more conservative and would opt to hold the dose. This is why you're encouraged to post your questions so you can see the differences in the way members here think through their decisions.
     
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