? Another low read - reduce again?

Discussion in 'Lantus / Levemir / Biosimilars' started by Elizabeth20, Jan 7, 2021.

  1. Elizabeth20

    Elizabeth20 Member

    Joined:
    Nov 20, 2020
    Previous post

    Hi

    This morning Lily had her 6th reduced dose since she was taken down by a quarter unit and has just hit 49 at AM+3. I am planning to reduce her again this evening - can I just check that's right? She has had a mild bounce the last day or so after her last two low reads but has settled really well. I only wonder whether the low read could be because of the remains of the depot at the higher dose.

    Having checked all my remaining BD Microfines syringes they are almost all out mostly by 0.5 unit, and I suspect I've been pulling back to the wrong point. The 0 line is behind the plunger. Is that right? Regardless she has been having a fairly consistent dose but it may have been half a unit higher than I was intending since I started her on Lantus.

    Thanks

    Liz
     
  2. Bandit's Mom

    Bandit's Mom Well-Known Member

    Joined:
    Oct 18, 2019
    This was the 6th cycle at 1U. So not the depot. And yes, you reduce to 0.75U starting tonight! Congrats :)

    If you have been dosing half a unit more, you should continue with that!
     
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  3. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    It doesn’t matter what you call it. Just reduce by .25.
     
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  4. Katherine&Ruby

    Katherine&Ruby Well-Known Member

    Joined:
    Oct 8, 2020
    As long as you're consistent, it doesn't matter where the plunger is. I use the BD syringes as well and I started a few weeks ago to use digital calipers to do the smaller doses my Ruby requires now as it's astounding how inconsistently printed the lines are on the syringe. On this morning's syringe the "zero" line was at least .5 units below where the plunger stops at the top, which means I would have given Ruby twice as much insulin as she needs!
     
  5. Elizabeth20

    Elizabeth20 Member

    Joined:
    Nov 20, 2020
    Thanks all

    Katherine I'm still figuring out how to use calipers having got them out of the box but inspecting the syringes was an eye opener. Out of 40 33 were consistently as I've described, but on 7 of them the line was a good 0.25iu out which as you say will make a lot of difference in a low dose. Will definitely sort them in future to save the risk of just believing what they say!
     
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  6. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    Congrats on the reducie.

    Did she really have 200g of food with her shot?
    Is this usual?
    How often are you feeding?

    This morning she was lower than she was midcyle, last night, and she had been bouncing, so you shot as a bounce cleared, when you do that they can gather some speed and keep rocketing down. I might have grabbed a +1 today, and she might have got some snacks to try and help her surf, she might not have dipped below 49 then, or she might have anyway if she really wanted the reduction.
    Whenever you are shooting a lower than normal PS its a good idea to get a +1 and +2, she might give you advance warning with those as to what she has planned.
     
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  7. Elizabeth20

    Elizabeth20 Member

    Joined:
    Nov 20, 2020
    Ah this is useful info. Yeah she ate all her breakfast straight away and then two more portions fairly soon after. Because she was clearing her plate, which she's been doing less often recently as she regained her weight, and because she had a low pre shot, I just fed her 200g on the basis she needed it to carry her through.

    She often eats up to 400g a day but recently she has been eating more like 350 and forgets she has food in her bowl so less starving. She's only supposed to have 200g for her weight but I'm free feeding to get her back up. She's put on a kilo since the end of November. Her max weight has been 4kg but that was when she was about 8 and she's 12 now.

    I'm still learning about the science of it together with how she reacts but I think I figured if she was within the TR ideal boundaries she was ok to shoot. If shed been less aggressively hungry I probably would have waited half an hour to check which way she was going. Would that have been better? I just waited till her breakfast had gone through her to measure intending to get her at +2 but I missed +2 and got her at more like +2.75 so recorded it as +3.
     
  8. Elizabeth20

    Elizabeth20 Member

    Joined:
    Nov 20, 2020
    Have updated sheet with the rest of today's reads. I should have tested again after AM+6 and the honey and food mix I gave her then.
     

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