? Dosing/failed reductions

Discussion in 'Lantus / Levemir / Biosimilars' started by Lisa and little, Jul 12, 2020.

  1. Lisa and little

    Lisa and little Well-Known Member

    Joined:
    Sep 24, 2018
    Hi again!!
    So Little was reduced from 3.75 to 3.5 after 3 reading in the 40’s over 11 cycles in late June. Reduction to 3.5 threw a 35 in cycle 4 so I reduced again to 3.25 which seems to be a failed reduction. Protocol says go back up to the last good dose. Welllp.. truthfully none of these doses were consistently good. To go back to 3.5 doesn’t seem right cause that 35 scared me a bit even though she was completely fine. Thoughts on a 3.5S- meaning just above the 3.5 line or what I’d call a 3.4?
    Guess I’m just a bit miffed by the fact that in the end of June she was at 3.5 and the numbers indicated an increase to 3.75 then 2 days back on 3.5 this week and she throws a 35!!! What in the heck?:banghead: Thank you all for always being there for us and sharing your thoughts. It is invaluable to me.
     
  2. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Your ss looks a lot like Max’s first one. He often failed reductions so I said start taking smaller increases and de decreases which I called skinny and fat. I used digital calipers to make the dosing as accurate as possible.
     
    Last edited: Jul 12, 2020
    jayla-n-Drevon likes this.
  3. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    First, I'm hoping you realize that for a long term diabetic on TR, your reduction point is below 40 or you can also use three drops into the 40 - 50 range. You've also been at this long enough that using a fat or skinny dose may make sense.

    Also, on the housekeeping front, could you take a look at Marje's post? In particular, could you look over the info on your subject line?
     
  4. Lisa and little

    Lisa and little Well-Known Member

    Joined:
    Sep 24, 2018
    Sheesh.thank you. Can you direct me to info on calipers? Ive done skinny and fat before but once you don’t have a direct above or below the line it becomes very subjective and tough To do by eye
     
  5. Lisa and little

    Lisa and little Well-Known Member

    Joined:
    Sep 24, 2018
    Yes I will look it over when I get back home. Thank you. As for the reductions. She did in fact go below 50 3 times on 3.75 and hit a 35 on 3.5 so I believe the reductions were warranted. Am I missing something?
     
  6. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Nope. I wasn't criticizing the reductions. I just was reacting to your concern over the numbers in the 30s. It's a bit nerve wracking that the longer term FD kitties have to drop so low. Some members forget about the cat needing to be under 40.
     
  7. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
  8. Lisa and little

    Lisa and little Well-Known Member

    Joined:
    Sep 24, 2018
    I must have missed that entirely. I thought under 40 was immediate dose reduction no matter how long the kitty has had FD. Is there something I should read? I was inclined to keep her at the 3.75 even after 3 drops under 40.. actually maybe even Increase The dose as the 3.75 wasn’t giving me the block of greens I am looking for consistently, but was advised otherwise. Even though it didn’t work I’m glad I tried both reductions as all of this is still a learning curve with new insulin. If there is anything you can site RE some cats needing to be in the 30S that may help me understand a bit better And I’d surely appreciate it. I don’t panic much any more but the 35 shocked me as I was so not expecting it at all. Thank you again and I will watch my post titles going forward. I was good for a while and that fell out of my brain too!
     
  9. Lisa and little

    Lisa and little Well-Known Member

    Joined:
    Sep 24, 2018
  10. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    From the Dosing Methods sticky:

     
  11. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    @Sienne and Gabby (GA) My concern was we thought she hadn’t reduced when under 40 but apparently she did. I used 3 times under 50 or any time u see 40 as my reduction numbers.
     

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