TID Need Advice bg 29@ +2

OK, so I went to TID a few days ago and was doing great. I had a few slip-ups due to FF w/gray effecting bg's and I think I shot too soon on March 16th at 2pm (bg 166) should of waited for it to raise again. Prudence is in the 300's at +8 about to take bg soon. I am just not sure if I should stay at 0.3 or go to 0.2? I want to say 0.3 because of the 300's, but I am scared of the 29 I had last night.

 

I would shoot 0.3 because of the high BG. I would not have shot 0.3 with a PS of 166

 

Thanks Larry. My head is spinning right now trying to figure out my scale.

Scale:

>300 - 0.5
>200 - 0.4
>80 - 0.3

but I think I need to change it to:

>300 - 0.4
>200 - 0.3
> 80 - 0.2

On the 15th & 16th I had a PS of 151 & 152 used 0.3 and that seem to work, but I think Prudence is getting too sensitive to the insulin? Not sure if this has anything to do with it, but by looking at her SS, I noticed that in one full 24 hours.. looks like she was doing fine with about a total of 1.0 if you add TID PS for the day. I think I need to somehow adjust this to maybe 0.8 or less for a full 24 hour dose. Not sure if that just made sense?

I gave a skinny 0.4 this morning, so my nerves are shot again wondering whats in store for us today. Thanks again for replying.

 

I'd raise the lower limit from 80 to 150. Then based on your spreadsheets, I'd stick with a 2-level scale:

150-250--.2
251+...... .3

When you're shooting TID, you are building up overlap so it's better to shoot low a low dose and collect data for 2-3 days than to try and aim at low numbers right from the start.

 

Michelle, that > 80 really scares me. I know Steve has been guiding you on this & he knows a lot more than I do and may have good reasons if that's what he told you.

Personally, I would set a NS of 150. With TID I would also do a rising # check with each shot - you may already have that covered with mid-cycle checks of course, but if you aren't sure she is rising I would wait 30 min & retest. Just my 2c.

 

I agree. I'd raise your no-shoot. JMHO

 

I have never seen a shoot/no shoot line of 80 on PZI. Not saying it hasn't happened. The 150-180 range is common.

 

Thanks everyone. Yes. I agree I need to re-work my scale. What I'm finding is that... In a 24 hour period. Prudence did well with a total of 0.9 units in her system... this lasted about three 24 hour cycles. What threw me off was that I started the TID in the middle of the day. With that being said, she did get too much in her last 24 hour cycle.

With the scale I posted about with the >80 - 0.3 that's what was working at the time. I had shot 0.3 with a ps of 99 and it worked out well because it was the start of my next 24 hour cycle.

I will explain more soon. I am waiting for her to raise since she's at bg +9 178 right now. +10 bg 113




It looks like (#C) ps 197 to ps 299 should of been 0.8 or 0.7 total for the 24 hour cycle. Her last cycle (D) ps 331 to ps166 was a total right there of 0.7 making her go hypo. She still has 0.4 from last ps 414 in her system, so I may skip this cycle but will keep checking her numbers.

 

Sweet chart!!! As the overlap builds up and things in their bodies change, the calculations and total insulin, etc., may change as well - I'd just hold on to everything lightly, because it can be an ever changing picture. With Bix I've learned the data is only as good as the last shot. Well, it's a little more useful than that. You are doing an awesome job, hang in there!!!!

 

The total amount of insulin over 24 hours is interesting data but it doesn't offer much guidance on what to do now or in the future. As you can see, the same 24-hour total of .9 gave you good results and then gave you bad results as a result of rebound (from the 29). What matters is the individual dose and time. With BID shots, you don't really have to calculate overlap into the equation because PZI rarely lasts more than 12 hours. So you can shoot more insulin and watch peaks to guide your decisions.

With TID shots, overlap is the key consideration. It's either your best friend or your worst enemy. Peaks don't matter as much as time and rate--when do BGs start to rise and how fast are they moving. Those are your overlap markers.

 

I agree that I can not prove any of this. I am doing the best I can by observing Prudence's SS. I also found it interesting that if you do add the PS# for #A. B, C cycle, I was getting a total of 0.9 for a few days. Isn't this what most people are doing when they change the dose either higher or lower..watch it for a few cycles to see how it's working? I should of realized that my next cycle #D should have been lower than 0.9. Lesson learned :sad: but I am glad that I am seeing a pattern in her SS. I went to TID b/c Prudence could not get out of the pinks & reds. PZI was only lasting about 8 hours. It just made sense to me that if I don't go to TID, she will be on a constant rollercoaster. Believe me - TID is taking its toll on me. @-) I kind of feel alone on this since most ppl are doing 12/12. I'm just doing the best I can.

 

IMHO there are others you SHOULD be using TID, but it's hard to do. I used it for about a year and after the first week or so realized that I was not going to maintain the schedule and keep a job if I didn't bring some control to it. So I had some rules: 1) I didn't stay up past my normal bedtime
2) If she was too low at midday to get in a shot that would allow me to fulfill #1 above, then we skipped the midday shot.
3) If she was too low at night to get a shot at normal bedtime, we skipped the evening shot.
4) Although I didn't shoot much lower than 150, when I saw her zooming (going up quickly), I would shoot low if time was a factor.

These rules worked out fine for me. Others who used TID on a regular basis tried shooting mini-doses when numbers were too low for a full shot. That just didn't work for Lucy.

Hope these help.

 

We are here for you Michelle! Even though mostly people are doing 12/12 at the moment, there are a couple people doing some variations on that, and several of us who have shot TID at one time or another. I never really got the hang of it so can't give you a lot of advice, but I am here for moral support. Others are too, though people don't always post to each thread, there are still peeps around who are pulling for you guys!!!

With Bix (on BID, guess he got better overlap than a lot of kitties) it got to where I could predict where he was overlap-wise and adjust doses accordingly. With him it was generally cycle 3, sometimes 4, of a new dose. I think that is the "waiting a few days" concept, to let the overlap build up & see if there will be enough of it to help. When Bix had good overlap, the change could be dramatic, from ho-hum #s one cycle to amazing #s the next.

With TID it's more of a factor - no insight on when it is likely to be there (overlap), except as Terri said to watch the zoom rate. With Bix sometimes I would test maybe +11 and then +12, or a +12 and a +1 after a shot. If the #s were flattish, voila, overlap. If the #s were rising a lot, I knew he would need more insulin to hold the #s steady, let alone bring them down to a nice nadir.

You are definitely getting the hang of it with what you are learning. ECID, and it takes some experimenting and learning curve to see how your cat responds, what works & what doesn't, etc.

 

Thanks Joanna!!! :YMHUG:

Yes. that's what I meant. There's just so much to learn about feline diabetes :? what works, what doesn't work. blah blah blah ohmygod_smile I get Kind of angry when I think about the fact that so many Vets don't know much about feline diabetes. I wish my Vet would of told me to try and change Prudy's diet first. I think that's what helped Kira and Max. Max was OTJ in like a week :YMSIGH: [/quote]

Just this bit of information helps a ton! I was trying to figure out why some #'s were raising or stay about the same after the shot. It's funny, it's the small things that are HUGE to newbies :smile:

Thanks Joanna for always picking me up when I am down :YMHUG:

 

Larry, Michele, Terri and Venita. Thank you for sharing your thoughts! :smile:

 

No dosing advice here, just wanted to say that I know you are doing your best for Prudence and that is awesome. She appreciates it, even if she doesn't know it. FD can be so frustrating and worrisome, but they are definitely worth it. Keep up the good work and keep on trying out things which you feel might work for you guys. That's the only way to learn!

 

Hey Michelle! Just cheering you on over here. We're returning to TID since my Aria has suddenly gone kaleidoscope on her colors (especially the lovely black she's so fond of in the morning), so I've been checking your SS to see how you're doing. Just wanted to send you some luck +*+*+*

 

Thank you Hope! Good luck too!!! I had a crazy night tonight, but hopefully we will be back on track tomorrow cat(2)_steam Read my post about the One Touch. I thought of you. but realized that you're using the ReliOn too

 

I've got the Relion micro in use now and a Relion Ultima on it's way (due to the lady at the store selling me the wrong strips a few weeks ago. Cheaper to buy the matching monitor) My original was the Accu-check Aviva, but the strips weren't cost effective. Yep, sounds like I'm collecting monitors!

 

I just started using the ReliOn Micro (had been using the OTU or the Precision Xtra) and it is unreal to me how TINY of a drop of blood the Relion requires!! Like, amazingly tiny. I thought the drop needed for the OTU was small but this is at least half that size.

 

I love the ReliOn Micro! Yes, all you need is a tiny bit of blood :thumbup

 

Michelle, Thanks for checking in on me. I have to tell you, I love seeing Prudence's picture and not just because she's black. :mrgreen: She looks like a sweety. I just checked out your spreadsheet and you are both doing awesome. You're getting good numbers and even at a lower dose. I hope you're getting some sleep in there too.

Paws crossed that Prudence's numbers will keep getting better, right into (antijinx) Ho*eyMo*n.