Annie & Craig - Getting too smart!

[Judi]

Re: Annie - Getting too smart!

Jenny has been in the 300's in the am and closer to 100 in the pm on the novolin. not doing a curve till next weekend cause she still has ear issues. I'm wondering if the activity makes a huge difference with this insulin

[CraigM]

Re: Annie - Getting too smart!

Jenny has been in the 300's in the am and closer to 100 in the pm on the novolin. not doing a curve till next weekend cause she still has ear issues. I'm wondering if the activity makes a huge difference with this insulin

Maybe some difference. With Humulin I usually gave 1/4 unit more (7.5 vice 7.25) in the evening. I might try an extra .25 of Novolin-N tonight.

[stylynjm]

Re: Annie - Getting too smart!

How r Annie's numbers doing?? Did u have a chance to check percentages on higher #'s.just curious if ur prime does the same thing at higher #'s!!!

[CraigM]

Re: Annie - Getting too smart!

How r Annie's numbers doing?? Did u have a chance to check percentages on higher #'s.just curious if ur prime does the same thing at higher #'s!!!

She's been in the 90s - low 200s since her "off" day. I'll try and remember to use both meters next time she gives a 300+

[CraigM]

Re: Annie - Getting too smart!

Well, Annie has been on Novolin for about 5 weeks and we've made several adjustments with the dosage. We've slowly increased the "N" from 7.25 - 7.5 with Humulin-N, to 9 - 9.25 with Novolin-N. The "R" has stayed between 1 - 2 units for the most, depending on how high the fasting number is.

Mid day numbers are generally very good, 90s - mid 100s. The problem is in the last two hours where there is usually close to a 200 point rise! Here are a couple of mini-curves that illustrate this:

12-1
730A 177 1.0R + 8.75N
1130A 116
330P 188
730P 416 2.0R + 9.0N

12-2
730A 158 1.0R + 9.0N
330P 157
530P 170
730P 307 2.0R + 9.0N

12-3
730A 294 2.0R + 9.0N
1030A 114
130P 95
430P 176
730P 382 2.0R + 9.25N

12-4
730A 83 1.5R + 9.25N
Readings were low the rest of this curve and I intervened with honey twice. Don't want to show the readings because they would make you GASP

So, what to do about the last hour or two? Can't increase the N to 9.25 without the nadir dropping into the 60s or lower.

The food has been a weighed 2.1 OZ of Blue Buffalo Healthy Weight dry kibble. I don't want to be stuck at home giving a mid-day meal/snack to raise the lowest numbers.

TODAY: I've tried a little food tweak. Instead of the 2.1 OZ of BB, I've fed 1.0 OZ of the BB mixed with 1.2 OZ Royal Canin HF Diabetic Formula. My hope is that the extra fiber in the RC might help? Can't hurt!

730A 86 0.5R + 9.0N (with the above food change)
1130A 148

This 1130A reading of 148 is a little higher than it had been on straight BB. Of course this could just be daily variance. The next several days will tell.

TESTING IS FUN!

[jesse girl]

Re: Annie - Getting too smart!

has annies curve changed?

it looks like you are seeing a good rise starting after that 6 hour mark and accelerating into fasting

that is quite a substantial change in insulin needs i always say when raising the dose and the numbers deteriorate maybe going in the wrong direction thats jesses m. o.

even though the numbers try to pull the dose upward and things don't improve i back down and reevaluate

wright now i am stretching the humilun i got a vial of novolin in the fridge and will have to take the plunge soon

another thought maybe pull back on the r a bit if you havent tried that maybe the novilin has enough punch i remember it being quite strong at onset

[Rubytuesday]

Re: Annie - Getting too smart!

I don't know Craig but if you find something that works please share as this is Ruby's typical curve just she usually jumps pre am fasting too. Funny that she doesn't jump before the am fasting. You could try lowering the nighttime dose to raise the am numbers and then see if you could raise the daytime dose

Could you use an automatic feeder on days when you were gone. I have been experimenting with giving Ruby a frozen Kong around nadir time.

I need to see if I can add some fiber to Ruby's food. Apparently EPI's do better with one type of fiber then the other and I need to do more research.

Tara

[Patty]

Re: Annie - Getting too smart!

I'd definitely see how your food change plays out. Seems Annie just doesn't get the duration out of Novolin.

Wonder if you can pull back her R more than your usual sliding scale in order to increase the N and not have the nadir go too low. I think you've said Annie's duration of R though is more like a dog on Humalog at ~ 3 hours instead of 5-6 hours.

[CraigM]

Re: Annie - Getting too smart!

I don't know Craig but if you find something that works please share as this is Ruby's typical curve just she usually jumps pre am fasting too. Funny that she doesn't jump before the am fasting.

I'm also surprised her morning fasting numbers aren't higher. When using Humulin, I needed to give 1/4 unit more at night to keep her morning number in check; seems to be the opposite now.

I'll do another test at 5:30, but it won't be worth much. I made a mistake and bought her a new ball this afternoon. She hasn't stopped running around, or trying to bury it under her puppy bed / bedding / pillow for the past 90 minutes straight. We are tired just watching her go berserk for 90 minutes!

[CraigM]

Re: Annie - Getting too smart!

TODAY: I've tried a little food tweak. Instead of the 2.1 OZ of BB, I've fed 1.0 OZ of the BB mixed with 1.2 OZ Royal Canin HF Diabetic Formula. My hope is that the extra fiber in the RC might help? Can't hurt!

730A 86 0.5R + 9.0N (with the above food change)
1130A 148

This 1130A reading of 148 is a little higher than it had been on straight BB. Of course this could just be daily variance. The next several days will tell.

TESTING IS FUN!

As I said at 4:58, I'm not sure how repeatable / accurate the late afternoon tests have been. Annie was in constant motion from 3:30 to 7:00 with her new ball. I figure this exercise equals running a marathon and probably affected her BGs

Here's today's numbers:
730A. 86 0.5R + 9.0N, 1.0 oz blue buffalo + 1.2 oz Royal Canin HF
130P. 148
330P. 98
530P. 91
730P. 77 0.25R + 9.0N, 1.0 oz blue buffalo + 1.2 oz Royal Canin HF

This is the first time the 730P fasting wasn't at least in the high 200s since switching to Novolin. I'm pretty sure the low numbers were due to the playing with the ball, and will continue testing the new meal.

She is now fast asleep, with the ball next to her! It was nice seeing her act like a puppy this afternoon.

[Patty]

Re: Annie - Getting too smart!

Oh my goodness Craig! What fun! I would have loved to have been a fly on the wall watching her run around like a puppy

[momofdecker]

Re: Annie - Getting too smart!

A new toy, a new toy, a new toy - cute Annie showing off her puppy skills! Glad she is still so young at heart.

[CraigM]

Re: Annie - Getting too smart!

A new toy, a new toy, a new toy - cute Annie showing off her puppy skills! Glad she is still so young at heart.

Yes, cute to watch, but got tiring for the humans after the second hour! We have several pieces of furniture that have about 5 inches of clearance off the floor, the ball is about 4 15/16 in diameter. She has a terrible habit of kicking toys under furniture and then trying to squeeze her thicker head in after them! Then the whining starts!

The other problem is with the Christmas tree. Her other favorite place to play, other than under furniture, is under the tree. Linda remembers from previous years and doesn't have ornaments within Annie height, but we do get concerned when we see the tree swaying with Annie running around underneath.

Getting back to diabetes. I intervened with a snack + honey at midnight because she was only 89 and the "N" might not have kicked in yet. She was 111 at this morning's fasting. I know I should hold things steady for a few days with the change in food (adding the high fiber Royal Canin Diabetic HF Formula), but I gave only 8.75 units of Novolin-N. For the first time in at least two years we didn't use any "R" insulin. I'm now second guessing myself and wish I'd have given at least a token 1/4 unit of "R", but I'll know more when we test after 2-3 hours.

TESTING IS FUN!

[Rubytuesday]

Re: Annie - Getting too smart!

Craig, I will update Ruby's thread later (at work now), but on the food rise....Ruby has not had one the last 2 nights. She has always gotten a very significant food rise????
She has been on the Novolin for at least a month, so don't think it could be anything tied to that. I did do a 1/2 food change to a higher protien about three weeks ago, but haven't gone any further with it as her poops don't look as good.

Don't know, just hope it continues.

Tara

[CraigM]

Re: Annie - Getting too smart!

Craig, I will update Ruby's thread later (at work now), but on the food rise....Ruby has not had one the last 2 nights. She has always gotten a very significant food rise????

Interesting Tara. You've added protein and haven't seen a food spike, I've reduced protein and added fiber and may have reduced the food spike ( pretty much the opposite of eachother).

730A 111
1030A 102 (this without any "R")

I'm thinking the "cure" for Annie is to give her a new toy every afternoon.