Lantus Shot Size Model Change
Why change? Several reasons, all of which imply preparation for getting off the drug.
The past week has shown remarkably normal BG numbers. Nominal normal is 68 - 126 mg/dL.
There is a red format for Top 10% of values. Note: none.
With a smaller shot size, comes the opportunity for bigger over and under errors in size selection. The drop per unit numbers below show just how wide the swings can be. The standard deviation of BG drop overnight numbers, using the current model, is mid to upper 50's. For high bedtime numbers, an "extra" drop of 50 is generally benign. For low bedtime numbers, an extra 50 down gets into serious hypoglycemia area. Those 2 green rr BG numbers TOD1 numbers are disquieting, to say the least. 37 is approaching dangerously low. No bueno.
In the original Lantus shot size model (here) the past 21 days data was used to construct the regression line. In the new model, only 11 days will be used.
The new model will include not only a simple read off the regression line, plus or minus applied windage, but also a low limit cut off to a very small, or no, Lantus shot. I'm thinking if TOD4 BG is below 100, no shot; if TOD4 BG is 120 or less, 10 units.
The past week or so has seen some of the smallest shot sizes ever. Recall, I started this experiment shooting 80 units of Lantus every night.
Smaller shot sizes are a result of better BG control, which in turn are the result of better food control and weight loss. Carbs cause a large bolus insulin requirement, protein a smaller bolus insulin requirement, and fats, the least. Fasting, especially longer than short fasts (greater than 20 hours) reduces the need for insulin to only basal, what your body needs to function in the absence of incoming food. It is entirely likely my pancreas produces enough endogenous insulin to meet my basal needs. Any exogenous insulin bolus, then, needs to be properly matched with food, else, hypoglycemia or hyperglycemia.
Weight loss is the real systemic magic here. There is an interesting hypotheses that individuals have a percent body fat threshold, over which they develop type 2 diabetes, and under which the disease goes into remission (see personal fat threshold and layperson reading). Over the last 10 days, as I lose weight (7.6 pounds), my _fatFreeBodyWeight declines less than that (2.4 pounds), leaving some _bodyWater increase (1.2 pounds, awaiting the next swoosh), All the rest of the decline in weight is fat, lowering my _bodyFat percentage by 1.7%, to 25.9%. Under 25% is "acceptable", under 17% is "fitness", and my goal is 15%.
I believe somewhere in that big fat range lies my own personal fat threshold. Once I cross that threshold, and if my pancreas is functional enough to produce the needed endogenous insulin (both basal and bolus), I'm no longer diabetic. Which is, after all, one of the goals here.
The past week has shown remarkably normal BG numbers. Nominal normal is 68 - 126 mg/dL.
 |
| rr BG numbers, on wakeup (TOD1), lunchtime (TOD2), pre-dinner (TOD3), bedtime (TOD4). Green is Bottom 10%. |
There is a red format for Top 10% of values. Note: none.
With a smaller shot size, comes the opportunity for bigger over and under errors in size selection. The drop per unit numbers below show just how wide the swings can be. The standard deviation of BG drop overnight numbers, using the current model, is mid to upper 50's. For high bedtime numbers, an "extra" drop of 50 is generally benign. For low bedtime numbers, an extra 50 down gets into serious hypoglycemia area. Those 2 green rr BG numbers TOD1 numbers are disquieting, to say the least. 37 is approaching dangerously low. No bueno.
In the original Lantus shot size model (here) the past 21 days data was used to construct the regression line. In the new model, only 11 days will be used.
The past week or so has seen some of the smallest shot sizes ever. Recall, I started this experiment shooting 80 units of Lantus every night.
 |
| rr Lantus shot data and statistics |
Smaller shot sizes are a result of better BG control, which in turn are the result of better food control and weight loss. Carbs cause a large bolus insulin requirement, protein a smaller bolus insulin requirement, and fats, the least. Fasting, especially longer than short fasts (greater than 20 hours) reduces the need for insulin to only basal, what your body needs to function in the absence of incoming food. It is entirely likely my pancreas produces enough endogenous insulin to meet my basal needs. Any exogenous insulin bolus, then, needs to be properly matched with food, else, hypoglycemia or hyperglycemia.
Weight loss is the real systemic magic here. There is an interesting hypotheses that individuals have a percent body fat threshold, over which they develop type 2 diabetes, and under which the disease goes into remission (see personal fat threshold and layperson reading). Over the last 10 days, as I lose weight (7.6 pounds), my _fatFreeBodyWeight declines less than that (2.4 pounds), leaving some _bodyWater increase (1.2 pounds, awaiting the next swoosh), All the rest of the decline in weight is fat, lowering my _bodyFat percentage by 1.7%, to 25.9%. Under 25% is "acceptable", under 17% is "fitness", and my goal is 15%.
I believe somewhere in that big fat range lies my own personal fat threshold. Once I cross that threshold, and if my pancreas is functional enough to produce the needed endogenous insulin (both basal and bolus), I'm no longer diabetic. Which is, after all, one of the goals here.
Comments