? 24 hr curve, advice?

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Heather&Dagron

Heather&Dagron

Member Since 2017
I just finished a 24 hr curve for Dagron. His daytime nadir was 191 at +9, so I was going to up his dose to 2u. However, his nighttime nadir was 104. I'm worried that if I up his dose, it will put him dangerously low at night. (Also, we are doing SLGS, not TR.) And his pre-shot numbers in the mornings are always really high. Way higher than I am comfortable with.
 
Hey there,
I would rely on a more experienced member to give dosing advice, but according to the SLGS sticky:

"After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours:
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit"
Given this info, and if you just saw a nadir of 104, I would hold the dose. Also, I recall reading that AMPS tends to be the highest number for kitties, so you're not alone in experiencing AMPS numbers that are too high for your liking... my cat's are usually pink. Your kitty could be bouncing from the low 100's nadirs, but from what I understand, dosecreases are not based on those bouncy, high numbers; they are based on the nadirs. Hopefully a more experienced member will chime in soon :bighug:
 
You may want to add a question mark to the thread title to get more inputs. Sorry I can't give dose advice. Need more experienced people to comment.
 
Since you are getting nadirs between 90 and 150, you hold the dose.

Many cats go lower at night, as he showed you. A curve only needs to be every two hours for 12 hours, or every 3 hours for 18 hours. You must be tired!
 
I'm exhausted, but I've not been able to get any good data up until this point, and I finally got a chance, so I took it.

Thanks for the input. I'll keep him at 1.75 for now. How will I know when it's time to do another curve to check for a dose change?

Also, do we know why they go lower at night and skyrocket for AMPS? It's so bizarre. The only differences between his night and day schedules are a little more activity during the day, and with dinner he gets fish oil and laxatone. Same exact type and amount of food. Same exact amount of insulin.
 
I had a weird thought too, since his daytime nadir was so much higher. What if I give 2u in the morning and 1.75u in the evening? Is that a thing that people do? I don't know how his body would respond re: the insulin depot, though.

Well, we finally see a specialist on Monday, so I guess I have a list of questions!
 
Give this dose another week, then do another curve and reevaluate it. This time you can do the easier curve. If he goes below 90 at any time, you automatically reduce the dose.

We find it's better to give the same dose AM and PM, due to the nature of the Lantus depot. What you shoot in one cycle can influence the next one. And you may find that the next time, his daytim nadir is lower. Neko's night nadir was usually lower, unless it wasn't. :p Cats aren't known for being predictable creatures.

I don't have the answer about why they go lower at night, but probably has something to do with them being naturally nocturnal animals and their hormone system impacting the BG as they get the body ready for night time hunting.
 
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