Angel dosing advice

Discussion in 'Lantus / Levemir / Biosimilars' started by Cherish Gallagher, Aug 24, 2017.

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  1. Cherish Gallagher

    Cherish Gallagher Member

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    Mar 27, 2017
    what should Angels new dose be according to SLGS? She earned a reduction but This is all kinda confusing to me still. Should I do 1.25 or 1U?

    She earned a reduction last night and then another one today. So would she be down to 1U?

    Also, to add, all along we have been very confused about what we feed angel and have been using a carb calculator. Turns out we actually haven't been feeding her low carb food. Most of the ones she eats are in the teens. Tomorrow morning she will be starting an actual low carb diet. She hasn't had any dry food since starting Lantus.
     
    Last edited: Aug 24, 2017
  2. Mandy & Rex (GA)

    Mandy & Rex (GA) Well-Known Member

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    If you are going to switch to LC, then I will take back my advice to do 1.25u and start with 1u. Switching to LC from MC can impact BG numbers. Better safe than sorry. Monitor her during the diet change.
     
  3. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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  4. Cherish Gallagher

    Cherish Gallagher Member

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    Mar 27, 2017
    Thanks Mandy! We thought we were feeding LC but just found out how inaccurate the phone carb calculator is
     
  5. Gill & George

    Gill & George Well-Known Member

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    I would suggest a different approach.

    We don't usually recommend back to back reductions as the depot from the higher dose is likely to still be influencing numbers. The food issue does pose a complication though.

    But I would probably tackle it a different way

    I'd take the reduction to 1.25u, but transition the food slowly. Instead of going cold turkey on the MC/HC food that you have been feeding I would introduce the LC slowly, mixing it in with the food he has been eating.
    Maybe starting by giving 20%new LC and 80% of his usual for a few days (maybe 3).
    Then 40% LC and 60% of his usual for another 3
    then 60% LC and 40% of his usual
    then 80% LC and 20% of his usual
    and finally 100% of LC
    Transitioning him slowly over a couple of weeks will allow you to adjust he dose effectively if he needs it and keep him safe, it will take the guess work of how much to reduce the dose by when you make the swap.
    Overestimating how much insulin he needs could see him bottom out and underestimating how much he needs could see him unnecessarily spend time in high numbers, for some kitties it can prove a real setback.

    You monitor him enough to be able to catch the lows and make adjustments accordingly to keep him safe.
     
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  6. Cherish Gallagher

    Cherish Gallagher Member

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    Thanks for the input!
     
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  7. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    I agree with @Gill & George

    Congratulations on the reduction and hope Angel will continue to earn them!!
     
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  8. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    This sounds like a good plan and it should keep Angel more level. Good idea Gill!
     
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  9. Cherish Gallagher

    Cherish Gallagher Member

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    Mar 27, 2017
    So she just gave me a 64 at +6. Gave low carb food and testing again soon. Staying calm etc. trusting she will be ok. But does this mean she gets yet another reduction?
     
  10. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Hi Cherish,
    I have no dose advise sorry - just saying hi and seeing if you need a company for the lows.
    Technically - yes, a reduction earned but taking them back to back might not work well.
     
  11. Cherish Gallagher

    Cherish Gallagher Member

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    Mar 27, 2017
    I was thinking the same thing. As long as we steer her through the lows we mignt just stay at 1U.
     
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  12. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    There are still some time to her PMPS - someone will be in to help. Just update the BG.
     
  13. Mandy & Rex (GA)

    Mandy & Rex (GA) Well-Known Member

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    I would stay with 1u tonight, but if she drops under 90 after that, do 0.75u in the morning.
     
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  14. Gill & George

    Gill & George Well-Known Member

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    Did you stop the higher carb food that you have been using up until now altogether?? or are you mixing it in?
    SS seems to suggest you've gone to the 6% with nothing else mixed in, if this is the case it may well be why you are seeing her drop to 64.
    ETA she may well continue to drop, changing the food up like that can make quite an impact on BG, which is why I suggested a slow transition
    Even though it's late in the cycle I would test her no later than +6.5
     
  15. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, Cherish, you're in an action-packed situation where her numbers tell you one thing (reduce) but they're coming close together under the influence of a depot that has to reset itself. Rules are good but sometimes you have to make a judgment based on what's happening. You're also in the middle of a food transition to lower carb and that can have an effect. Maybe hold the 1 u for tonight at least.
     
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  16. Cherish Gallagher

    Cherish Gallagher Member

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    She's holding at 66. Will test again soon. Yes, we switched foods. The foods she was getting before were by no means high carb. More towards medium but I know she will do better with 10% or less. If she is low tonight for preshot we will give her a new one we got that is 10% and test often.
     
  17. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    She is likely to bounce up tonight like she did last night. If that's the case, I would hold the 1 unit but monitor closely like you are doing.
     
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  18. Gill & George

    Gill & George Well-Known Member

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    Depending on how carb sensitive she is will determine to some extent how much of an impact the switch will have on her numbers.
    I would urge you to be cautious, as a dose that has been OK for her up till now with the MC fuds may turn out to be too much now she's on the LC.
     
  19. Cherish Gallagher

    Cherish Gallagher Member

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    I will thanks so much! I'm off work the next 4 days which is why we chose today for the transition. :)
     
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  20. Gill & George

    Gill & George Well-Known Member

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    that's a good plan, you test enough to keep her safe.
     
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  21. Cherish Gallagher

    Cherish Gallagher Member

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    Mar 27, 2017
    Ding ding ding lol you are correct!
     
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