BG Curve high and flat; test more often to catch a bounce?

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by tackeee, Jan 11, 2019.

  1. tackeee

    tackeee Member

    Joined:
    Jan 9, 2019
    So admittedly I’m new to all of this. Just started at home blood testing, and this forum has been an immense help already!

    Little One’s numbers only briefly dipped below 400 about four hours after his 3units of Lantus this am. He just got upped to 3 units Tuesday night. Regardless, I’m wondering if when I do a next curve if I actually do need to test more often than every two hours to catch a potential bounce, or should I see it regardless on Lantus? I’ve gotten some feedback that the flatness of the curve might mean I skipped over the ideal dose, but I also know it may mean I haven’t gotten to it yet. I just want to make sure my testing protocols can help me notice key details!
     
  2. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

    Joined:
    Jul 18, 2011
    Hi and welcome to Lantus & Levemir Land, the nicest place you never wanted to be.

    Congratulations on home testing. It is the best way to keep Little One safe. When doing a curve, you do test every two hours. The only real reason to test more often in that situation is if you get a low number - which, if you are using a pet meter, would be below 68. Or, if you see him headed that way and want to catch it sooner. You don't say which method you are following - Tight Regulation or Start Low Go Slow, but since you reference a curve, I assume it's the latter. Although this method calls for a curve once a week, it's still a good idea to get as many tests in as you can in between curves. There is no such thing as too much data! For sure you want to test before every shot, to be certain it's safe to give insulin. At least once more test sometime during the cycle is always a good idea, too.

    It would be helpful if you could add a couple of pieces of info to your signature block, so you don't keep getting the same questions. Where do you live (you can be vague if you want - we mainly need to know time zone)? How much does Little One weigh? What do we call you? You don't have to use your real name if you don't want to, but it makes it easier to "talk" to you if we have a name of some kind besides "Little One's Mamabean". Please also add the type of meter you are using. This is especially important when you are using a pet meter, because the suggestions we make may be different than if you were using a human one.

    Here is a post we put together for new members, to help them get more comfortable with the Forum. Kind of like a FAQ. Keep reading the info in the stickies at the top of the L&L page. There is a ton of info there, and it can be overwhelming, so ask lots of questions. We love to help!
     
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  3. tackeee

    tackeee Member

    Joined:
    Jan 9, 2019
    Thanks! I will update my signature when I have a bit more time later. Little One was over 13 lbs at the beginning of Dec and now is under 11, but he wasn't too heavy; he's naturally a big cat and his good weight is around 13.

    I'm working today and can't do a full curve, but plan on getting morning and evening and at least one or two during the day if possible. I plan on doing another curve in a few days when his 3 units has had a chance to settle in too (per my vet).
     
  4. Tracey&Jones- GA

    Tracey&Jones- GA Well-Known Member

    Joined:
    Dec 12, 2016
    Hi Elizabeth! Scritches to Little One.

    To answer your question, a bounce is pretty obvious to see every two hour testing.

    I personally didn't test more than every 2-3 hours unless I was monitoring a low number event. All data is good data though and it is up to you and Little about how much testing works best for you. I was lucky to have someone help me out and do testing while I worked so I always had a +4 to +7 during the week and I filled in blanks during the evening and weekend.


    He is very high and flat....man! He just started to it may take a few days to stabilize that depot and see some movement in those numbers.
     
  5. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    Hey there and Welcome! Another question: When was Little One diagnosed?
     
  6. tackeee

    tackeee Member

    Joined:
    Jan 9, 2019
    Yes! High and flat. =/ I couldn't test as much today, but got a few. I am also crazy busy tomorrow, but will try to get a few again too. I'm hoping the 3 units kicks in, but I'm starting to think that his dose needs to go up, not that I've missed the key lower dose.

    He was diagnosed Dec 7 (just over a month now), and I'm pretty sure it was pretty quick onset!
     
  7. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    You're certainly testing enough during the AM cycle to know if there's any bouncing going on. I'd encourage you to get at least a "before bed" test during the PM cycle. Many kitties experience lower numbers at night so it's possible that there are some drops in numbers in the evenings.

    One other possibility is that Little One just need more insulin. You may not be at a dose that is budging your kitty's numbers.

    What dose did you start Little One at and by what amount have you been increasing doses. In some cases, vets are aggressive about dose increases and if you are increasing by a large amount, you miss what may be a good dose. Alternatively, if your vet has been encouraging you to hold doses overly long, glucose toxicity can result. (The name sounds a lot worse than it is -- your kitty starts treating high numbers as the new "normal.")
     
  8. Crista & Ming

    Crista & Ming Well-Known Member

    Joined:
    Jun 10, 2018
    Welcome! :bighug: A lot of good advice here already!

    If you've done any other tests in the past, I'd definitely post them up on your SS. The more data people can see, the better they can help you.

    Correct me if I'm wrong anyone, but the two days worth of data, I can sort of see the typical Lantus curve. So one thing that I would tentatively get from the data so far is that food does have quite an effect on your kitty. Some kitties aren't too affected by food (like mine).

    Again, I encourage you to pick a method even if it's temporary. If you choose TR, then someone (much more knowledgeable) might suggest an increase after today. If you ever need eyes on your thread, you can always change your title with the "?" icon and put your question in the title. For example, if you're looking for dosing advice, I'd add to the title with "dosing advice needed". We also start new threads every day and put BGs of our kitties so it's quick for everyone to know what's going on but we can go one step at a time for now. It's a lot of info and rules to keep up with so just do what you can for now :)

    As well, something that was really really REALLY helpful for me in the beginning, was to look at other kitty's SS and see their responses to insulin and what their people did to help in certain situations. It provided me both information and encouragement in times of distress and worry.
     
  9. tackeee

    tackeee Member

    Joined:
    Jan 9, 2019
    Thanks to everyone for all this helpful advice! I added Little One's BG to his chart this am. I worked til 2am, and checked when I got home (after which I gave him a small snack) and it was 334, so it does look like it's dipping at night. My thoughts are he does need to go up, but my vet wants to wait to do a full curve next week. Perhaps I do a full curve Tuesday, which is one week after he's been upped to 3 units, and then he can move up sooner?

    He was on one unit for about 1.5 weeks, from which his vet BG test dropped from 500 to about 400. Then, he was upped to two units for about 2.5 weeks, and when he went back in for his vet blood test it was still around 400. She upped him to 3 units. Then I started home testing, and we get the numbers you see now (only a few days into at home testing).

    I am starting to think he needs more insulin.
     
  10. Crista & Ming

    Crista & Ming Well-Known Member

    Joined:
    Jun 10, 2018
    Do you mean you did a fructosamine test? FYI: I personally and some would agree that if you're home testing already, a fructosamine test isn't necessary. So I'd keep that in mind for the future if your vet asks you to do one again.

    As @Sienna and Gabby have stated, some vets are either too aggressive with dose changes or wait too long and kitty builds glucose toxicity. Keep in mind, here at FDMB, any increases or decreases range from 0.5 units to 0.25 units. Only in certain situations are whole increases or decreases encouraged.

    A lot of us have battled/been in dilemmas of whether to listen to our vets or follow what's been done on this forum. So you may need to make that decision and have a discussion with your vet (or don't lol. I've been advised to just nod and smile at the vet's advice on Ming's insulin/dose intake. I'm lucky now that the vets I work with have an understanding that I'm on top of Ming's diabetes even if they don't understand or agree with me).

    I would definitely try to get some tests in at night time. Even set up an alarm in the middle of the night to wake up and just do a quick test. Sometimes, cats go low at night and bounce all AM cycle.
     

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