BG Dropping Farther than Usual? 289 to 58 in 3 Hours (2u). 303 to 66 in 4.5 Hours (1.5u)

Kay&Kiara here,

Having a bit of an issue with BG lows.

Mornings have been starting out normal, in the upper 200s, not a big deal, but when she's given the usual amount of insulin for those BG I've noticed the last two near-nadir (Either an hours before or 1-2 hours after) check, she has been running extremely low. 70 and lower.

And now I'm wondering...is this normal? For the insulin to suddenly have a great affect on her BG levels?

A week ago, she would drop from 263 to 85 on 2u; 2 weeks ago, she was 284 dropping down to 91 with the same dosage. Today, however, she's dropping from 289 to 58 (taken 1 1/2 hours before she hits nadir) and she's been give honey with her afternoon tuna (which sounds a little gross typing out, lol).

Why is this? Is her body starting to re-produce its own insulin again in small doses that are adding on to the insulin I'm giving in the shots? Or again, are the shots just somehow having a bigger impact? Or is this just some kind of fluke?

I am now wondering if I should start a new glucose curve for new insulin dosages, and toss out the old numbers.

No changes in diet, still getting Fancy Feast and community free-for-all Tuna/Chicken. She got into the dry food a few days ago, but one would think that would jack up her BG, not drop it. No changes in exercise or daily activities. Haven't changed any of the testing equipment.

She's still happy-go-lucky, and can't wait for meals.
I just don't know what's going on, or if its good or not. And now, all that confidence that I've got this figured out her diabetes just went down the toilet, and hypo-episodes are now back to being a very real and terrifying possibility, especially when I go to work right after giving her her evening shot.

(Ps. I also just found out that she only has two fangs left of all her teeth, which has probably been commonplace for her for a while now, though it didn't stop her from eating dry food or killing mice. So...)

 

With Vetsulin you don't want Kiara dropping much below 90 and certainly not before her expected nadir. Any time BG drops below 90 I would suggest you reduce the dose and hold the new dose for a few cycles unless BG again drops too low.

I am confused about the PMPS for the last few nights marked "fasted". Once a day dosing with any insulin is very unlikely to be successful and can in fact make BG worse and make it harder to figure out a safe dose. While there have been times when you've kept the dose consistent for a bit there are also times when it appears the dose was being changed based on pre-shot numbers. Dose needs to be adjusted based on nadir and in some cases Kiara's nadir has been too low. Scaled dosing based on pre-shot numbers can work for some cats once they are regulated but in the early days, it just doesn't work.

Insulin is a hormone so how BG is affected each day can change and nadir timing can change too. It won't always be at exactly 4.5 hrs post shot. It's important to find the best dose to lower BG to decent levels but also to avoid BG dropping too low to keep Kiara safe.

It's hard to see exactly what the dose should be given all the dose changes of late however it appears 2u is too high. You are using U100 syringes and can make small incremental dose changes so I would suggest you try a consistent dose of 1.5u AM and PM for at least 3 days, as long as BG doesn't drop below 90 and pre-shot is high enough to give insulin (200 or higher). Get mid cycle tests and at least one PM cycle test to see how low that dose is dropping BG and then re-evaluate.

I am so sorry your post got missed. Any time you don't get a response you can either tag one of us or repost in Health where there is more traffic to get attention. We are usually fairly quick to respond but since this is all volunteer and sometimes the board gets busy, posts can occasionally unintentionally get missed. My apologies for the delay.