Confused again

Hi everyone,

Between looking for a new job and looking for a new job I sometimes get the time to read/post and get info on how to dose Lantus.

Now I find some text that just doesn't make any sense to me.
The protocol on Lantus says:
If nadir blood glucose concentration < 200mg/dL but peak is > 200mg/dL (11 mmol/L)
Increase every 5-7 days by 0.25-0.5 IU depending on if cat on low or high dose of insulin.

The glossary says:
NADIR: The lowest point on a BG curve, often considered the same as the peak insulin reading.
PEAK: The time period when the insulin is strongest causing the BG level to be lowest. Will vary depending on the cat and duration of insulin used. Should not fall below 100 mg/dl or 5.5 mmol.

It seems to contradict: peak = nadir. Can anyone explain??
I'm a bit, well ... okay ... a lot, confused now. :?

 

Peak and nadir are two different terms for the same thing.

 

you are right to be confused...

The Lantus protocol that you have quoted looks like it needs some editing.

Basically, if the nadir is > 200, there is room to increase the insulin dose.

 

I reported it to the moderators; someone involved with the Lantus group will figure it out and fix it.

 

Someone in the PZI group asked that the other day. Here is what I wrote:

I think in the Rand documents it should read :

If nadir blood glucose concentration < 200mg/dL but peak blood glucose concerntration is >
200mg/dL (11 mmol/L)
Increase every 5-7 days by 0.25-0.5 IU depending on
if cat on low or high dose of insulin


Further down under Reducing the dose it does state "peak blood glucose concentration >200.

That would be my interpertation.

So even if the Nadir is less than 200, if the cat has a number above 200 (highest BG) then an increase should be made.

Nadir is the lowest BG reading during a curve or when the insulin is at peak (working the strongest)

Peak can refer to the peak of the insulin, or the Peak BG concentration, those 2 are opposite of each other.

 

I think you're right Monique. Makes much more sense now.
Thanks a lot for clearing this up.