Double low points?

Discussion in 'Lantus / Levemir / Biosimilars' started by monty_dweezil (GA), Jan 6, 2018.

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  1. monty_dweezil (GA)

    monty_dweezil (GA) Member

    Joined:
    Dec 15, 2014
    I think I asked this before, but it has happened more often lately so I am asking again.

    The phenomenon on the double low point with one true nadir that comes on way after the first low point (which was the assumed nadir) and lasts way beyond the next dose time.

    Example...PM shot at 5.30pm. Went slowly and steadily down from yellows / pinks to blues. No greens. After 6-7 hours, slowly climbing back to the yellows and then a pink. Then, after about 8-9 hours, back down to the blues.

    At AM dose time of 5.30am, still blue. 30 minutes later, now greens. Breakfast given but no insulin. Still greens and dropping further into low greens. More food. Medium carb. Another 30 minutes later, the monitor said LO. High carb food given and some biscuit treats, and then numbers returned to the low greens.

    By now it was 4 hours past the AM dose, which obviously could not be given.

    Why does this happen? How can the BG go down moderately and then up again, and then go down so low for so long??

    Usually that first lower point is it, and once it starts rising after 7-ish hours, it just keeps going up until the next dose.

    Is this what they call a "sputtering pancreas"? Does it sometimes get prodded into action and decides after the injected insulin is out that it wants to create its own insulin?

    That's great, but it messes up the 12 hour dosing!!!!!
     
  2. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    It looks to me like he's having some late nadirs, recently, in the past two months.
    I would have lowered the dose when you saw that 36 on December 22nd. And I surely would lower the dose with the 36s and LO on the 29th.
    Can you add the doses you gave between 12/29 and 01/05 to his spreadsheet, please? I don't think I would have shot 2.00 again this morning, but I can't see what his numbers were this past week, and I guess you didn't use a regular glucometer to test?
    We like to keep all questions and answers in one thread (condo) per cat per day, that way ideas don't get all mixed up. Can you delete your other condo for today, while you still can before someone responds to it?
     
  3. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    The "double low" numbers that your referring to is what we call a "double dip." Usually, numbers drop again after the first nadir but then would generally start rising prior to insulin onset. That's one scenario. It's also hard to know if this occurs because a kitty's pancreas is kicking in. (Those darn cat's refuse to tell us what's going on!!) I'm pretty sure that Gabby's pancreas wasn't really too lively but she would occasionally double dip. There's really no definitive explanation for what this happens that I know of.

    The other explanation is what Dyana suggested. You may be getting longer duration from the insulin or Dweezil may have a late nadir. Not all cats have a mid-cycle nadir. Gabby's nadir was early (at around +3). Nadirs can vary.

    FWIW, I can appreciate your wanting information on where your kitty's BG is. You probably don't need to test hourly, though. Do you ever sleep?

     
  4. monty_dweezil (GA)

    monty_dweezil (GA) Member

    Joined:
    Dec 15, 2014
    He has a monitor fitted! lol. We scan it and it tells us what he is but also we can look back and see what he's been all the time even when not actively been scanned. Sadly though, he can only wear it for 2 weeks at a time and then it stops working and he has to have breaks in between (and each one costs $400, eep!)

    Anyway, after that last monitor stopped working on Dec 29, the dose was lowered to 1 unit which was too low for him but my partner was still on her own (I was away for Christmas) and Dweez won't let us do his ear and never has.

    In the past, we have found 1.5 to 1.7 units seems good until he has a really late nadir and then the routine is ruined!

    When we had him on 1.5 consistently for weeks (with no monitor), he got ketones (which thankfully we caught early as we test his pee a lot) so that dose must not be high enough.

    But when on 2 units, he sometimes has these late lows, and the Dec 29 one was only on 1.5 units! So we just never really know what his ideal dose is!
     
  5. Tracey&Jones (GA)

    Tracey&Jones (GA) Well-Known Member

    Joined:
    Dec 12, 2016
    Is that like the new monitor that they are advertising for humans? You stick it on and then you can read it anytime. It looks like you have to move it every now and again.
     
  6. monty_dweezil (GA)

    monty_dweezil (GA) Member

    Joined:
    Dec 15, 2014
    Yep! Harder with cats as you have to shave the fur and use a special glue, and if any air gets in under the monitor (from them licking at it), it'll stop working. Grr. :) And there are only so many places it can go that they won't find annoying and fiddle with it excessively.
     
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