? SLGS dose increase?

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by cataphraz, Mar 6, 2018.

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  1. cataphraz

    cataphraz Member

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    Feb 25, 2018
    Mookie has been on 2.25U per day (1.125 am, 1.125 pm) for almost a week. I'm going to do a 12 hr glucose curve tomorrow. I just want to make sure I understand the SLGS protocol. If his nadir is above 8.3 mmol/L tomorrow then I should increase his daily dose to 2.5U (1.25U am, 1.25U pm). Is that correct?

    Also, I am using an AlphaTrak2 glucometer. Is the 8.3 mmol/L given in the SLGS protocol for an animal glucometer or for a human glucometer? If it is for a human glucometer, what would the reading be for an animal glucometer?

    Thanks :)
     
  2. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Feb 14, 2011
    I'm not super-great at translating non-US BG numbers, but at a quick glance at all the pink on Mookie's SS, I would say you probably will want to do an increase, depending of course on what the actual curve says.

    Are you able to grab any nighttimes tests? Without those tests, you are missing lots of info on Mookie, and many times kitties will go lower at night. A before-bed test can give you a lot of good information and will help fill in the blanks a bit more.

    SLGS is really a "method/guideline" rather than an actual "protocol". With that said, it is designed around human meters, not pet meters. There is not set formula to adjust numbers between the two different types of meters, so when you're using a pet meter, "know thy cat" really comes into play. However, with SLGS in conjunction with a pet meter, we do consider 90 (US) to be the "take action/reduce dose" number.

    One other thing, we usually do dose adjustments in .25U increments per shot, not per day. There are times when smaller (or larger) increments are warranted, but the standard usually .25U.
     
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  3. Juliet

    Juliet Guest

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    Sep 8, 2017
    You increase 0.25 per shot not per day. All readings in the protocols are on human meters.
     
  4. Juliet

    Juliet Guest

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    Sep 8, 2017
    Non US numbers - multiply by 18. Eg 10 mmoL would be 180.
     
  5. cataphraz

    cataphraz Member

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    Feb 25, 2018
    Thank you for the clarification! I am hesitant to increase Mookie's dose by .25U per shot. He had a sudden drop to 6.2mmol/L when I tried to go up to 2.5 Units per day just over a week ago. After tomorrow's glucose curve tomorrow, I will likely need to increase the dose considering his numbers. I don't want to overshoot and then have to deal with super low preshot numbers. Would it be effective to increase by .125U per shot and hold for 3 days, recheck and then increase another .125U per shot if needed? Or would his body just be more likely to adapt to the insulin and then ultimately need even more to bring his numbers down?
     
  6. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    The rate at which you increase largely depends on whether you are following TR or SLGS. Technically, to be following TR, you need to be getting at least 4 tests in per day - the two preshot tests, and at least one test per cycle. With TR, you can consider increasing every 3 days/6 cycles. With SLGS, you do hold the dose longer.

    Yes, one potential issue of not increasing adequately and/or holding a dose too long is the possibility of glucose toxicity - the body getting used to those higher BGs, which in turn requires more insulin to break through to get into healthier numbers.
     
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  7. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    Hope you see some better numbers soon on that new dose.
     
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  8. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    If you look at the Spreadsheet Instructions here, we do have a World version of the SS. That way you can enter data on the World tab in mmol/L and it'll do the conversion to the mg/dL that the Americans are used to using. We also start a new tab for each year, otherwise it takes a long time to scroll down to see the current data. If you need help doing that, we have some people here who can help you.

    Good luck with the increase. What a cat needs for insulin can change over time.
     
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  9. cataphraz

    cataphraz Member

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    Feb 25, 2018
    Thank you!
     
  10. cataphraz

    cataphraz Member

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    Thank you!
     
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