When should I start seeing changes in bg?

Discussion in 'Lantus / Levemir / Biosimilars' started by Raechel, Jan 23, 2015.

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  1. Raechel

    Raechel Member

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    Jan 18, 2015
    Phobos just started on Lantus on Tuesday, so we're very new to this. I know numbers may bounce all over the place for quite awhile, but is there a general flow to how much change we should start seeing and at what point?
    Right now, I'm just home testing before each shot - trying to get him a little less skittish about the testing. The vet had wanted me to bring him in next Friday for a curve, but I talked to her today and she's fine with me doing the curve at home, so that's what I'm planning.
    I know the Lantus needs to build up in their system, so I wasn't sure if I should be concerned about his numbers going up again at this point?
    Thanks!
     
  2. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    You're looking for the glucose to be lower between the shots, not at pre-shot. The nadir, or lowest glucose level, is often around +5 to +7 hours post shot.
     
  3. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    Hi and welcome to LL. It takes time for lantus to build up. You are doing a great job of testing but at this point don't need to test hourly. I would test amps, +2+4+6 and the pmps and one test before bed while the numbers are above 200. There is a good chance you will find lower numbers at night.
     
  4. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    One really, really important thing to get about Lantus is that the dosing decisions are based upon how LOW the dose takes the blood sugar. You're testing at preshot, which is typically the highest point of the 12 hour cycle.

    I'm seeing BJM's post just now - some cats have their low point as early as +2 or +3. What is most helpful is to vary the times of your mid-cycle tests. Think of his spreadsheet as being a jigsaw puzzle. If you get a sprinkling of tests here and there, we'll have a very good idea of what the dose is doing. Preshot tests are like a stripe down the middle of the puzzle - it shows a limited amount.

    Anyway, the short answer is that I'd get a sprinkling of tests here and there rather than focusing on doing a curve on one day. One mid-cycle test in each cycle will tell more than a curve on one day.

    How long it takes to get a cat regulated varies all over the place. Some cats go on insulin, switch to low carb and are off insulin in 2 weeks. Some never go off. There's no way to know in advance what the path will be for any particular cat.

    You're on the right track, though - you've learned to hometest, you've got a good insulin and you've found a good source of experience. Hang in there.
     
  5. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    It just occured to me that maybe what you're asking about is that you saw a red preshot test this morning and you're thinking that the reds should be gone? is that right?

    Cats blood sugar will fluctuate - so seeing that red doesn't mean too much. Don't let it stress you out. We look at about the past 3 days worth of data and that says a lot more than one test.

    You're doing great, Raechel! It's a process to pick all this up and you're off to a good start.

    Often cats will show their lowest blood sugar in the pm cycle. You could conceivably see that 474 this morning and have a 50 in the middle of the night tonight.
     
  6. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Good to see you back Raechel!

    It's important for you to try to get a few more tests in if you can, especially on the PM cycle since most cats go lower at night. If you can just grab a test "before bed" it'll help to know what Phobo's has in mind

    If you can just sprinkle some tests in at different times during the day (if you can) and at least one test on the PM cycle, it'll be easier to see how he's really doing. We've had cats here that had Pre-shot numbers in the 400's, but mid-cycle, they were dropping into the 40's!

    Did you not shoot last night? There's nothing in the U column on your spreadsheet for the PM cycle on 1/22
     
    Last edited: Jan 23, 2015
  7. Raechel

    Raechel Member

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    Jan 18, 2015
    You guys are awesome!
    I don't know how I missed that I should be more concerned with a mid-cycle number. I will grab some other numbers and see where they are.
    Yes, Julie, those red numbers were what raised my question. Not really concerned about them, but curious.
    Thanks for pointing out that discrepancy on my sheet, Chris. I missed filling it in last night - it's added now.

    So, is the nadir going to vary a lot, by day, too? I did a curve the first day he was given insulin (we didn't shoot that night because we needed to re-set the shoot time), but only tested every three hours. Of those, his low point was +9...maybe he was actually lower at +7 or +8, I suppose. Eh, just pondering now.
     
  8. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    The nadir is a moving target, but as you get further down the road, you'll begin to figure out if he's an early, mid or later nadir'ing cat

    Of course as soon as you think you have it figured out, they change it! ....LOL

    The nadir is "usually" around +5 to +7, so that's when we stress getting tests in when you can to start with (of course there's no such thing as too much data, so any test is a good test!)

    We don't concentrate so much on "curves" here, but just getting tests sprinkled throughout the cycles so you get a good idea what they're doing.

    Like Julie said, it's like a puzzle....if the only pieces you have filled out are the edges, it makes it hard to see what the whole picture is, but if you sprinkle "pieces" throughout, it becomes clearer and clearer
     
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