10/7 Zeus AMPS 226 +3 341 +5 301 +7 303 +9 302 PMPS 266

Discussion in 'Lantus / Levemir / Biosimilars' started by knolet, Oct 7, 2012.

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  1. knolet

    knolet Well-Known Member

    Joined:
    May 23, 2012
    viewtopic.php?f=9&t=80547


    Happy Sunday morning :coffee: :coffee: :coffee:

    So I was just amazed at last night's drop in numbers:

    PMPS 414
    +3 312
    +6 225
    +9 164

    My question is regarding how Lantus works, I mean does it work more effectively at higher numbers? I don't know if that is really the right question, but here is what I am wondering... Zeus dropped at least 250 points overnight, and today he is at 226. He doesn't have 250 points to drop today. I know food will spike the number, but it should have last night as well. I don't know if that makes sense... Maybe I should go back to bed, :lol:

    Zeus was not happy about being tested this morning, he ran away from, had a little chase around this big oversized chair that I have. But he ate well after the test, no fur shot this morning (even on the left side that I have problems with), left me lots of presents in the box, and has retired to the chair for his bath. :smile:

    Hope everyone has a great day,
    Kathie
     
  2. Teresa and Poopy

    Teresa and Poopy Well-Known Member

    Joined:
    Dec 17, 2011
    Re: 10/7 Zeus AMPS 226

    Good morning, Kathie. :coffee: :coffee:

    I'm sure others more knowledgeable about Lantus will be along...just wanted to mention there are many other variables that play a part, too. If insulin and food were the only two variables we had to deal with, getting our kitties regulated would be a breeze! :D

    And last night's drop was great! :D
     
  3. Jane & Jack & Karre the Emperor

    Jane & Jack & Karre the Emperor Well-Known Member

    Joined:
    Dec 30, 2009
    Re: 10/7 Zeus AMPS 226

    Hi Kathie

    Let me see if I understood what you meant. First, a little SS Recap:

    Yesterday morning, Zeus bounced up off the blue PS. So last night, you had a PS of 414, and then Zeus spent the entire cycle dropping steadily down into the mid-blues, while he was clearing that bounce. With that bit of food at (+9), and the Lantus action of that cycle's shot gradually wearing off, he stabilized and stopped dropping and rose a bit, giving you the PS of 226 - but it looked to you as though the food didn't bump him up as much as it normally does. Remember though: the foodspike was working against bounce-clearing effect of steadily dropping BGs.

    Lantus, when it works perfectly, ideally creates a gentle, fairly flat curve that goes something like this:

    +0 - PreShot number.
    +1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
    +2 - Often similar to the PreShot number.
    +3 - Lower than the PreShot number, onset has started.
    +4 - Lower.
    +5 - Lower.
    +6 - Nadir/Peak (the lowest number of cycle).
    +7 - Surf (hang around the nadir number).
    +8 - Slight rise.
    +9 - Slight rise.
    +10 - Rising.
    +11 - Rising (may dip around +10 or +11).
    +12 - PreShot number.


    However, when a cat is not yet regulated, there are factors that affect and change the way the curve looks. A bounce is one of them. When a bounce is happening, it can sometimes look as though the insulin isn't actually doing anything at all - a cat can go from the 40s to the 400s in a couple of hours *regardless of whether it is early or late in the cycle* and regardless of having received its regular dose of insulin.

    This is because there is no way for the body to resist the glucagon and counter-regulatory hormones released by the liver when it "recognizes" certain scenarios, like (1) a fast drop, (2) a low drop, (3) a fast *and* low drop. When a cat's BG goes outside of its current "comfort zone", either through the speed at which it changed, or the range into which it dropped, that cat's liver "panics" and releases sugar and hormones, which inevitably bump up the BG, creating the BOUNCE. Bounces can happen anywhere in the cycle, and can vary in speed, severity, and duration. It can take up to 3 days for a bounce to clear - or it can go faster (the way it did yesterday for Zeus).

    So, yesterday, as Zeus was clearing his bounce, the onset of Lantus action began, and it looked as though the Lantus was having more of an effect than normal. But it wasn't: It simply appeared that way, because while the bounce was clearing, at the same time the Lantus shot began to take effect. The food Zeus ate at (+9) did stabilize him and give him the rise to the yellows - it was just also working against the bounce-clearing effect, which masked the *usual* signs of a "typical" Lantus curve and a "typical" food spike.

    Does that make sense, and does it answer your question?

    Jane
     
  4. knolet

    knolet Well-Known Member

    Joined:
    May 23, 2012
    Re: 10/7 Zeus AMPS 226

    Thanks for stopping by Teresa, and Jane - thank you so much for that explanation.... That was my question, just couldn't put it into words. ;-) It does make sense now that you have explained the bounce thing (i wasn't thinking about that). I have been struggling to understand it, even when I think I do, I really don't. I am going to bookmark this so that I can refer to it as it happens again.


    Thanks again. :coffee: :coffee: :coffee:

    Kathie
     
  5. Jane & Jack & Karre the Emperor

    Jane & Jack & Karre the Emperor Well-Known Member

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    Dec 30, 2009
    Re: 10/7 Zeus AMPS 226

    You're welcome, Kathie. Thanks for the visit to KCC :smile:

    Hugs
    Jane
     
  6. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Re: 10/7 Zeus AMPS 226

    Let me add a bit to what Jane posted. I think there are a lot of people who have that same question regardless of whether a bounce is involved. If your cat drops from say 300 to 90, there's a 210 point drop from pre-shot to nadir. That 90 is a good place for your cat to be so no worries. But if your pre-shot is 200, a 210 point drop isn't even possible!

    You may have heard people mention that Lantus is known for "flat" curves and "shoot low to stay low." In an ideal situation, you'd see very little variation between your pre-shot and nadir numbers. This happens for cats that are tightly regulated or going into an OTJ trial. Essentially, you're shooting low numbers. Once you get into lower ranges, there is, in fact, less variation between your pre-shot and nadir. In part, this is because Lantus is not as potent as some other types of insulin. What it lacks in potency, it makes up for in duration. So, once your pre-shot numbers are in better ranges, the insulin can "grab on" better and bring the overall level down. It's much easier for a cat to dive and bounce if the starting point is high. (That's not to say that a cat can't drop into low numbers even with a low pre-shot. It's just that the drop isn't big.)
     
  7. Jane & Jack & Karre the Emperor

    Jane & Jack & Karre the Emperor Well-Known Member

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    Dec 30, 2009
    Re: 10/7 Zeus AMPS 226 +3 341 +5 301

    Thanks for that, Sienne! Great expansion!

    Hugs
    Jane
     
  8. knolet

    knolet Well-Known Member

    Joined:
    May 23, 2012
    Re: 10/7 Zeus AMPS 226 +3 341 +5 301

    Thanks Sienne, that is very helpful. I appreciate you stopping by,

    Kathie
     
  9. knolet

    knolet Well-Known Member

    Joined:
    May 23, 2012
    Re: 10/7 Zeus AMPS 226 +3 341 +5 301 +7 303 +9 302

    Well, it has been a pretty flat day, high and flat. I hope we see some better numbers tonight.
     
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