I’m going to copy and paste a response from one of our moderators to another new member who is struggling with a lot of questions. A few of the things she says in here may be helpful in answering some of your concerns. I was going to say some of these same things in response to your question of last night, but then this morning I was reading this and thought I would just copy and paste it. This member is using Lantus insulin, but nevertheless a lot of the information applies: Wendy said:
“You asked me several questions in a PM:
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but would you mind taking a moment to look at Jessi's spreadsheet and give me your opinion on what to do next? We did back to back reductions that have caused quite a lot of change and I'm concerned that now she's slipping back into a hyperglycemic state, not just in numbers but in how she's acting.
I know it could be other factors as well, but I would just like to hear your take on it. Several people have responded suggesting I do TR but that doesn't help me understand the SLGS method and what to expect in the next 24-48 hours, what to do if she stays up in these numbers, and other aspects of the method.
Doesn't back to back reduction cause a sudden release of stored insulin into the bloodstream, couldn't that be why she had that long stretch of low numbers the other night? If this is a known effect of doing the reductions so close together, wouldn't we want to slow that down more? And if this happens, does that deplete the depot that is so important to the Lantus effect?
Can a bounce cause higher numbers even 2 days after the low ones? How do you know if it's a bounce or just not enough insulin?
Sorry for all the questions, I'm just trying to understand the thinking and science behind this method so I don't feel so in the dark. Whatever knowledge you can share would be great.
It's hard to see her so low and lethargic after seeing her spry and energetic the last few days. Maybe it has nothing to do with the reductions at all, but I feel like the more I know the more empowered I will be.
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First piece of advice is to learn to relax and take some time to do some things for Stefania. All of us start out as helicopter parents, trying to interpret everything our cat does. You might want to read this post:
Dear Mom/Dad (letter from your kitty)
Feline diabetes is a marathon, not a sprint. We also say that Lantus teaches you patience, which definitely was not a word to describe me when I started here, so I can relate to the million questions.
Jessi is bouncing. Bounces can take up to 3 days/6 cycles to resolve. Bouncing and the phrase "my cat's numbers are all over the place" are the two mostcommon complaints we hear from new caregivers. You know what, this is not something we can control. It happens and it takes much more time in normalnumbers to reduce or stop bouncing. My cat took a year to stop bouncing to over 400. And note, we have a phrase that you have to Learn Your Cat and ECID, each cat is different, because it's true. Over time, you might learn to predict Jessi's patterns on Lantus. At which point she'll change those patterns, because CAT.
But the basics of when she onsets, and her response to carbs should stay pretty much the same.
We cannot do anything about back to back reductions when following SLGS, and we sense your frustration with having to hold the dose a week now (unless she goes under 90 again), which is probably why people are suggesting trying TR. You test enough for it and are feeling low carb food. In spite of that, we say that the choice of dosing method is also a matter of your life style, goals for Jessi, and comfort level. Some people just aren't comfortable with the concepts of TR, and that's OK if you want to stick to SLGS. However, that means changes have to be done more slowly iffollowing SLGS. You will have to stay with 0.5 units for a week, so 11 more cycles.
Not just back to back reductions, but even single reductions will feel the effect of the higher depot for 4-6 cycles after the reduction. In that case, you may wish to help prevent her earning another reduction prematurely. Yesterday you saw a huge drop from +2.25 to +3.35. That might have been a good point to give something like medium carb, to try so slow her down and prevent her from going under 90. Rather that waiting until she went under 90 to boost her up. Learning how sensitive Jessi is to carbs will help immensely. I see you are noting when and what you feed (excellent), you might also want to note the amount.
Another suggestion for you, look through the posts on this forum and look for people who have recently diagnosed cats. Read their posts, look at theirspreadsheets. A lot of the same questions get asked, or you might find one you had not thought of yet. You may also see some similarities between newly diagnosed cats and their response to insulin.”
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