? Dose when Switching from Novolin-N to Glargine

Nyrie (a 17.5 year old female) is currently getting 3 units of Novolin-N twice a day.
I'm making the switch to glargine.

The vet recommended starting at 1 unit, but this forum seems to recommend ~70% of the original dose (so 2 units). Is that right? What should the starting dose be?

 

The forum only recommends 70% when you are switching from one depot style insulin to another. So something like Lantus to Levemir you would do at 70%. But not with an in and out insulin like Novolin. There you would take the existing/current dose into consideration. Given that you've seen under 100 on 3 units. I wouldn't go that high. She also got into the 20's on 3 units, which is scary low. That means that dose is way too high.

When are you planning on making the switch? There really is a lack of data for me to make a good call on starting Lantus dose. You need to start getting tests before each and every shot, to make sure it's safe to give insulin. Perhaps with a bit more data, we could give you a better suggestion on starting dose. Do you think for the next couple days you could get AM and PM preshot tests, plus one or two other in the AM and PM?

When you start Lantus, please make a blank line in the spreadsheet after the last Novolin dose, the put Start Lantus on that blank line. So it's easier for us to see.

 

Definitely don’t go back to 1.0. What is she eating? It looks like this is your first post. Please post an intro on the main/health forum and set up a signature. Look at our dosing methods too. I would actually start at 2.5 but need the rest of the info to see.

 

Info in this post to help you set up the Signature, etc.
New? How You Can Help Us Help You!

 

She's on wet food (Purina Pro Plan DM Dietetic Management).
Here's her tracker. I have it on my signature too, but maybe I did it wrong!

 

Update
I made the switch this evening and gave her just 1 unit (was at 3 units of Novolin-N). Just tested her BG (+4.5 hours) and it's 57.
That's a huge difference from Novolin.

 

Definitely will monitor her over the next few hours. Maybe drop it down by 0.25 for the next dose?

 

I saw your spreadsheet. You just don’t have enough test to see how her dose is doing.

 

Lantus is a depot insulin and it takes 5-7 days for the depot to build. I suspect that 57 is not from lantus although some cats have a big response to the first couple of doses. The 57 could be from Novolin.

You need to get a test before every shot and you haven’t done that. That’s why Wendy said there’s not enough info for a start dose.

Have you read the stickies at the top of this forum? Lantus works very differently than Novolin. Are you using U100 syringes with half unit markings?

Does Nyrie have any other medical issues? On any meds?

 

Re: You need to get a test before every shot and you haven’t done that.
True. I got a little lazy since the preshots were so consistently in the high 300s/low 400s. I can be more diligent there for sure.

Re: The 57 could be from Novolin.
Seems unlikely, no? The last Novolin shot was 14-15 hours ago.

Re: Have you read the stickies at the top of this forum?
I have, but could always use a refresher.

Re: Lantus works very differently than Novolin. Are you using U100 syringes with half unit markings?
Yup.

Re: Does Nyrie have any other medical issues? On any meds?
Nope, just old 17.5 years and still kicking it.

 

Have a look at our dosing methods. SLGS requires tests at amps and pmps and a curve every 7 days. Until you know how she’s reacting to lantus especially the first few days it’s good to test every 2-3. If you follow that method you would reduce to .75 as a bg under 90 earns a reduction. TR requires amps and pmps and at least one other test each cycle. Reductions earned if under 50. That’s a very brief explanation so read the methods directions.

 

Please test her again. The nadir for Lantus is later than for Novolin, she could still be going down into dangerous numbers.

Definitely reduce her dose for the next shot. And make sure to get preshot tests. They will vary a lot with Lantus.

 

Last night she got down to 29, but I fed her some dry food and she was OK.

This morning, her preshot was 458.
I gave 0.5 units to be on the safe side since she went down so low at 1 unit. Thoughts?

I’ll measure her BG a few times through the day today (and will do preshots).

 

That was way too dangerously low a bg. I would have given honey or Karoo with food as it brings up the bg more quickly than dry. When that happens you need to feed hc food. What is your hc food? It needs to be at least 15% carbs or more. Then you need to recheck every 20-30 minutes until the bg is well into the 50’s feeding every 20-30 minutes until the bg is at least into the 60’s or higher.
Please read and print out the sticky on handling low numbers. Do you have a hypo kit?
Thank goodness she did not have a symptomatic hypo.

Lantus onsets around +2 for most cats. So start with a +2. If it’s lower than the amps/pmps it could be an active cycle like last night and more tests are needed. Just because she’s bouncing now does not guarantee she won’t go lower today. After a +2-3 we can tell you when next to test.

https://felinediabetes.com/FDMB/threads/dont-panic-or-how-to-handle-low-numbers.210109/

 

Please start a new thread when you read this today. One new condo every day helps us help you. If you have a question just add a question mark prefix and change your subject bar.

 

https://felinediabetes.com/FDMB/threads/posting-guidelines-please-read.231511/

 

I'm hoping you will start a new post for today, but had to respond to this before then. Going down to 29, is not OK, especially since you didn't test afterwards. High carb food can wear off, who knows if it did and she went low again. Spending any time in low numbers like that is dangerous and could damage her.

I'm glad you went down to 0.5 units today.