Hello everyone! Vet wants me to do a glucose curve on M'row, check glucose one hour before insulin (0.5 U), then every two hours for 12 hours. I am puzzled:M'row is quite stable (glucose which I check just before next insulin, that's every 12 hours is never above 300 or below 100), clinically he's great, eats Fancy Feast Classic. I read online that some 1/3of scholars say glucose testing for Lantus should be done every 3-4 hours for 12 hours, and everyone else says that glucose curves for Lantus are useless because of the constant release of this insulin into blood. He is a nibbling free-feeder, drinks 1 to 2.5 ounces of water every day. So, what do you all think about blood glucose curves for Lantus, and two-hour curves in particular? Thanks for your wisdom!
Hmmm . . . I'm curious as to who that "everyone else" is who says that glucose curves for Lantus are useless. Although Lantus is a depot insulin, which means that it is released into the bloodstream over time, that doesn't mean that kitty's blood sugar is going to be constant throughout the day. There are a number of factors which influence BG, one of which is the effect of the insulin at a given time. But even though the effect of Lantus is long-acting and smoother over time than shorter-acting insulins, there is a definite curve to it's effectiveness. You will begin to see its effect an hour or so after the injection, and it will reach peak effectiveness usually sometime between 3 to 6 hours after the injection, after which the effectiveness begins to decline over time. The effectiveness generally lasts 13-14 hours, so there is going to be some overlap between the two shots, which helps to keep the curve relatively flat. So while you have the effectiveness of the insulin waxing and waning, the BG is going to decline and reach a low point which corresponds roughly with the high point of the effectiveness of the Lantus, and will then gradually increase until the next injection begins to take effect. You say that M'row is quite stable, yet 200 points is a pretty big range, and the 300 is well above the "renal threshold" - that is, the point at which excess sugar tends to spill into the blood. Also, Lantus dosage is not based on the pre-shot numbers, because those are the values that are likely to be the highest in the 12-hour period. Instead, dosage is based on the nadir, or the lowest the BG goes during a 12-hour cycle. If you're having pre-shot numbers of 100, then she could well be going low enough in between shots to be at risk for hypoglycemia. Please take some time to read the stickies for this group to understand just how Lantus works and how people decide on when to adjust dosage. It would be helpful as well if you were to set up a spreadsheet to track M'row's BG and dosage, so that people here can give feedback specific to how M'row is doing. Nearly everyone who participates in this group - i.e., the L/B and L group - keeps such a spreadsheet and has a link to it in their signature. Please check out Benny's spreadsheet, as well as that of other members here; you will see that while he may have a pre-shot number of 100 or higher, he has still had some nadirs that dropped into the 40s. If you are not testing throughout the cycle, you will not be able to keep M'row safe from a possible hypoglycemic episode, which can be fatal.
