? Remission

My cat Jupiter has been kind of dancing around remission for the last few weeks, In my spreadsheet you can see the spans of time he's been off insulin (during gaps in data he was on 0.5u SID) Now his numbers are really good again and I want to check for remission again.

Someone on this forum wrote in a thread of mine that the best thing to do is continue administering insulin as long as is safely possible to get a "strong remission" rather than a fast one.

I'm wondering if this concept is widely accepted. Would allowing him to be mainly diet regulated with numbers mostly in the 100-200 range be better than regulating him on insulin in the 50-99 range. Is forcing them to work good for the recovered beta cells? Or is it better to let them rest for as long as possible?

 

Hi Pierre,

When I was doing my initial internet digging after Saoirse was diagnosed, I came across info that advised beta cell damage was more likely to occur above 7.8/140 but that some studies put the threshold for potential damage as low as 5.6/100 (Alphatrak values). I can't remember the source but it might have been the PetDiabetes wiki.

As best I could work out from the guidelines for pet meter users in the published Roomp-Rand TR study, one way of earning a dose reduction is if the cat's BG stays above the hypo threshold but below about 7.2/130 for a week so that might be a good target to look at for Jupiter's BG as measured on your Alphatrak. (NB: This is only my take, not an FDMB guideline.)

When a cat is approaching potential remission, the FDMB recommendation for Lantus kitties is to gradually step down the dose:

- 0.5IU BID until dose reduction is earned.
- 0.25IU BID until dose reduction earned.
- 0.1IU BID until dose reduction earned.

Some members will then go to a drop dose before attempting a remission trial. If you post on the Lantus board they may be able to give you additional guidance.


Mogs
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Thanks for your response, I think I'm going to restart as low a dose of insulin as I can feasibly measure with some consistency and see If I can keep him in the 60-80 range before attempting another remission check. I know there's instructions on the forum for getting good precision using calipers, I'm just going to have to do my best eyeballing with my single unit marked syringes :/

 

Initially I was working from the protocol defined in this paper which seems to aim for a regulation target considerably higher than what those on this forum seem to aim for, 180-216 pre shot and nadirs 90-160 (granted numbers would need to be adjusted lower to line up with human meters), by those characteristics Jupiter should be off insulin but when I see the numbers you have in Wink's spreadsheet from his long remission it really does look like aiming lower gives a strong result.