Re: Please help, I just don't know what to do.....
Here are a few definitions of some terms that are used when talking about insulin and BG (blood glucose) curves.
The
peak of any insulin means when it is strongest, or working the hardest. At this time, your pet's blood glucose levels will be at their lowest, or at their
nadir. Once you know this time for your pet on a particular insulin, you know the ideal time for a peak blood test.
na·dir
/ˈneɪdər, ˈneɪdɪər/ Show Spelled[ney-der, ney-deer] Show IPA
–noun
1. Astronomy . the point on the celestial sphere directly beneath a given position or observer and diametrically opposite the zenith.
2. Astrology . the point of a Horoscope opposite the midheaven: the cusp of the fourth house.
3. the lowest point; point of greatest adversity or despair.
Origin:
1350–1400; ME ≪ Ar naẓīr over against, opposite to (the zenith)
Onset is the length of time before insulin reaches the bloodstream and begins lowering blood glucose. Insulins with long onset (2 to 4 hours) are typically the long-acting insulins, or those that have long duration. Those insulins with the shortest onset times (30 minutes) belong to the fast-acting category, or those with relatively short duration. The intermediate-acting insulins have a 1-2 hour onset with 8-12 hours of duration.
Duration is the length of time an insulin continues to lower blood glucose.
The four duration categories are:
* Rapid-acting or Fast-acting insulin begins to work shortly after injection, peaks in about 1 hour, and continue to work for 2 to 4 hours.
* Regular or Short-acting insulin reaches the bloodstream 30 minutes to an hour after injection, peaks anywhere from 2 to 3 hours after injection, and is effective for approximately 6-8 hours.
* Intermediate-acting insulin generally reaches the bloodstream about 1-2 hours after injection, and is effective for about 8 to 12 hours.
* Long-acting insulin generally reaches the bloodstream about 2 to 4 hours after injection, peaks 4 to 8 hours later and is effective for about 12 to 18 hours.
Note that an insulin that is long-acting in humans may be intermediate-acting in cats. The duration classes used here are for humans and usually match those in dogs -- their classifications in cats are somewhat shorter due to cats' faster metabolism.
Carryover or carry-over refers to insulin effects lasting past the insulin's official duration. It's been observed that some long-acting insulins leave an insulin depot[1] under the skin that has a small residual effect that may last anywhere from 12 to 48 hours, after the principal action has ended. Note* this effect is primarily observed with insulins like Lantus and levemir.
Overlap refers to the period of time when the effect of one insulin shot is diminishing and the next insulin shot is taking effect. Caregivers can purposefully manage overlap to increase the effect of insulin on their pets' blood glucose levels and thus hold the curve of their blood glucose levels fairly flat.
Suppose a cat gets an insulin shot every 12 hours, gets 15 hours duration from each shot, and is on an insulin that has a three hour onset. During the 3 hours after each insulin shot, there will be two insulin shots working to reduce blood glucose levels: the diminishing previous shot and the rising current shot. This may mean that the ongoing insulin dose should be less than if no overlap was used.
*consider the principal action of the insulin to be its onset, peak, and duration. If you shoot insulin again before the duration has expired, there will be
overlap.
Carryover is whatever small residual effect is left after duration has expired.
Hope that helps! For other terminology used on this message board here is our
Glossary