Can anyone make sense of these numbers?

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With Lantus, the most important part is to base dose adjustments on the nadir, the lowest glucose post shot. This is somewhere between +5 to +7 for most cats, although the nadir can and does vary day to day. What will be most helpful is if you get tests in the +5 to +7 hours post shot on any days off, weekends, or even setting the clock for overnight on some nights. You need to see how low Princess is going between shots in order to adjust the dose.

Read over each of these protocols for using Lantus/Levemir and decide which will be best for you to follow.
Tight Regulation protocol
Start Low, Go Slow protocol
For the average diabetic cat, each of these protocols has you hold the same dose for a minimum of 3 days for Tight Regulation and more for Start Low, Go Slow. This is because it takes some time for the insulin dose to stabilize due to its depot, or residue left over from the previous shot. The Stickies at the top of the forum provide a great deal of information on how Lantus may be used most optimally.
Both protocols make dose adjustments in amounts of 0.25 units for many cats, not 1 unit jumps which you seem to be doing. This is so you don't pass over the best dose for your cat.

When you have to drop a dose because of a suddenly low pre-shot, that suggests the dose could be too high. Looking at the spreadsheet, you might give 1.5 units for a minimum of 3 full days, and test during the nadir period as much as possible.

 
Hi Marie and welcome to Lantus/Lev Land!

If you've not already read through the "sticky" notes at the top of the board, I'd encourage you to take a look at them. It will help you get you a basic understanding of how Lantus works. It's a very different sort of insulin because it is a depot-type of insulin. Frankly, not all vets appreciate the difference between Lantus and some of the earlier generations of insulin.

One thing that stands out on Princess' spreadsheet that is likely effecting her numbers is that you eliminated dry food from her diet. What you're seeing in terms of a drop in numbers is very consistent with what we often see here. In fact, we urge people to monitor carefully if they are removing dry food because numbers can drop unexpectedly. The other thing to appreciate is that when her numbers drop they way they did, a "bounce" occurred. Because Princess' body hasn't been accustomed to being in normal blood glucose (BG) numbers for a while, she's redefined what "normal" is. So, when she dropped into a legitimately normal BG range (i.e., 50 - 120), her liver and pancreas panicked. This is a normal response to what her body perceived as a potential danger signal. When that happens, her body released a stored form of glucose along with counter regulatory hormones. This causes the BG numbers to spike upward -- hence the term "bounce." It can take roughly up to 3 days for the bounce to clear. In other words, what you're seeing is pretty normal.

Like BJ suggested, you may want to read through the protocols and sort out which may work best for you. Regardless of which you opt for, you're doing a great job of getting pre-shot tests. Because Lantus dosing is based on the nadir (the lowest point in the cycle), if you can get some tests that are closer to mid-cycle, that will help you in making decisions about dose (and it will help us to help you with those decisions). I'm assuming that you may work during the days. Many of us do -- which makes it impossible to get a mid-cycle test during the work week. Getting at the minimum a test before you go to bed each evening will help. If you can get some additional tests over the weekend or on holidays, that will also help to fill in some of the question marks.

Please let us know if you have questions. People are very responsive and generous with their time and knowledge.
 
looks like you're on the right track! you've mastered hometesting (great job!) and gotten rid of the dry food. Well done!

Sienne's explained what you're seeing with the high numbers right now and given you lots of good advice. Keep asking questions and you'll have the hang of it in no time.

Welcome to you and Princess!
 
Th
Sienne and Gabby said:
Hi Marie and welcome to Lantus/Lev Land!

If you've not already read through the "sticky" notes at the top of the board, I'd encourage you to take a look at them. It will help you get you a basic understanding of how Lantus works. It's a very different sort of insulin because it is a depot-type of insulin. Frankly, not all vets appreciate the difference between Lantus and some of the earlier generations of insulin.

One thing that stands out on Princess' spreadsheet that is likely effecting her numbers is that you eliminated dry food from her diet. What you're seeing in terms of a drop in numbers is very consistent with what we often see here. In fact, we urge people to monitor carefully if they are removing dry food because numbers can drop unexpectedly. The other thing to appreciate is that when her numbers drop they way they did, a "bounce" occurred. Because Princess' body hasn't been accustomed to being in normal blood glucose (BG) numbers for a while, she's redefined what "normal" is. So, when she dropped into a legitimately normal BG range (i.e., 50 - 120), her liver and pancreas panicked. This is a normal response to what her body perceived as a potential danger signal. When that happens, her body released a stored form of glucose along with counter regulatory hormones. This causes the BG numbers to spike upward -- hence the term "bounce." It can take roughly up to 3 days for the bounce to clear. In other words, what you're seeing is pretty normal.

Like BJ suggested, you may want to read through the protocols and sort out which may work best for you. Regardless of which you opt for, you're doing a great job of getting pre-shot tests. Because Lantus dosing is based on the nadir (the lowest point in the cycle), if you can get some tests that are closer to mid-cycle, that will help you in making decisions about dose (and it will help us to help you with those decisions). I'm assuming that you may work during the days. Many of us do -- which makes it impossible to get a mid-cycle test during the work week. Getting at the minimum a test before you go to bed each evening will help. If you can get some additional tests over the weekend or on holidays, that will also help to fill in some of the question marks.

Please let us know if you have questions. People are very responsive and generous with their time and knowledge.
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Thank you for your thoughtful response. I am so glad i found this forum and will surely be asking for more advice. I do not understand the whole diabetes/insulin dilemma yet but will start reading the stickies as suggested.
 
Hi Marie and Princess and welcome to Lantus/Lev.
Sienne and BJM have given you some great info., and you are already testing and feeding appropriate food. There is a ton of information in the "Stickies'. Don't think you have to master everything at once: it's a steep learning curve, but it all will fall into place soon. Ask as many questions as you need. We hope to see you posting here frequently, since that is the best way to get others to know your cat and your situation and to get timely help.

Welcome!

Ella & Rusty
 
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