Levemir Testing at +2 or +3--any value?

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Christianna

Member Since 2014
Hello all,
I read on the forum that Levemir generally onsets at +4 to +7 in many cats. If this is accurate (and I might have it wrong) what is the use of testing at +2 or +3, if the Lev hasn't really gotten into the system and/or there is a possible food spike from the meal that is given at shot time? I don't want to poke Noodle any more than necessary and am still getting used to the little differences between Lantus, which Noodle was on previously, and Lev, which he is on now.
Thanks for any and all thoughts :-)

Christi
 
Hi Christi

When we switched from Lantus to lev, it was almost like starting over because we had to relearn Gracies patterns. Just as some Lantus cats might onset and nadir earlier than others, lev cats can as well. You will have to do some testing to find out what his onset, nadir, and duration are.

For example, Wendy's Neko clearly onsets at +4 and so Wendy doesn't need to test her earlier. But Gracie will often nadir very late (+14 or so) or she will get a late second dip and then onset. So I test her at +2, generally, because I know if she is the same or lower, she's going to potentially drop a lot at +4 when she onsets. ECID.

You can look at some lev SSs and see the differences. Neko, Gracie, Tess, Rusty, are some who have been on lev a while and have lots of data.
 
Are you referring to the suggestion to Lantus users to get a +2 as a heads-up for where the cycle might be headed? If so, you're right that specific suggestion goes with Lantus.

Until you've identified how Levemir works in Noodle's body, I'd vary the times of your tests. Patterns will emerge as you do that, and you should be able to identify when Lev on sets and how long it lasts.
 
Milo is a Levemir kitty. I now know he rises after shot and hits nadir about +7-+9. Some days I just spot test to see if changes. If I increase dose, like I did tonight, I test more a couple cycles to see if changes.

We are only on Levemir for 6 weeks so I am no expert, but that is what I found with my kitty.

Good luck.
 
I agree with Marje and Julie. Know thy cat! Rusty usually onsets after +4, so I don't test again after PS until +4 or +5. His nadir can vary anywhere from +5 to PMPS, but usually is somewhere between +8 and +9. It takes some getting used to when you are used to Lantus, but it is very nice to have that big stretch of time before the insulin kicks in. It enables you to shoot lower numbers than you might otherwise, because you can usually count on a rise before onset begins.

Good luck!

Ella & Rusty
 
Marje and Gracie said:
Hi Christi

When we switched from Lantus to lev, it was almost like starting over because we had to relearn Gracies patterns. Just as some Lantus cats might onset and nadir earlier than others, lev cats can as well. You will have to do some testing to find out what his onset, nadir, and duration are.

For example, Wendy's Neko clearly onsets at +4 and so Wendy doesn't need to test her earlier. But Gracie will often nadir very late (+14 or so) or she will get a late second dip and then onset. So I test her at +2, generally, because I know if she is the same or lower, she's going to potentially drop a lot at +4 when she onsets. ECID.

You can look at some lev SSs and see the differences. Neko, Gracie, Tess, Rusty, are some who have been on lev a while and have lots of data.
Click to expand...
Hi Marje and Gracie,
You are so right when you say it is like starting all over again (switching from Lantus to Lev.) In Noodle's time on Lantus I had become fairly educated about his patterns, logical testing times, etc. but none of that seems to apply now. Most of the time, though not always, Noodle's lowest BG reading is right before his PM shot. I really don't know what his duration is (?) He had a pancreatitis flare last month which derailed his numbers somewhat and the vet told me not to do any dose adjustments till we got him stable again. Was this decent advice? Anyway, thanks so much. I'm going to study some of the SS you mentioned and vary Noodle's testing times so maybe I can eventually spot a pattern. Thanks so much for your help.

Christi
 
julie & punkin (ga) said:
Are you referring to the suggestion to Lantus users to get a +2 as a heads-up for where the cycle might be headed? If so, you're right that specific suggestion goes with Lantus.

Until you've identified how Levemir works in Noodle's body, I'd vary the times of your tests. Patterns will emerge as you do that, and you should be able to identify when Lev on sets and how long it lasts.
Click to expand...
Hi Julie,
Yes, that was the suggestion I had rolling around in the back of my mind. I thought it was for both Lantus and Lev. users so appreciate your clarifying for me that it only applies to Lantus. I am going to try to get more varied tests as I would really like to pin down what to expect with Noodle on Lev. Thanks so much for your help--I really appreciate it :-)

Christi
 
milosmommy said:
Milo is a Levemir kitty. I now know he rises after shot and hits nadir about +7-+9. Some days I just spot test to see if changes. If I increase dose, like I did tonight, I test more a couple cycles to see if changes.

We are only on Levemir for 6 weeks so I am no expert, but that is what I found with my kitty.

Good luck.
Click to expand...
Hi milosmommy,
It looks like you are better at getting a variety of tests that I am :-( When Noodle had his pancreatitis flare last month and we weren't doing any dose adjustments, I cut back on the testing because he seemed to feel so bad and the vet told me his numbers would probably run a little higher during the flare. He is much better now and I increased his dose yesterday, so am getting more tests in. You're way ahead of me if after 6 weeks on Lev. you know Milo nadirs around +7 to +9. Noodle seems to nadir right before his PM shot but not consistently, so looks like I'll be poking his poor ears till I can get a pattern nailed down :-) Thanks so much for your help.

Christi
 
Ella & Rusty & Stu(GA) said:
I agree with Marje and Julie. Know thy cat! Rusty usually onsets after +4, so I don't test again after PS until +4 or +5. His nadir can vary anywhere from +5 to PMPS, but usually is somewhere between +8 and +9. It takes some getting used to when you are used to Lantus, but it is very nice to have that big stretch of time before the insulin kicks in. It enables you to shoot lower numbers than you might otherwise, because you can usually count on a rise before onset begins.

Good luck!

Ella & Rusty
Click to expand...
Hi Ella and Rusty,
Sometimes I am more confused than ever because of the things I learned while Noodle was on Lantus and virtually none of them seem to apply on Lev. I do like that Lev seems to have a nice slow onset with Noodle so I am not as nervous about big swings while I am searching out his pattern. To nadir anywhere from +5 to PMPS is quite a wide time frame. I had noticed that Noodle seems to rise about 3 hours after his AM shot and I'm not quite sure why this is. If I knew what his pattern was I wouldn't be such a basket case :-) I'm going to increase my testing now that he seems to be over his p-titis flare and hope that I can see an emerging pattern. Poor Noodle's ears... Thanks for your help.

Christi
 
Hi Christi, good to hear that Noodle is getting over his pancreatitis. The worst part of switching from Lantus to Levemir for me was learning Neko's new patterns. For the most part, everything is switched 2-3 hours later. She now onsets after +5 and I've spotted her nadir anywhere from +5 to +15, though it's most commonly between +9 and +12. If she's low and dropping into preshot, then I'll often get a +2 or +3 ause it might be one of those time when her nadir is after PS. Also, if she doesn't get much of a rise after preshot and before onset, there's a good chance she'll have a more active cycle. Since I most often go to bed before her evening onset, I use this information to help me determine if I need to set an alarm for around nadir time at night.

If Noodle is rising for three hours after preshot, that means onset for him is after that. Getting a good idea of his onset and nadirs may mean a bit more testing at first to find them, but then you'll get a better of idea of when the best times are to test, and when you don't need to.
 
I just want to echo what others have said about observing Noodle's patterns. Also, not every cat's cycles end up flattening out on Lev. The fundamental rule -- every cat is different (ECID) -- applies to switching insulin just like it seems to apply to everything related to our kitties.
 
Wendy&Neko said:
Hi Christi, good to hear that Noodle is getting over his pancreatitis. The worst part of switching from Lantus to Levemir for me was learning Neko's new patterns. For the most part, everything is switched 2-3 hours later. She now onsets after +5 and I've spotted her nadir anywhere from +5 to +15, though it's most commonly between +9 and +12. If she's low and dropping into preshot, then I'll often get a +2 or +3 ause it might be one of those time when her nadir is after PS. Also, if she doesn't get much of a rise after preshot and before onset, there's a good chance she'll have a more active cycle. Since I most often go to bed before her evening onset, I use this information to help me determine if I need to set an alarm for around nadir time at night.

If Noodle is rising for three hours after preshot, that means onset for him is after that. Getting a good idea of his onset and nadirs may mean a bit more testing at first to find them, but then you'll get a better of idea of when the best times are to test, and when you don't need to.
Click to expand...
Hi Wendy and Neko,
I feel exactly as you stated--the hardest part about the switch from Lantus to Lev is that I've had to "unlearn" virtually everything about Lantus and start over "relearning" it about Lev. Noodle definitely has a very slow onset with Lev., that's why I felt it was pretty much a waste of time to test him at anything earlier than at least +4, because it seemed that the Lev. hadn't even gotten to work yet. I have not yet gotten enough tests to see if +14 or +15 might be when he is the lowest. He usually seems to be lower right before his evening shot and almost always higher before his morning shot. Just about the time I think I'm spotting a pattern, he throws me a curve with some off-the wall number :-( I swear he's making my hair go gray before its time :-)
Thanks so much for your explanation--it's nice to know I'm not going totally nuts and that trying to go by the Lantus rules doesn't apply for Lev. Give Neko a loving pat from me :-)

Christi
 
Sienne and Gabby said:
I just want to echo what others have said about observing Noodle's patterns. Also, not every cat's cycles end up flattening out on Lev. The fundamental rule -- every cat is different (ECID) -- applies to switching insulin just like it seems to apply to everything related to our kitties.
Click to expand...
Hi Sienne and Gabby,
Boy--what you said is so true! Every kitty that I read about on here has his own unique story and Noodle is writing his own too. Just wish he was a little more predictable and didn't like to throw in so many rollercoaster moments for his old bean :-)

Christi
 
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