Hi Katrina!
As Liz said: Welcome to the Lantus Basaglar and Levemir forum. I am going to provide the link to your other post as well as a quote of it so you can get some answers to that post as well:
Katrinas Previous Post
Zoe is on her third week of her diagnoses and she was started at two units twice a day. I’ve been home testing and her numbers have been all over the place. Sometimes it’s too low for me to give it. Sometimes I’ve done one unit. I was advised on here that it should really have consistency so I’m thinking about moving her down to one unit twice a day but of course still testing her. My question is it was suggested that I even start lower. I’m injecting her with a syringe I don’t see on the syringe how I could possibly go lower than one unit and be able to accurately measure it.
Maybe I’m misunderstanding. At this point I’m so overwhelmed and feel so lost that I don’t know what I’m doing. I’m so incredibly stressed out I feel like I’m about to lose it. I will openly except any information. I know I need to upload her numbers onto the spreadsheet I just don’t have access to a computer at this time
Without having Zoe's test data it will be hard for members to provide advice, Like Liz, I also use the google sheets app on my phone to keep track of Mowgli's numbers... this might be a better option for you if you don't have regular access to a computer. Do you have your results written down somewhere? Until you can create a spreadsheet, you could take a picture of the written down results and post it with your phone, that will give members an idea of how Zoe's numbers have been
In the meantime, there are a few things from around the board which could help you, especially if you're willing to adopt one of the boards dosing protocols. If you wanted to follow one of the protocols you would have to follow Start Low Go Slow ( SLGS) as it sounds like you're feeding dry food. The other dosing method is Tight Regulation (TR) you can find a description of both dosing methods
HERE .
I am going to give you some advice based on the SLGS protocol in case you decide you would like to follow it:
Dose changes in SLGS happen once a week: In SLGS you hold the same dose for a full week
UNLESS Zoe goes below 90mg/dL on her blood test, at which point she would qualify for an automatic reduction of 0.25u. At the end of the week you do a blood glucose curve, which is a 12 hour test schedule testing every 2 hours. You decide whether or not to change the dose based on the lowest point (aka nadir) in the curve as below:
- If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
- If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
- If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
For dose changes we actually change dose by 0.25u at a time: (this applies to both SLGS and TR.). This would mean that if you wanted to try a reduction for Zoe that your next dose would be 1.75u. To change dose by 0.25u you would need to get needles that are 100u with half unit markings as Suzanne had mentioned above. You still have to eyeball between the half unit and full unit to get a quarter unit, but it is much better than trying to eyeball a quarter unit on a needle with full unit markings. For you, this would mean you want the syringe plunger halfway between the 2u and 1.5u line. You can buy the relion brand 100u with half unit markers needles for an affordable price at walmart, if you're in Canada the only option I am aware of is the BD ultra fine 100u needles with half unit markers.
If you don't have needles with half unit markers, and you do think that Zoe definitely needs a decrease, I personally might try 1.5u 2 times a day (BID = 2x/day). It is always better safe than sorry in these instances so I think it would be ok to decrease by a half unit at this time... this would mean you would eyeball the plunger to be halfway between the 1u and 2u line... it's awkward at first but you can do it!
I get up at 5:00am I can push her eating to about 5:30. I don’t test her until after she eats usually because if she gets mad then she won’t eat. So then that puts her at 5:45 getting her insulin. I usually leave the house at 7:30 am.
I don’t get home until 5:00 pm which is fine but sometimes I run late then I’m late giving her insulin.
Sunday’s are a big problem because I go to church in the evening and don’t get home until about 7:15 pm. I leave the house about 4:15 pm. I don’t go to church every Sunday evening but when I do I run into the problem of what to do. ??
Also I was doing 2 meals a day but have been giving her small meals in between.
Your schedule is challenging but not impossible. As Justin mentioned it is very important to stay on a 12 hour shooting schedule with Lantus, that is because if you shoot earlier than 12 hours later than the previous shot then it acts as if the new shot is a dose increase, likewise if you shoot late it acts like the new shot is a decrease in dose. This is where it gets a little complicated: you have a half hour window on either side of your dosing schedule that you can play with without actually changing your dose schedule for example: if you shot at 5am and 5pm you could actually shoot anywhere from 4:30 to 5:30 once per day, if you needed to shoot early or late twice a day you could do it within +/- 15mins so anywhere from 4:45 to 5:15 twice a day. I think with some fancy footwork you could come up with a schedule that would work. If I were in your situation I might do something like this:
Sunday: 7:00am - 7:30pm
Monday: 7:00am - 7:00pm
Tuesday: 7:00am - 7:00pm
Wednesday: 7:00am - 7:00pm
Thursday: 7:00am - 7:00pm
Friday: 7:00am - 7:00pm
Saturday: 7:00am - 7:00pm
With this schedule you could give Zoe a
little snack at 5am (maybe 1-2tbsp) since it is 2 hours before test-feed-shoot time, and just make sure that she finishes it by 5;15 or so, take the bowl away until 7am, then test at 7am ... if the BG is a safe level feed and then shoot. For Lantus you don't have to worry as much about when they eat, it is a long acting insulin and in most cats it doesn't take effect until 2 hours after the shot (known as +2), the most important thing (more important than immediate eating) is that Zoe's BG level is high enough to shoot. You can see the SLGS sticky I linked above for more guidance on that.
I have to stress it is important for you to take a BG before you shoot and that you don't want food to be in their system before you get their BG as the food can mask what their baseline BG levels are at and risk a hypo event. Please make sure you read the sticky about how to prevent and treat HYPOs
HERE
I know you are overwhelmed right now and there is so much information but trust me you will eventually learn... we have ALL been in the same shoes as you are right now so never, never feel afraid to ask questions! There is a ton of awesome people here who will help and support you as you learn this sugar dance!
