What hour does Lantus start to work? - dose recommendations for 8/30

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Lion

Lion

Member Since 2021
Hi, previous post: Morning Dose 8/29/21 ? | Feline Diabetes Message Board - FDMB

Can someone please tell me when Lantus starts to work?

Given the morning dose on 8/28 dropped his BG 317 and his morning dropped on 8/29 does his BG 285 I was scared to give him very much for the evening does on 8/29.

i gave only .25 at 6pm. When it had gone _up_ at 7pm I gave another .25 - so total evening dose was .50.

It look like his low may be be at +8 or +9, I know we need more data! But I am wondering when Lantus generally starts to work? At 2+ ?

All feedback appreciated!

Thank you!
 
In theory, Lantus onset begins at arou9nd +2. Likewise, in theory, nadir is arou9nd +6. That said, this varies depending on the cat. My kitty had an early onset and nadir. Other cats are shifted later in the cycle. This is why getting curves is so important. This is from the New to the Group sticky:
Example of an ACTIVE, but NOT necessarily typical Lantus/Basaglar cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus/Basaglar cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. Onset begins around +2 for most cats. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Often lower than the PreShot number.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Basaglar/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.
Click to expand...

A couple of other observations:
  • Lantus is a depot insulin. It's not advisable to give 2 shots in a cycle. (You should make a note on your spreadsheet as to what you did in case you need to back track for any reason.) The reason being that if you give insulin on 2 occasions in a cycle, you can have 2 nadirs. In the future, know that this is not a good idea since it messes with the depot.
  • In all likelihood, it would have been fine to shoot the full dose tonight at PMPS. The PMPS numbers where high enough and they were rising.
  • There is a high likelihood that the AM cycle today was still seeing the effects of the 1.75u dose.
  • Making back-to-back changes in doses can result in wonky numbers. Lantus likes consistency. Unlike the shorter acting insulins, the depot has an effect on the current and subsequent doses. Every time you make a change in dose, it has a ripple effect on the depot. The more changes, the more ripples. It's why doses are held for several days. It allows the depot to stabilize.
Probably the hardest part of understanding Lantus is how the depot works. You'll get it figured out!
 
This is tremendously helpful, thank you very much.

Perhaps I will move back to 1.00 for now and stay there. I was very nervous about shooting even 1.25 tonight and I suspect that will happen again.

Basically, now that I have the FreeStyle......perhaps I just start over again starting with 1 unit?
 
Lion said:
Basically, now that I have the FreeStyle......perhaps I just start over again starting with 1 unit?
Click to expand...
I see that our Moderators suggested 1.25U and it might be a good idea to stick to 1.25U. With SLGS, you hold a dose for a week (unless the BG drops below 90 earning a reduction in dose by 0.25U). If you drop the dose too much, you may end up seeing higher numbers and having to wait a week to increase.

Since you have the Libre and are feeding low carb canned, would you consider doing TR?

In future you may want to post on the Lantus / Basaglar (glargine) and Levemir (detemir) forum where there are several experienced Lantus users and you could get more eyes on your threads.
 
Hi! TR is a great idea! The Libre is new and I didn't even think of TR. That is a great idea. I will read up on it.

Everyone here has been tremendously helpful! The numbers are a lot better already. I did just post another thread on Lantus as you suggested.

I think the recommendation of 1.25 may have been based off the very little data I have, or it may not have been, I don't know.

I'm very happy to see the numbers may be leveling out. That is good news.
 
Sienne and Gabby (GA) said:
  • Making back-to-back changes in doses can result in wonky numbers. Lantus likes consistency. Unlike the shorter acting insulins, the depot has an effect on the current and subsequent doses. Every time you make a change in dose, it has a ripple effect on the depot. The more changes, the more ripples. It's why doses are held for several days. It allows the depot to stabilize.
Probably the hardest part of understanding Lantus is how the depot works. You'll get it figured out!
Click to expand...

Ugh. This is so frustrating and I feel so bad for Lion. Its my fault I originally went too high too fast. Now that I can see his numbers on an hourly basis I want to do something to help him.

I understand everyone has (correctly) told me to hold for 3 to 5 days. I will hold at 1.50. But this is difficult!
 
Lion said:
Ugh. This is so frustrating and I feel so bad for Lion. Its my fault I originally went too high too fast. Now that I can see his numbers on an hourly basis I want to do something to help him.

I understand everyone has (correctly) told me to hold for 3 to 5 days. I will hold at 1.50. But this is difficult!
Click to expand...
Hi Susan, you may want to post this on your latest thread in the Lantus forum so you get more feedback from Lantus users. Thanks :-)
 
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