High Fructosamine??

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Jonika & Boobie

Jonika & Boobie

Member Since 2021
Hello,

This is my second post on here since my cat Boobie was diagnosed. She has been on Lantus 1 unit 2x/day since August. She is a 9 year old Bengal I got from the humane society 2 years ago and she developed diabetes last summer. I test her BG before each meal with a Bayer Contour meter. I track her numbers and have seen as of the past few months her range has been between 109-450 (only if I have to skip a dose) But I would say her average BG has been 250-300 recently. I took her to the vet for some other tests and they ran a Fructosamine test that came back with numbers in the high 600s! Her Fructosamine was not even that high when she was first diagnosed/unregulated. I have not seen BG levels above 450 let alone 600!

Wondering if anyone has had similar results and knows what could be causing this discrepancy? Additionally, I’ve been using a human BG tracker but my vet keeps telling me it will not give me accurate results and I need a pet one. How do people feel about the Bayer Contour? Should I look into a different BG meter?

Thanks for any advice!
 
I would wait for someone who knows more than me, but I do not believe the values associated with a fructosamine test are the equivalent of the value scale that measures BG. It measures the byproduct of glucose metabolism, not the glucose itself. So I wouldn’t focus on that number as an average of BG.
 
Previous post
https://www.felinediabetes.com/FDMB/threads/pricking-cats-ear-cleaning.254141/
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.

It's best if you start a spreadsheet so members can see how the lantus is working for Boogie in order to give you any advice
Have you read the 2 dosing methods for lantus and which one you want to follow

They will let you know when an increase or decrease is needed
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/


Here is the link on how to create a spreadsheet and how it works
We track our cats BG numbers on it, if you need help setting it up just ask
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
 
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Jonika said:
Hello,

This is my second post on here since my cat Boobie was diagnosed. She has been on Lantus 1 unit 2x/day since August. She is a 9 year old Bengal I got from the humane society 2 years ago and she developed diabetes last summer. I test her BG before each meal with a Bayer Contour meter. I track her numbers and have seen as of the past few months her range has been between 109-450 (only if I have to skip a dose) But I would say her average BG has been 250-300 recently. I took her to the vet for some other tests and they ran a Fructosamine test that came back with numbers in the high 600s! Her Fructosamine was not even that high when she was first diagnosed/unregulated. I have not seen BG levels above 450 let alone 600!

Wondering if anyone has had similar results and knows what could be causing this discrepancy? Additionally, I’ve been using a human BG tracker but my vet keeps telling me it will not give me accurate results and I need a pet one. How do people feel about the Bayer Contour? Should I look into a different BG meter?

Thanks for any advice!
Click to expand...
Sorry to hear about the test. Most of us forgo fructosamine tests because they don't tell you much about how the dose is working on the cat on a day to day basis. Could be that the cat is overreacting to lower numbers and then does what we call "bouncing" (more about that here). Best to follow Diane's advice, get your signature and spreadsheet set up and enter some of that data you have on your meter. We can look at those numbers and help you understand why the fructosamine test is so high. It could be that Boobie is getting not enough insulin or too much. Hard to know if you don't test the cat outside of shot times. If you look at my signature, you can click on my Ruby's spreadsheet to see an example.
 
Katherine&Ruby said:
Sorry to hear about the test. Most of us forgo fructosamine tests because they don't tell you much about how the dose is working on the cat on a day to day basis. Could be that the cat is overreacting to lower numbers and then does what we call "bouncing" (more about that here). Best to follow Diane's advice, get your signature and spreadsheet set up and enter some of that data you have on your meter. We can look at those numbers and help you understand why the fructosamine test is so high. It could be that Boobie is getting not enough insulin or too much. Hard to know if you don't test the cat outside of shot times. If you look at my signature, you can click on my Ruby's spreadsheet to see an example.
Click to expand...
I will create all this tomorrow so we can get the bottom of it. I have noticed she is very sensitive to Lantus and can drop very easily so I will update once I have input all of her data. Thanks.
 
Jonika said:
I will create all this tomorrow so we can get the bottom of it. I have noticed she is very sensitive to Lantus and can drop very easily so I will update once I have input all of her data. Thanks.
Click to expand...
It would be good to have the last two weeks of numbers.

I would also encourage you to test more often. Including the tests you do before her shot, you should get some tests in between. Lantus onsets around 2-3 hours after the shot, so it would be good to see what effect it has on lowering the glucose levels by getting what we call "mid-cycle" tests. We dose according to how low insulin takes a cat--this is to prevent hypoglycemia from too much insulin. We increase doses based on the methods Diane linked to above, also after seeing how low (or not) the insulin takes the cat.

It's great you're using Lantus, as it's the insulin that's been shown best at controlling feline diabetes and achieving remission, but in the meantime you have to learn how to use the insulin and food as tools to help you on your journey. :bighug:
 
Katherine&Ruby said:
It would be good to have the last two weeks of numbers.

I would also encourage you to test more often. Including the tests you do before her shot, you should get some tests in between. Lantus onsets around 2-3 hours after the shot, so it would be good to see what effect it has on lowering the glucose levels by getting what we call "mid-cycle" tests. We dose according to how low insulin takes a cat--this is to prevent hypoglycemia from too much insulin. We increase doses based on the methods Diane linked to above, also after seeing how low (or not) the insulin takes the cat.

It's great you're using Lantus, as it's the insulin that's been shown best at controlling feline diabetes and achieving remission, but in the meantime you have to learn how to use the insulin and food as tools to help you on your journey. :bighug:
Click to expand...

I have added all of this years BG numbers into the spreadsheet in my signature. After looking at some of your guys' BG numbers, I am quite embarrassed by Boobie's number so I am assuming I am doing something wrong with dosing.

I am a college student and this is my first cat ever. Her diabetes diagnosis a year into having her was a shock to me because I am navigating this alone. I have been to multiple vets in my area to get advice but they either have little experience with FD or give me conflicting or bad advice.

Any and all dosing advice welcome! I was told not to give insulin with a read of less than 110 hence why I put zeros in those. I see some people here still give doses with numbers lower than 110 so let me know if I should start doing that.

I will input 2021 data later today, but in the meantime I would be very grateful for any dosing tips.

Thanks in advance!
 
2021 isn't really relevant at this point, the data you've entered is enough to provide some feedback. I have a couple of thoughts.

It is really important to get mid cycle tests because we dose based primarily on nadirs with only some consideration given to preshots. At the moment, you are making decisions based only on preshots. You've also had a lot of low preshots where you've needed to skip, but you went right back to 1u (when you should have reduced) - with SLGS it is important to remember that anytime you get a number under 90 you need to reduce the dose.

You've been hopping around between skips, 0.5 and 1u too quickly. Lantus craves consistency, so you want to try and find a dose that you can safely give both am and pm.

Following SLGS, you would hold a particular dose for 7 days, run a curve and then re-evaluate. Unless Boobie gives you a number under 90, in which case you would take an immediate 0.25u reduction next dose. Even with SLGS, getting spot checks now and again when you can helps to give you an idea of how the dose is working.

At this point, are you able to get any midcycle tests both am and pm cycles? It would be helpful to get some additional data so that you can figure out how the insulin is working for your cat. Right now, since all you have are preshots, you don't know anything of how the insulin is working. By getting additional tests in each cycle, at various times over a few days, you'll be able to determine how the dose is working, and get a feel for onset, nadir and duration.
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
  • How to do a Curve - a simple explanation
Think of it as pieces in a puzzle. Right now, there are a lot of blank spots in Boobie's SS, random tests now and again at different times will help fill in the missing pieces.

I would try and see if you can consistently dose 0.5u, get some midcycle tests over the course of a few days, and see what's happening during those cycles. Of course, if you get any numbers during this time under 90, reduce the dose by 0.25u.
 
Christie & Maverick said:
2021 isn't really relevant at this point, the data you've entered is enough to provide some feedback. I have a couple of thoughts.

It is really important to get mid cycle tests because we dose based primarily on nadirs with only some consideration given to preshots. At the moment, you are making decisions based only on preshots. You've also had a lot of low preshots where you've needed to skip, but you went right back to 1u (when you should have reduced) - with SLGS it is important to remember that anytime you get a number under 90 you need to reduce the dose.

You've been hopping around between skips, 0.5 and 1u too quickly. Lantus craves consistency, so you want to try and find a dose that you can safely give both am and pm.

Following SLGS, you would hold a particular dose for 7 days, run a curve and then re-evaluate. Unless Boobie gives you a number under 90, in which case you would take an immediate 0.25u reduction next dose. Even with SLGS, getting spot checks now and again when you can helps to give you an idea of how the dose is working.

At this point, are you able to get any midcycle tests both am and pm cycles? It would be helpful to get some additional data so that you can figure out how the insulin is working for your cat. Right now, since all you have are preshots, you don't know anything of how the insulin is working. By getting additional tests in each cycle, at various times over a few days, you'll be able to determine how the dose is working, and get a feel for onset, nadir and duration.
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
  • How to do a Curve - a simple explanation
Think of it as pieces in a puzzle. Right now, there are a lot of blank spots in Boobie's SS, random tests now and again at different times will help fill in the missing pieces.

I would try and see if you can consistently dose 0.5u, get some midcycle tests over the course of a few days, and see what's happening during those cycles. Of course, if you get any numbers during this time under 90, reduce the dose by 0.25u.
Click to expand...

This is incredibly helpful! I cannot thank you enough as I have felt so lost with advice from vets who have just told me to continue to up her dose regardless of low numbers. I will start doing mid cycle tests and reduce to 0.5u to keep a consistent dose. I also plan to do a full blood glucose curve as soon as I can be home for a 12 hour period.
 
Jonika said:
This is incredibly helpful! I cannot thank you enough as I have felt so lost with advice from vets who have just told me to continue to up her dose regardless of low numbers. I will start doing mid cycle tests and reduce to 0.5u to keep a consistent dose. I also plan to do a full blood glucose curve as soon as I can be home for a 12 hour period.
Click to expand...
You're welcome, I'm happy to help! I'm sorry that was your experience, one of the things I like about this forum is there are always people with hands on experience with feline diabetes willing to help each other. That, and the dosing methods here are proven to work for many kitties to get them better regulated or in some cases, into remission.

Please post any questions you have, and many of us with Lantus experience can help you going forward with dosing, if you'd like. Dosing methods are found here https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

The subforum is here: https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
 
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