How is it that I give the same exact dosage no matter what the reading is?

[Shell]

Unless it is below what it should be, I should be giving Pumpkin 1.75 every 12 hours.

I am having anxiety because I am trying to understand how I should give the same dose if he reads 502 or 260 before dosing. My logic is where I did a curve on a 502 day and the numbers fell to 98 within that same day. That is a drop of around 300. So I was just applying that to the reading of 260. Same dosage, but my huge concern that if that dose could drop his glucose 300 points from 502 that it could drop it 300 points from 260. But apparently this doesn't happen. I get really concerned when I see the number low and yet I do not decrease the dosage. Is this safe?

 

[Sienne and Gabby (GA)]

What you're saying makes logical sense. And then there's what generally happens. I also think that pretty much everyone has this concern. Then they start seeing that their cat is in green numbers and get "addicted" to seeing those greens!

The manufacturer describes Lantus as having a "flat" curve. This typically happens as a cat (or human) is getting better regulated. Fistuk's spreadsheet is a good example of a cat that had been in high numbers and the curve has flattened out to almost entirely green.

While no doubt this will sound terrifying, the basic mantra with Lantus is "shoot low to stay low." I would give a shot as long as numbers were over 50. I also had tons of data and was very comfortable with steering Gabby's curve if her numbers were dropping. I'm not suggesting that you shoot low numbers. However, you want to gradually get comfortable with shooting progressively lower numbers since the goal is to get Pumpkin into normal range numbers for as long as possible.

 

[Shell]

What you're saying makes logical sense. And then there's what generally happens. I also think that pretty much everyone has this concern. Then they start seeing that their cat is in green numbers and get "addicted" to seeing those greens!

The manufacturer describes Lantus as having a "flat" curve. This typically happens as a cat (or human) is getting better regulated. Fistuk's spreadsheet is a good example of a cat that had been in high numbers and the curve has flattened out to almost entirely green.

While no doubt this will sound terrifying, the basic mantra with Lantus is "shoot low to stay low." I would give a shot as long as numbers were over 50. I also had tons of data and was very comfortable with steering Gabby's curve if her numbers were dropping. I'm not suggesting that you shoot low numbers. However, you want to gradually get comfortable with shooting progressively lower numbers since the goal is to get Pumpkin into normal range numbers for as long as possible.

Does shoot low, stay low mean that even if the number is low give him the dose anyhow? And by flat curve, I am guessing that this means that there is consistency rather than peaks etc ? I am just trying to understand so that I am not anxious the more I learn.

 

[Sienne and Gabby (GA)]

You're going to be anxious no matter what! Managing your cat's diabetes is not for the faint of heart -- well, at least not at the beginning. It does get easier.

Shooting low depends on your level of experience and comfort. I would never tell someone who is new to this process to shoot low numbers. We typically tell new members that if you test and get a pre-shot number in the 150 - 200 range, post and ask for help. If you're comfortable shooting those numbers, lower the threshold.

There are three options that are used mostly with the Start Low Go Slow approach:

• don't feed your cat. Stall for 15 - 20 min and then re-test. You can repeat this process several times to see if numbers are spontaneously rising without the influence of food.
• shoot a reduced dose
• skip the shot

With the Tight Regulation method, we encourage someone who's new to follow the same guidelines but there's a bigger push to start shooting lower numbers.

A typical insulin curve has a nadir (low point). The curve is far more pronounced in the shorter acting insulins. Lantus has a much gentler curve (most of the time) and as a cat is regulated, the curve shows less variability -- not much of a dip at nadir.

And keep asking questions!