BG Levels Won’t Go Down?

M

Maya_

Member
Previous post: https://www.felinediabetes.com/FDMB/threads/8-11-lulu-amps-379.293035/

Hello,

I’ve been giving my cat 0.75 units twice a day since Aug 7th and the BG levels would decrease to the 200s throughout the day. However, I was not able to give the pm dose on the 15th and since then the BG levels have not gone below the 300s. Is this normal?

In addition, I feed her 3 times a day by the am / pm being the main meals and giving a small portion mid day. Could this be affecting the BG levels in being regulated?
 
Maya_ said:
Previous post: https://www.felinediabetes.com/FDMB/threads/8-11-lulu-amps-379.293035/

Hello,

I’ve been giving my cat 0.75 units twice a day since Aug 7th and the BG levels would decrease to the 200s throughout the day. However, I was not able to give the pm dose on the 15th and since then the BG levels have not gone below the 300s. Is this normal?

In addition, I feed her 3 times a day by the am / pm being the main meals and giving a small portion mid day. Could this be affecting the BG levels in being regulated?
Click to expand...
@Sienne and Gabby (GA)
@Wendy&Neko
Hi Sienne and Wendy looking at Lulu's SS do you think she should increase the dose
@Maya_ can you can a before bed test please
You actually should have done a curve
From the SLGS dosing method sticky:

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours.
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments (emphasis mine).
  • 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
Unfortunately with only preshots you aren’t able to get a good sense of how the dose is working, particularly details on where she onsets, nadirs and how much duration she’s getting. From the Basics sticky:
  • 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
 
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I doubt that the issue is with when you're feeding Lulu. If you need to, you can adjust the mid-cycle meal to before nadir.

I would second what Diane was suggesting. You're not really sticking to the instructions for SLGS. With that approach to dosing, you would want to get a curve (i.e., testing every 2 hours over a 12-hour cycle) on a weekly basis. In addition, you evaluate the effectiveness of the dose and increase after 7 days if the dose is not bringing your cat into a normal range (50 - 120). Having nadirs (the lowest point in the cycle) in the 200s is still higher than you want since it is likely above renal threshold.

It's also difficult to know if Lulu's numbers more recently were all above 300. It may be an issue of when you're testing. If your cat is following the "rule" book, the lowest point in the cycle would be around +6. (However, that's not a guarantee since nadirs can and do move around.) Thus, if you're testing at +8 or +9, the numbers are likely to be on the rise. Also, numbers that are in the higher 200s are not that different than numbers in the lower 300s. There's a 20% variability in any test result.

Bron also has a very good point. We have no idea what's happening during the PM cycle.
 
@Diane Tyler's Mom @Bron and Sheba (GA) @Sienne and Gabby (GA)

Hello, I will be able to do a curve test on Wednesday and keep you posted. I just did a test in the pm cycle 4 hours after giving a dose and the BG level is 363. From before the BG level would at least decrease to the 200s but for the past couple of days it’s been sticking in the 300s. It seems like I would need to increase to 1 unit but when I first did that in the beginning of the journey, the pm pre shot level would be too low to give another dose. I guess we will see how the curve test comes out and go from there.

Thanks!
 
Maya_ said:
@Diane Tyler's Mom @Bron and Sheba (GA) @Sienne and Gabby (GA)

Hello, I will be able to do a curve test on Wednesday and keep you posted. I just did a test in the pm cycle 4 hours after giving a dose and the BG level is 363. From before the BG level would at least decrease to the 200s but for the past couple of days it’s been sticking in the 300s. It seems like I would need to increase to 1 unit but when I first did that in the beginning of the journey, the pm pre shot level would be too low to give another dose. I guess we will see how the curve test comes out and go from there.

Thanks!
Click to expand...


@Diane Tyler's Mom @Bron and Sheba (GA) @Sienne and Gabby (GA)

Hello, I did a curve yesterday and my cat's BG levels remained in the 300s. Would it be a good idea to increase to 1 unit twice a day?

In addition, I increased the food portion size a bit when giving her meals. Could that be a factor as to why the BG levels have been high?

Thanks
 
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Maya_ said:
@Diane Tyler's Mom @Bron and Sheba (GA) @Sienne and Gabby (GA)

Hello, I did a curve yesterday and my cat's BG levels remained in the 300s. Would it be a good idea to increase to 1 unit twice a day?

In addition, I increased the food portion size a bit when giving her meals. Could that be a factor as to why the BG levels have been high?

Thanks
Click to expand...
I'm no expert on dosing, but it looks like you should increase to 1 unit.
Hopefully other members will respond
@Wendy&Neko
@Bron and Sheba (GA)
@Sienne and Gabby (GA)
 
Yes I would increase the dose to 1 unit tomorrow morning as long as she doesn’t drop into blue overnight.
I can see the BGs are pink but as you do not have many pm tests w do not know if she is dropping lower overnight. Can you try and get a before bed test in each of cycle please?
 
Bron and Sheba (GA) said:
Yes I would increase the dose to 1 unit tomorrow morning as long as she doesn’t drop into blue overnight.
I can see the BGs are pink but as you do not have many pm tests w do not know if she is dropping lower overnight. Can you try and get a before bed test in each of cycle please?
Click to expand...


Yes, I just tested her 4 1/2 hours after giving 0.75 units and her BG level is 327.

Sorry just to confirm, when you say as long as she doesn’t drop into blue overnight, do you mean with the 0.75 or 1 unit? And blue is between 100-199?

Thanks
 
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