10/27 Thos - Help me think about some numbers?

Tom & Thomas (GA)

Tom & Thomas (GA)

Member Since 2018
This is my first post on the Lantus etc forum.

We're not trying for TR. My goal, which may or may not be reasonable, is to keep Thomas consistently under the renal threshold without an intensive level of glucose monitoring.

At the beginning of the month we went up to 1.5u bid. I'm seeing some lower numbers, and Thomas seems perkier.

I wonder, however, why we have days that start high and swing real low at PMPS, then others where we're flattened out in a narrow range of high values. I've seen a bit of this flattening in the past, but it really sticks out alongside these days with very low numbers.

Thursday and Friday were two days of flattish and high, the 25th ranged just 281-294, the 26th 252-294. Then today's AM +4 was 106, a number never before seen during the day.

Is this just something that I'll see from time to time? Food related (though it doesn't look like it to me)? Some reflex of insulin depot impacting the cycle? Do I need to understand this, or worry about it?

I'm afraid my spreadsheet is not what the forum uses, so I'll understand if you don't want to delve into the numbers. Plus, getting my Excel up into Google Sheets took some massaging.

Any insights would be greatly appreciated, and any comments about how we're doing.

Thanks so much. - Tom

P.S. I am in awe of all the time, work and love many among you put into taking care of some very ill little creatures.
 
Hey there and Welcome to the L, B, & L forum!

Could we get you to transfer your numbers onto the SS that we use. I can't see yours in a linear fashion the way we are used to viewing the spreadsheets.
The link for getting our up and going is here: FDMB Spreadsheet Instructions:

If you have any trouble getting it set up, yell and someone will assist you, not me, as I am a tech mo- mo.

It sounds like Thomas is bouncing a bit, but without seeing it in our SS form, I am not sure. We can give you a lot better advice once you set our SS up.
 
Tom & Thomas said:
I wonder, however, why we have days that start high and swing real low at PMPS, then others where we're flattened out in a narrow range of high values. I've seen a bit of this flattening in the past, but it really sticks out alongside these days with very low numbers.
Click to expand...
Just a general comment...
When using the long acting insulins, you want to look at the data as "waves of action" rather than expecting to see the same glucose lowering effect in each and every cycle. Until kitty becomes very well regulated, the waves of action usually last for 3 days/6cycles:
  • dip into low numbers
  • numbers rise (bounce begins)
  • numbers remain high (the bounce)
  • the bounce breaks... and it starts all over again.
FYI: Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

And just when we think we have that figured out, we increase the dose. Within the first 2 - 3 days after a dose increase, the cat's BG numbers will rise... usually lasting for less than 12 hours. We call that by a very scientific term: New Dose Wonkiness (NDW).

I really think you'll be able to see these patterns a whole lot easier if you decide to use the spreadsheet most of us use. The color coding makes it pop.

That said and given the goals you've mentioned, I do think you'll want to bring the BG numbers down some more. You'll want to pull numbers down under renal threshold. Depending on the source, renal values are said to be anywhere from about 200 to 250 mg/dL. Those are lab values so that means the BG numbers you'd want to see using a meter calibrated for humans would be less.

I also used a meter calibrated for humans. Using a human meter and testing strips to measure glucose, the closest I could come to figuring out Alex's renal threshold was for it to be in the 140 to 180 mg/dL range. Knowing that, my goal was to keep her under 140 on my meter as much as I possibly could, but it's important to note that range might be different for another cat (ECID). That might give you a little more perspective.

Hope this helps a little...
 
Thank you both, Bobbie and Jill, for your kind responses.

Yes, it does sound like Thomas's recent numbers could reflect bouncing. Jill's very nice explanation inspired me to (re)read a bunch of material both on and off the board.

The big eye-opener was that the standard numbers for renal threshold need to be adjusted downward when using a human meter. And I read that the threshold can be lower for cats that are diabetic. So I have to wonder whether I can stay below the renal threshold without tight regulation and intensive monitoring. But I have a ways to go before I have worry about this.

I do appreciate the virtues of the board's spreadsheet and will look into it.

Thanks again. - Tom
 
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