10yo male just diagnosed with BG of 385

Status
Not open for further replies.
griam01

griam01

Member Since 2014
Hi my name is Amy from re Pittsburgh, PA area. My kitty Jack who is at least 10 years old (he was a stray) was diagnosed with diabetes. He was drinking a lot if water and going to the bathroom a lot so we took him to the vet. His BG was 385 and he also had a cold. The dr gave an antibiotic for the cold and glipizide and switching him to friskies Pate for his food. I have 2 other cats that I am switching to friskies as well now. I read a lot that tr glipizide is not good. I have only given him 2 doses but he seems tired. He is eating his new food but I am worries that the glipizide is doing more harm than good. Should I discontinue the glipizide immediately and just adjust the food and see how his results are next week at the vet? I don't have a meter yet but will get one ASAP. Thank you all I'm advance or your help. I am worried and overwhelmed by this. I may be reading into his symptoms too much too now that I know of his diagnosis.
 
385 is not a terribly high number considering he was at the vet. But a combination of no insulin, and aninfection can lead to DKA, a dangerous condition. We don't advocate Glipizide; we think it makes the liver work harder when it is already taxed by the diabetes.

If he were mine, I 'd get the supplies for home testing and start that, get ketone strips and test for ketones, and stop the pills. If his blood glucose levels don't improve with a wet low carb diet, then yes, insulin is best.
 
Thank you for your comments. I have been reading all day today since we received the diagnosis yesterday. I did just give him his 3rd dose of the glipizide. My husband says that he seems the same as before. He plays some and is eating and drinking. I understand what the glipizide does and am worried that it could be harming him. Could the antibiotics be causing any harm with glipizide? He is on clavamox. The vet said it would be fine but this is the same one that prescribed the glipizide. He was having some sneezing with flem but no fever. He hasn't sneezed today at all. I will get the testing supplies tomorrow and try that and see where we are. I don't know if I will be able to get a good ketone since he doesn't like to go when you watch. Can I dip it in the clump able litter to test immediately after he goes to get an idea or will that be completely invalid? Thanks agin for your advice.
 
Oliver wouldn't go while we were watching either. We put aquarium gravel in a clean box and left him in the room with it. He'd christen the box and we could swoop in and get in and get the sample because it wouldn't be absorbed.
 
You could try putting a layer of Saran Wrap over the litter box, but that might discourage him from using it. Getting the testing supplies and checking his numbers tomorrow will be a big help in knowing what's going on with Hom.
 
I will try something. Out of curiosity is the insulin for cats the same for humans? Like if I had samples from a drs office would that work for the cat?
 
Glipizide does not help the pancreas to heal (something human's pancreas cannot do.) Really, really suggest you stop that and follow a good insulin protocol with low carb diet for the best chances of getting him off the insulin at some point.
 
I didn't give the glipizide this morning. I also have a call into the vet to discuss doing something else. Problem is we are getting a lot of snow and cannot make it out to get the testing supplies. He is still eating, drinking and going to the bathroom. The bathroom visits seem to be producing less urine, more like a normal amount I used to see, not flooding the litter box like the past month or so. But he doesn't seem to be as "peppy" as he once was. Maybe it is the cold he has that his body is fighting off as well as the antibiotics he is on? He did play with some catnip and a string for a bit last night too. He is purring and came to bed with us (between our pillows) as usual. Again, maybe I am reading too much into it (yes, I read the letter from my cat again, I needed it :) ). Thank you all for the advice so far. I truly appreciate it!!!
 
Well, I still haven't heard back from the vet, so I called again and they said he should be returning calls soon. But I had them fax me over Jack's original lab results so I could find out what the big picture looked like. The good new is that there are no ketones, but the glucose in the urine is 3+. I have attached a screen print of the results if someone could look at them and let me know their thoughts. I don't know exactly what I am looking at. Thanks again for all your advice and support.
 

Attachments

I heard from the vet finally last night, he said that the glipizide works more often in male cats with a lower BG and no ketones about 30% of the time. He said he prescribed it because it was new years eve and there was nothing else that could be done that last minute. We are headed back today to have his BG tested and determine where to go from here. I have noticed that his urine output does not seem to be as much as previously and the dr. said it could very well be because of his cold/infection that caused his BG to raise and that now he is being treated for that it may be coming down. Praying and crossing my fingers.
 
I'm no good at reading medical charts but there's a cheat sheet somewhere online for it (I can't seem to find it now). Hopefully someone will be able to link you to it. :-D

Glipizude is not good for any cat, regardless of whether or not they're male or female.

How is the diet and testing going? Hopefully it's just the infection causing elevated BGs and you'll be able to see them come down with the food change.
 
We went to the vet today and this vet (the original vet not the one that prescribed the glipizide) looked at him. He gained an ounce in 4 days and his BG went down from 385 to 300. She wants him off the glipizide and to continue with just the diet change and monitor him. He was noticeably more social and upbeat earlier today. Urine output is more normal amounts but I am going to continue to monitor him and see how he does with everything. He goes back next Monday (10 days) for another blood test.
 
1 oz weight change can be elimination related, ie, not a true weight change.
 
Well..I have been testing Jack all weekend and did get a urine check in there. Ketones are still negative. His BG has been down except for one reading yesterday afternoon it said 360. This morning it was 121. It has been progressively better each draw, except for that one, so not sure if it was a bad reading or his numbers spiked. He seems better and almost back to his old self. He has one more clavamox pill today to take. I wonder if the clavamox is messing with his numbers too. I have been testing him twice a day, first thing in the morning and then sometime in the afternoon after a meal, should I be doing it more, less? We have tried 2-3 meals a day, they are adjusting. My big cat is "starving" by morning, but doesn't seem to eat all of his meal during the next two meals if I give 3 meals. Jack eats consistently during all the meals and my other cat keeps looking at me like where is the dry food, but does eat the wet food. Jack does seem to be coming back to regular routine. He still sleeps, but he is a cat. Yesterday he crawled up on my husband like usual and wanted held, and last night cured up on my chest under my chin. That was a usual for him, always a cuddler.

Thank you again for all of your support and comments, I truly appreciate it.
 
Very often, about 2 hours after eating, the glucose spikes. If the pancreas is working, the glucose will start to decrease after that.

Spreading food out thinly on a large plate, and/or freezing some to be nibbled as it thaws will slow the glucose from spiking as much and put less burder on the pancreas. In other words, it is OK to leave the canned food out for 10-12 hours at a time.
 
Thank you for this info. I wish I could leave it out. Unfortunately, my dog (with food allergies) will clean that plate faster than anything the minute the cats step away. Then he will break out. Its a tricky balance at eating at this house between the cats and the dog. LOL
 
Well, his levels are not decreasing, they seem to be all over the place, unless I am doing something wrong with testing. Here are his numbers, let me know your thoughts.

Initial at DR. office 12/30 11:30am 385
Follow up at DR. office 1/3 3:30pm 300

The rest are home readings

1/4 12:11pm 260
1/5 9:02am 268
1/5 4:37pm 361
1/5 7:13pm ketone negative urine test
1/6 9:01am 121
1/6 6:13pm 271
1/7 12:09am 235
1/7 8:15am 326
1/7 12:32pm 273
1/7 11:52pm 263
1/8 8:57am 311

Thank you again in advance for all of your assistance. I truly appreciate it.
 
Well, the 121 was a nice number, but the others are higher than we like to see. We consider a cat not in diabeitc numbers if they range from 40-120 off insulin. Is he still on the glipizide? What are you feeding him?
 
He is no longer on the glipizide as of Friday. We are feeding Friskies (Mixed Grill, Oceanwhitefish or Turkey and Giblets) wet exclusively since the diagnosis. There is no dry at all, so I have completed moved them all to wet food. I know the Fancy feast is better carb wise, but the vet said that these were must less than the dry food I have been feeding and that that is what she feeds her cats. She didn't recommend the vet food either. She said that on average I am staying below the 10% carb values which is good.
 
We don't go back to the vet until Monday, which I am sure they will start it at that time. Do you think Monday is too long to wait to go to the vet? I am supposed to work tomorrow and Friday and she is not in over the weekend. I am sure they will start insulin on Monday as we did already discuss it. They said if his number are not down below 250 and staying there and decreasing that we would start. I have insulin here ready to go (my mom works for a dr's office so I was able to get Lantus from a drug rep.). When I discussed insulin with the vet, she said they would start Lantus and she how he does.

You don't know how much I want to start it on my own today, but I am sure that is not advisable. :(
 
As for the food, I know Friskies has rice in it, which is a high carb, but I also see that the 9 Lives has several that are VERY low carb and I could try those, but I thought I read that those have rice or something that I should stay away from too. The issue is that I am trying to feed 3 cats, so that is 3 cans a day total, which is adding up. If I get Fancy Feast which I have heard is highly recommended for feline diabetes, then that is 6 cans. I am trying to do what is best for him and all the rest. I am open to any suggestions. I will not go back to the dry food, but I have to factor in costs somewhere. I know I am very lucky to get the insulin, so maybe I can adjust with the food somewhere.
 
Since you are hometesting, you could ask the vet if you could start on a small dose (maybe .5) and monitor carefully. Don't shoot under 200; get midcycle numbers. It would be better if you could monitor the first few days so the weekend would be best for your schedule, but I get that your vet wouldn't be available. But would Monday pose the same problems as you wouldn't be home to monitor?
 
My husband and I both technically work from home for the most part. He travels occasionally for his job and I make sure I am home when he travels (for our son), so one of us is almost always here (rare occasions someone is not). So, he is back tonight and I have to go into the office the next 2 days to handle a few things there. I could probably get away with only going one day this week and staying home the other again, but my husband can monitor too. I found a chart for the Lantus of starting numbers and was wondering if I should start even lower than that.
BG
US ( mg/dl)   Metric (mmol/L)      Dose
150 - 250.......8.3 - 13.9............0.25u 
251 - 400......14.0 - 22.0............0.5u 
400 +...........22.2 +.................0.75u

I haven't worked out my schedule for next week to determine which days to go into the office, because I usually do that around my husband's travel schedule, so I am pretty flexible at this point and could work around this.
 
Lantus is not my insulin. I'll post on the Lantus forum and see if someone can come over to guide you. (the Lantus forum is a good place to post daily as they all have experience with your insulin, but they will want a spreadsheet so they can see your history of numbers and dosing,when you want dose advice)

Here is the spreadsheet info:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

It's a little tricky. If you need help, ask.
 
Hi Amy,

The starting dose on Lantus takes Jack's numbers into consideration, but also what he weighs can be important. So what is his current weight? And would you say he is currently under or over what his ideal weight should be?

Also I wanted to be sure - he's eating low carb canned, he's been off Glipizyde since last Friday, and you can home test/monitor after the shots? Is he currently on any meds?

Carl
 
On Friday he was 10lbs 1 oz, I can tell he has lost some muscle mass, as I can feel his vertebrae more than before, but he doesn't feel malnourished.

He is off of glypizide since Friday
He finished his Clavamox (7 days worth) on Monday
No other medicine


He is on Friskies pate wet food only. I did just realize I have been reading the incorrect column when judging what Friskies to give him. :( So it is lower carb than the dry food (which he went off of since 12/31). I will be switching again tonight after I can get to the store. I took the chart online and converted all the numbers onto a spreadsheet to determine what I can get at my local walmart that would be best and elimiated all fish foods. I know I will need to check the ingredients when I get there, but it looks like the following would work for me, thoughts?

DRY MATTER % kcals/ 5.5 oz

Brand Group Flavor P F C Phos DM kCal
Fancy Feast Poultry Turkey and Giblets Feast 53 33 3 1.69 94
Purina ONE Poultry Chicken Pate 52 31 3 2 93/3 oz
Purina ONE Poultry Turkey Pate 50 23 3 1.77 95/3 oz
Fancy Feast Classic Chicken Feast 50 23 4 2.1 91
Fancy Feast Tender Liver & Chicken 50 23 4 2.3 80
Fancy Feast Kitten Tender Turkey Feast 50 27 5 2 92
Fancy Feast Tender Beef Feast 50 18 5 2.2 93
Fancy Feast ∞ Chunky Chunky Chicken Feast 50 18 5 2.2 90
Purina ONE Beef Beef Pate 50 23 5 2.05 95/3 oz
Fancy Feast Chunky Chunky Chopped Grilled Feast 50 18 7 1.6 94
Fancy Feast Chunky Chunky Turkey Feast 50 18 7 2.2 87
Fancy Feast Tender Beef & Liver Feast 48 23 5 2 94
Fancy Feast Tender Beef & Chicken Feast 48 27 6 2.1 94
Fancy Feast Classic Chopped Grill Feast 45 27 5 2.3 91/3 oz
Friskies Special Beef & Chicken Entrée 45 32 6 1.1 181
Friskies Special Beef & Liver Entrée 45 32 6 1.1 181
Friskies Special Turkey & Giblets Dinner 45 30 6 0.8 166
 
That pasted horribly.....basically it is sorted by order of amount of protein (highest at top) and all are under 7% carbs.

I realized I missed answering a question...I can monitor after the shots, or my husband can. I will need to train him. :)
 
I called into the vet and gave them Jack's numbers. She asked about how I am doing the blood tests, etc. She said she will call in the insulin script and will call me back later with instructions. She told me that once I start with the insulin that I am not to test at all for the first week. She said that the numbers will go up and down and it will not change the dosing at all, that she will not change how much or how little she gives. She didn't sound thrilled that I called and wanted to change things and start on insulin. I am worried about not testing for the first week, I would have thought it was critical to test during this time, please help me understand!
 
You're right; you should be testing the first week! :thumbup Yes, with Lantus, the first 5-7 days the numbers will fluctuate greatly or will remain relatively high, so most of your data might be "off," HOWEVER, your cat can still drop low and/or have a hypo! If at any time Jack drops below 50, that is considered an automatic dose reduction. Only way to tell if he drops below 50, even in the first week, is by testing.

Besides, it'll be a good time for practicing your testing. ;-)
 
griam01 said:
He is on Friskies pate wet food only. I did just realize I have been reading the incorrect column when judging what Friskies to give him. :( So it is lower carb than the dry food (which he went off of since 12/31). I will be switching again tonight after I can get to the store. I took the chart online and converted all the numbers onto a spreadsheet to determine what I can get at my local walmart that would be best and elimiated all fish foods. I know I will need to check the ingredients when I get there, but it looks like the following would work for me, thoughts?
Click to expand...

The Friskies Pates are fine, although they're a bit higher in carbs (8%) than the Friskies Special Diet.
 
griam01 said:
Once I start, how often should I be testing, etc? Thank you!
Click to expand...

I recommend at minimum four tests a day:
  • AM Pre-shot to know if it's safe to give insulin. If he's below 200, you do not want to give insulin but post here first for advice. We will usually tell you to not give the shot or food, but to stall for 30 minutes and test again to see if the number is "rising." Then, depending on how close to 200, you might skip the dose, give a reduced dose, or give the full dose.
  • Mid-cycle test when possible (some days, I can't because of work). With Lantus, it "peaks" (the lowest point in the cycle) at around 5-7 hours. Some cats and even some cycles might have an earlier or later nadir/peak, so any test you're able to get about halfway (4-8 hours) through the 12-hour cycle will help pinpoint the low point.
  • PM Pre-shot to know if it's safe to give insulin. Same as the AM shot: if he's below 200, don't feed, don't shoot, but post here for advice first.
  • Before-bed test. This usually gives a heads up to how low he might be going overnight while you're asleep. Depending on this number, you might want to set an alarm in the middle of the night to test later or leave some medium carb food out for him to graze on if you're not going to be around. Cats react differently across each cycle, so it helps to get numbers across the entire day/night instead of just one cycle.

Then, any other tests you're able to get simply add data on how the insulin affects Jack, how food impacts his BGs, if he has an earlier or later nadir, etc.... When first starting out, the more data, the better. :mrgreen:
 
Well, they called in Lantus and instructed to give him 1u every 12 hours and to not test his BG for a week. After the week, run a curve (take a draw, feed, insulin, then test every 2 hours 6-8 times). Please everyone let me know your thoughts on this, because from what I read online that 1u is a lot of Lantus for him and I am worried. Maybe I am wrong, I would rather hear from someone who is using it. THANK YOU!!!!
 
1u is actually a fairly good starting dose for most kitties. Since you're testing, you'll see fairly quickly if it's too much/too little. In your case, with the recent switch to wet and most of the numbers under 300, I have a feeling it might be a bit too much and might even suggest starting with .5 or .75u instead. I'll wait for others to offer their suggestions.

And ignore her about not testing the first week. If you were diabetic, do you think your doctor would just prescribe you insulin, tell you to take it a week, and not test your blood sugar? Besides, how is she to know whether or not you're testing?
 
I agree on ignoring the "no test advice". Home testing is a very powerful tool in managing the treatment, because it let's you know at any given moment how things are going.

And a usual starting dose can be 1u for many kitties. The weight-based formula is ".25u per kg of lean body weight", every 12 hours (AAHA guidelines for dosing). So it would be logical for a ten pound cat. Many people will start at .5u though. It is easier to start low, monitor what happens, and increase if needed based on the results over 5-7 days. I'd probably go with .5u to start. I tend to want to err on the side of caution.

Do your syringes have half-unit markings?
 
I would prefer to err on the side of caution too. I thought 1u was too high. I would prefer to start with the .5u. The syringes I have are the Monoject 3/10mL 29Gx1/2" I show they start at 5 with the smaller lines below which I assume the first line is the 1u mark and then smaller marks inbetween which would be the 1/2 markings?

I planned to ignore her testing advice, but wasn't sure how overboard I should go with testing. I was also curious how other Lantus mommies did this. Test in the morning, food, then give insulin and test every 2 hours after that?

I truly appreciate all of your assistance!!!!
 
Here is a link that will show you the syringe scale with and without 1/2 unit markings.

http://www.bddiabetes.com/resource.aspx?IDX=2210

It sounds to me like your's would match the scale on the left?
If so, then yes, the lines to the right of the vertical center line would be whole unit marks, and the lines to the left of center would be the 1/2 unit marks.
So you would be drawing up to the first line on the LH side.

I planned to ignore her testing advice, but wasn't sure how overboard I should go with testing. I was also curious how other Lantus mommies did this. Test in the morning, food, then give insulin and test every 2 hours after that?
Click to expand...

What you describe is what we would call a "full curve" - testing before the shot, and then every 2 hours after the shot. People don't do that every day of course, but when first starting, every three or four hours is a good idea. The first couple of days with Lantus might not tell you a great deal, as her body will most likely be adjusting to her first shots of insulin. But the point is that you will be gathering data that will help you to understand how the insulin is working, while at the same time checking to make sure her BG doesn't drop lower than you might think it will. Some cats respond pretty quickly, while others take a few cycles to show you some sort of pattern. We say "ECID" a lot here (every cat is different) because every one of them really is. There are general things you might expect to see, but each case is somewhat unique.

Your plan is to start with insulin on Monday? By then, maybe you could post on the Lantus forum and people will know to keep an eye out for your posts and answer any questions that come up during that first cycle. Posting here is fine too, as long as you let folks know your plan so they can watch out for your posts.

Carl
 
Oh, and if you haven't been pointed there yet, there is some great info specific to Lantus found on the "Tight Regulation" forum in the "sticky threads" towards the top of the front page.

Here is some info from the New to the Group sticky:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139
Learn how YOUR kitty is responding to insulin:
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

Example of an active Lantus cycle:

+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.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

An active Levemir cycle will have an onset at approximately +4 and a nadir around +8 - +10. However, please keep in mind every cat is different (ECID). Data collection will offer you a better picture of YOUR cat's response to either of these insulins.
Video: Levemir: Mode of Action

Initially, don't expect to see "active" cycles after every single shot whether you're using Lantus or Levemir. Chances are, your kitty had diabetes for some time before diagnosis. It requires time for kitty's body to become used to dropping into lower numbers than their bodies have become accustomed. Don't expect immediate results! Regulation takes time and patience: "Fluctuations are very common in this phase before BGs start to stabilize under consistent dosing: a typical curve of cat over the first 1.5 months on Lantus can be seen here: Lantus Starting Graph".
http://www.tillydiabetes.net/en_6_protocol2.htm
Click to expand...
 
Thank you very much. I will be starting Friday/Saturday because that will put me at a longer stretch at home that I can monitor him and do the testing.

My plan is to start with .5u and test and record his numbers and go from there.

I am curious about the cost for Lantus, I went to pick it up at Walmart and it was $230. Is that average, is that high, I was just curious what everyone else's thoughts are.

I truly appreciate all of your assistance and guidance, I am truly grateful for all of you.
 
That cost is similar to what others have seen for the vial in th US. The pens, typically sold in a 5 pack, are better, even with the upfront cost, because effectiveness doesn't drop before you finish a pen, whereas you might find the vial becoming less effective and not emptied by 6 months out.

There are some savings plans out there if you Google for Lantus Savings card, etc.

On a per unit basis, it is less expensive than ProZinc.
 
Thank you, I could also do Levimir, does anyone have any recommendations/issues with one over the other?

I currently have a "sample" pen from the drug rep for Lantus, I haven't opened it yet, since I will be starting this weekend, but was wondering how long this will last me approximately?
 
Levemir is a great insulin as well. Some cats even seem to do better on Levemir over Lantus.

Michelangelo is currently on 2u BID of Lantus and a pen lasts me to the last drop, about 2-4 months (depending on dosage). We just started a new pen on New Year's (last pen was started on 10/18).
 
I started my first this morning. We fed at 8:15ish and I gave him his first does of .5u of Lantus at 8:30, I will test every 2 hours and update the spread sheet.

I read about all the locations to give shots, where does everyone give their shots, I see they talk about alternating, etc. I gave this shot in the scruff. I read about the slower and faster absorption rate as well. I wasn't sure if I put in other locations ( flank, side, back) do I do the same as the scruff and tent the skin and inject? I also wanted to make sure I was doing it correctly being a first timer. I did read that you should leave the shot in for a count of 10 after injecting before removing, which I did. Also, when getting the Lantus from the vial, I just put the syringe in and withdrew the amount needed and recapped for about 10 mins until they were done eating. I didn't shake or anything, is that correct? I don't know how to see if there is a bubble or air in there since the dosage is so small.
 
Jack's numbers have come down nicely, but I know that they may continue to drop, I am going to feed them lunch soon because I don't want them to go too low either, I know it will take a while to even out, but I am so glad I did not follow the dr's advice and give him 1u.
 
griam01 said:
I read about all the locations to give shots, where does everyone give their shots, I see they talk about alternating, etc. I gave this shot in the scruff. I read about the slower and faster absorption rate as well.
Click to expand...
When Wink was still on insulin, I shot mostly in his flanks, all the way back towards his hips, alternating sides AM and PM. You can do only one side if that is easier.

I wasn't sure if I put in other locations ( flank, side, back) do I do the same as the scruff and tent the skin and inject? I also wanted to make sure I was doing it correctly being a first timer.
Click to expand...
Yes, still tent the skin and inject. Easier when the cat is skinnier to tent the skin on the flanks or along the sides.

I did read that you should leave the shot in for a count of 10 after injecting before removing, which I did. Also, when getting the Lantus from the vial, I just put the syringe in and withdrew the amount needed and recapped for about 10 mins until they were done eating.
Click to expand...
As long as you get the shot it, you don't really need to hold for a count of 10. Just press firmly on the plunger so you are sure to get that tiny amount under the skin. Before you draw the insulin, moving the plunger up and down, to spread the lubricant helps the plunger to move more smoothly. With the vial, draw up a bit of air into the syringe, put the syringe in the vial, inject the air into the vial, and then turn the vial over to draw out the insulin. Keeps the pressure equalized in the vial. You may want to draw up a tiny bit more than the dose, in case you have air bubbles.

Leaving the filled syringe out for 10 minutes is no problem. Keep the vial refrigerated to make it last longer.

I didn't shake or anything, is that correct? I don't know how to see if there is a bubble or air in there since the dosage is so small.
Click to expand...
Correct, no shaking required with the lantus insulin. It's not a suspension, like the cloudy insulins (Prozinc, Humulin).

Try pointing the filled syringe, needle up towards the ceiling. Give the barrel of the syringe a couple of quick "flicks" with your fingers. This should move any bubbles to the top of the syringe. Magnifiers may help you to see if there is a bubble.
 
Thank you Deb, I will try the flanks this next time I think.

One thing that I have read about Lantus is that you don't want to put air into the vial. I am actually using the pen and withdrawing from the pen and not a standalone vial, but they said putting air into it would mess it up? Again, just reading the internet. :) Maybe there is a difference with the pen and vial which is why you cannot do that. I need a magnifying glass for sure to read those numbers!!!! :)
 
Status
Not open for further replies.
Back
Top