24/5 - New Member - First Glucose Curve, Question About Insulin Dose

[melissa.joy]

Hello!

This forum has been a huge lifesaver since my cat got diagnosed a few weeks ago.

I was instructed to give him 1 unit of Optisulin daily and change him to a diabetic friendly diet. I have been feeding him Fancy Feast Classics pate, and I have spread out his meals so he has half a can at 6am before his insulin, a quarter/third can at 10am and 2pm, and then the same feeding pattern overnight. The vet initially recommended feeding twice daily and no grazing, but just transitioning him from dry food was hard enough (he wasn't eating enough at 6am/6pm and was so upset in between), so I got an automatic feeder so he can eat throughout the day.

Today is the first day I have done my own blood glucose curve at home. Ani was diagnosed with in-clinic readings of 23mmol/L and 19mmol/L and a positive (not sure if that's the right term, but the vet said it indicated diabetes) fructosamine test. There was also evidence of glucose in his urine.

These are the results I've gotten so far today:

• 5:45 (AMPS) - 11.3mmol/L
• 7:45 (+2) - 8.3mmol/L
• 9:45 (+4) - 3.9mmol/L (I got a bit worried here as 3.8mmol/L is apparently the hypo point for the Alpha Trak 3 and gave him three pieces of the Royal Canin Diabetic dry food, I keep it on hand as a bit of a "treat" for him. This is also just before his automatic feeder went off, and he ate between 10 and 10:30am)
• 11:45 (+6) - 5.4mmol/L

I will keep testing today before 2pm, 4pm, and 6pm to finish the curve. I just wanted to check whether it would be okay to give him his usual dose of insulin at 6pm? My thought is that I might give him half a unit if he's around that 11mmol/L mark because I don't want to worry about him getting too low overnight. Would that be right?

I'm sending the curve to my vet tomorrow, so I can ask for clarification then, but I'm also trying not to get into my head too much about it right now (which isn't going great, but I figure it's a learning curve for us all). I think I'm also struggling because he's very upset about all the manhandling that comes with blood testing (and I'm not the most gentle or efficient just yet haha).

Any advice would be super welcome!

 

[It'sSunshineOverHere]

My vet advised me to give him his normal insulin dose as long as he measured 10 or above. Though she also said, and I've seen it echoed on this board and on reddit, that missing a dose is less of an emergency than giving an unnecessary one. If I felt really nervous about him dropping too low while I slept I'd rather skip a dose than worry.

I have also seen others give a smaller PM dose than the AM dose - glucose is naturally a little higher in the mornings than in the evenings. I haven't done this myself so I can't attest.

 

[melissa.joy]

My vet advised me to give him his normal insulin dose as long as he measured 10 or above. Though she also said, and I've seen it echoed on this board and on reddit, that missing a dose is less of an emergency than giving an unnecessary one. If I felt really nervous about him dropping too low while I slept I'd rather skip a dose than worry.

I have also seen others give a smaller PM dose than the AM dose - glucose is naturally a little higher in the mornings than in the evenings. I haven't done this myself so I can't attest.

Thank you so much! He came back up to 14.8 so I gave him his usual 1 unit. I guess there's just a lot more to freak out about now that I am testing at home haha. I appreciate the tips.

 

[Sienne and Gabby (GA)]

Welcome to FDMB. Great job with getting your spreadsheet and signature set up.

For members reading your post, Optisulin is another name for glargine (Lantus). It looks like you're located outside of the US. It would be helpful to not only have your time zone in your signature but also the country where you're located. A large segment of our membership is in North America.

I'd encourage you to read the information on dosing methods for glargine. There are two methods that we use. They differ based on how long doses are held and where the point is for reducing a dose. With Tight Regulation, doses are held for 3 days/6 cycles whereas with Start Low Go Slow (SLGS), doses are held for a week and reduced if numbers fall below 90. Those numbers are based on a human meter.

Please be aware that Royal Canin Diabetic dry food is very high in carbohydrates. There are far better alternatives for treats.

You don't need to do a daily curve unless you want to test frequently. The minimum number of tests we suggest is 4 -- your two pre-shot tests and at least one additional test per cycle. It is helpful to get more than one additional test especially if you're needing to see how the dose is effecting your cat. Also, please test during the PM cycle. We strongly suggest getting a test before you head off to bed so you know if your kitty is in safe numbers.