5/26 Heart - Inverted curve?

[dodgingwrenches]

Yesterday during the day we went up between shots, and today it looks like we're starting to do the same... Could this be an inverted curve? Sign of too much insulin again? Or can a food spike drive it up so much that four hours later it's still high? Haven't given him food since his shot this morning

 

[BJM]

You could test it empirically - what is the worst thing that might happen if you take a dose reduction? The glucose levels will go up and you'll see that.
And what we say about that? Better too high for a day, than too low for a moment.

Remember, Levemir tends to have a later onset and nadir - maybe check around +7 to +9, and remember that food spikes tend to be about +2ish, especially if meal fed. And it may take a bit longer to settle into a dose, so be sure to give it a full 3 to 5 days to do that - you've been changing faster than that a few times and that will just make it harder to determine where the dose needs to be.

If you go to your spreadsheet and zoom out, you can get a better sense of the color patterning. See what you think when you do that.

 

[julie & punkin (ga)]

you're only 9 days on the Lev and don't have obvious curves on it yet. Nadirs can also move around. I'd dose based upon the low point the dose is getting Heart to, Sophia, and ignore where the highs and lows in the cycles are. I've seen cats with their nadirs at the next shot time and even a couple of times the nadir from one cycle was after the next shot.

That 90 says to me that you're in the ballpark with the dose. I wouldn't reduce, personally. I'd try to get some more varied times in on testing and go from there.

Wendy's Neko is on Lev and has changing nadirs - you might look at her spreadsheet to see examples.

 

[Ann & Tess GA]

Levemir often take up to 4 hour to start to work add to that the food and yes it isn't unusual for BG to still be up at +5 or 6. ECID, but Tess often climbs until then and nadir is frequently at +12. It takes some time to get used to the change.

 

[Marje and Gracie]

I agree with Ann. Gracie is also on levemir. When I think of an inverted curve for a lev cat, I would think they would be highest at about +8 through +12. I often notice that many of the lev cats (my Gracie, Neko) will go up around +4/+5 and then come down and might not nadir until +12 or after.

Also, it does take time when you switch to see an improvement. When I switched Gracie, it was probably three or four months until she really started settling in and producing nice, flat curves that lev is known for.

 

[dodgingwrenches]

My cat has never been on insulin for more than two months, so I'm not thinking four or more months down the road! I'm thinking optimistically that he will go back into remission :razz: But yes, a nadir at +12 would definitely be a lot simpler to manage!