? BG Under 100, Should I Still Give Levemir?

[Mac88]

At this point, Butters has been on Levemir, 1 unit twice daily for a week now. As you can see from the spreadsheet, his BG has been a bit all over the place--two nights ago, it was 95 and I withheld insulin that night. The next morning his BG had gone up to 539. Tonight I took his BG and it was 74. I gave him a snack right away and he ate it. He is due for his next insulin dose in a couple hours. Should I give it even if BG is under 100 or should I withhold it?

 

[Nan & Amber (GA)]

I'm sorry you haven't gotten a reply yet. Usually in this situation we recommend stalling for 20-30mins-- don't feed a meal, then re-test. If you've already fed, we can try to figure things out from there, but unless he's really high, you'll probably be skipping.

Also, since you are following SLGS, that 74 means an automatic reduction from 1.0 to 0.75, whether you shoot tonight or tomorrow morning next.

 

[Nan & Amber (GA)]

I'm sorry, I got confused and thought you were at pre-shot. OK, if you have a few hours to go that is easier!!!!

You will still be taking the reduction down to 0.75U, but the decision to shoot or not won't happen for a few hours or so. Likely he'll be high enough by then-- but only Butters knows right now!

 

[Wendy&Neko]

It's not uncommon for Levemir kitties to nadir at preshot. You do have to get used to shooting lower. Though I wouldn't shoot below 90 per SLGS. The numbers have been all over because it takes some time for the depot to build up.

What happened to Butters's Lantus data spreadsheet? It's best just to have all on one spreadsheet. Just do a blank line between the day you stop one insulin and start the next.

 

[Mac88]

It's not uncommon for Levemir kitties to nadir at preshot. You do have to get used to shooting lower. Though I wouldn't shoot below 90 per SLGS. The numbers have been all over because it takes some time for the depot to build up.

What happened to Butters's Lantus data spreadsheet? It's best just to have all on one spreadsheet. Just do a blank line between the day you stop one insulin and start the next.

He was on Novolin N before Levemir actually, we switched him from that because I've heard it is not as effective/safe for cats (and indeed, he dipped quite low twice before on it and again less than a week after starting it back up). I think I have his BG readings from the one week on Novolin saved on my phone and will add those to the sheet.

I'm sorry, I got confused and thought you were at pre-shot. OK, if you have a few hours to go that is easier!!!!

You will still be taking the reduction down to 0.75U, but the decision to shoot or not won't happen for a few hours or so. Likely he'll be high enough by then-- but only Butters knows right now!

Right, and I guess this is the part that confuses me. My dad is also diabetic and takes Lantus (similar med from what I understand) once daily. Even when his BG is low, they tell him to take his dose and if it's continuously low, they adjust the scale because it's a long acting insulin and doses I guess shouldn't be skipped. I wasn't sure if it's the same with cats, although it does make sense to adjust to 0.75U. Would it be the same deal with keeping it at this dose for the next week and seeing where he's at?

Thanks again for everyone's help, I definitely have a lot to learn!

 

[Wendy&Neko]

What dose was he on for Novolin?

With Lantus and Levemir, we keep holding the same dose unless (A) he earns a reduction by going under 90, or (B) after a week you do a curve and if his nadirs aren't between 90 and 149, you increase. In your case, since Butters went below 90, he earned a reduction to 0.75 units. So you should hold the dose a week at 0.75, unless he does under 90 again.

Cats have faster metabolisms than humans, so the insulin doesn't last as long, hence two shots a day.

The L insulins definitely make you think differently!

 

[Mac88]

What dose was he on for Novolin?

With Lantus and Levemir, we keep holding the same dose unless (A) he earns a reduction by going under 90, or (B) after a week you do a curve and if his nadirs aren't between 90 and 149, you increase. In your case, since Butters went below 90, he earned a reduction to 0.75 units. So you should hold the dose a week at 0.75, unless he does under 90 again.

Cats have faster metabolisms than humans, so the insulin doesn't last as long, hence two shots a day.

The L insulins definitely make you think differently!

He was put on 3 units of Novolin N, twice daily. I was told here that dose was high for a starting dose, and I believe that's right because his BG dipped so low so fast (it was 142 12 hours after a dose and after food, so it was likely much lower than that).