Blood monitoring and feeding

[Raewyn]

How much does feeding affect the blood glucose levels? If I'm doing a blood curve is there anything I should keep in mind with feeding times? It seems to me that feedings times can significantly affect the blood glucose level. Today Tim was fed earlier than his shot time (and hubby gave him some of the dry food the vet gave us for him). I test him +4,5 and 6 and levels were high, although slightly less on the third one. I didn't feed him all afternoon and the pre shot level wasn't much lower than what he'd been mid-cycle, and lower than what he normally is pre-shot. I can't seem to get any sense of a curve at all.

 

[Veronica & Babu-chiri]

Food definitely affects the blood glucose levels, actually what he eats is a mayor factor in his blood glucose that is why giving low carb food is so important, because his body will turn carbs into sugar in his blood. That being said, he has to eat, so yes after eating his numbers (and even those in healthy cats ) will usually be higher obviously if he had high carb food they will be higher than if he had low carb and will lower as time passes.

The reason that we make the pre shoot test withdrawing food for 2 hours prior to this particular test is so that the result won't be food influenced and we then can know if it is safe to give insulin but when doing a curve you want to keep his routine as normal as possible including food schedule so test every 2 or 3 hours (depending if you are doing a 12 or an 18 hour curve ) even if he ate so that you can see how he's reacting to the insulin dose he's getting on a normal regular day and again just no food 2 hours before his preshoot test

If you tested 1 hour after he had ate odds are he still had some influence of the food so his number was a bit high because of the food when you tested, given his numbers it is not too much of a concern but as his numbers go lower you do want to make sure he has not had anything to eat prior to his preshoot test for safety reasons

Yesterday that he didn't had dry food his numbers were a bit better but on both days his nadir (lower number ) was around +4 +5 which is pretty normal with Lantus, and then his numbers start to raise a bit but not much which is normal too so ok, odds are that you will need to raise his dose because his nadir is a bit high still, what protocol are you following?

 

[Raewyn]

Thanks for your answer. I told my husband not to feed him before I have tested him from now on (this is difficult for him as he gets up an hour before me and the cats are very vocal about wanting their breakfast ) Tim isn't on a regular feeding schedule, I'm just feeding him "on demand" during the day. Two or three times in the first hour after his shot and then usually after I test his blood. He is underweight so I want him to eat as much as possible, but not too much at a time (he often over eats and then throws up - though he hasn't done that as much since the diabetes, maybe because I've been more conscious not to over feed him). It seems logical to me the best time for him to be eating is when the insulin is having its maximum effect as this is when his body is best able to process the nutrition.

He is booked in at the vet for a blood curve tomorrow, so I will let them guide me on the dose. I know now that a home blood curve is more reliable than a vet one, but he was already booked in so I will go ahead with this one but ask them if I can do future ones at home. I will try to test every two hours today, then I can show that to the vet tomorrow as evidence I can do a decent blood curve at home. I think his nadir might be earlier than +4. I have just done a test +2 and it's one of the lowest yet (despite him having eaten quite a bit since his shot this morning).

 

[Veronica & Babu-chiri]

If he's used to free feed is just ok actually is probably better since then he doesn't get a huge amount of food forcing his pancreas to process a lot of glucose at once getting a bit several times a day is better to help his blood glucose levels to be more consistent and not have big peaks just withdraw the food 2 hours before his preshoot tests and this is only for security reasons so that you are sure is safe to give insulin

 

[Raewyn]

Having said that about the +2 test, his +4 and +6 tests were even lower!
Is it normal for the readings to be so variable from day to day at this stage?
The readings today are so low I keep thinking maybe I gave him extra insulin by mistake, but I could swear I double checked the dose.
The +4 one was so unexpected that I checked again 10 minutes later, but then it was slightly down again.
Of course I had a slight panic wondering if this was the start of hypoglycemia, but these levels aren't low enough to worry about are they? It seems to have levelled out at +6 anyway.

 

[Veronica & Babu-chiri]

Looking at his numbers he's looking very good actually for a cat that's just started, the curve looks just as it should with his nadir around +4 to +6 , if you can try and get a +2 at night just to be sure because cats tend to go lower at night .

Of course I had a slight panic wondering if this was the start of hypoglycemia, but these levels aren't low enough to worry about are they? It seems to have levelled out at +6 anyway.

Yes 130 is actually a very good number and nowhere near hypo, is very good that you are already getting blues, since he's just started with insulin it is usually recommended to hold the dose for 8 to 10 days but after that you will probably have to up his dose a bit, to 2.25 units