Hi Richie,
There is one thing that really sticks out on your ss; your increases are in full units and you may find Clyde's numbers are better if you increase according to the protocol most people are following here...
If you think about your increases..... you started at 1u which is great, but then you DOUBLED the dose by going right up to 2u. It is only one number but it's double the amount of insulin. Your next increase was another full unit which was a 50% increase, and another big amount .... because of the shed.
With Lantus and Lev, you have a spare tank of insulin hanging out just under the skin, and that shed has to equal your dose. While you are topping up the shed, Clyde is not getting the full dose because some has to go to the shed.
Also, you are holding each dose longer than you need to hold it..... 3days or 6 cycles is usually good enough to see if it's a good dose for Clyde. If you don't have U100 syringes with 1/2 unit markings, you will need to get some.
Here's the gist of the protocol for dosing decisions...
"General" Guidelines:
--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).
--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).
--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Reducing the dose...
--- If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
--- If an attempted reduction fails, go right back up to the last good dose.
--- Try to go from 0.25u to 0.1u before stopping insulin completely.
Random Notes...
Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.
I don't know what links for info you have been given but here are some that you can read, print out to have handy and refer to as needed.
Tight Regulation Protocol
Lantus & Levemir – Insulin Depot –AKA- Storage Shed
Lantus & Levemir – Data Ready to Shoot Low Numbers
Lantus & Levemir: Info, Proper Handling & Storage has picture of syringe and insulin pens.
Here are some links to info on how to handle really low numbers in case Clyde drops to a low BG
List of Hypo symptoms
How to treat HYPOS-They can kill! Print this out!
Jojo’s HYPO TOOLKIT
With high BG numbers, and even not so high, it's good to be testing for ketones.
Ketones
Feeding Your Cat: Know The Basics of Feline Nutrition
As you are away at work, it may be an idea if you could get an autofeeder for Clyde as his numbers may be more steady if he were to eat more frequently while you are away. I know it's an issue with more than one cat, so see if you can set up in a way that only Clyde can reach.
Petsafe 5-meal Auto Feeder
