Curious about Prozinc

[monty_dweezil (GA)]

My Dweezil seems to have semi-regular very late nadirs on Lantus.

Like last week he had 1.5 units one night at 5.30pm, went down as normal (to the blues) and then started climbing back up to the yellows after about 7 hours later. Normally this would mean he would keep climbing until his next dose 5 hours later.

However, at the time of his dose, he was down in the blues and then despite eating his breakfast and waiting an hour, then kept going down to the greens and then into the clinical hypo range.

3 hours after his dose should have been given he was still just on hypo (constantly monitored and fed higher carb food). So obviously no insulin could be given and then he bounced high after that, as expected.

This also happens in the day. His 5.30am dose does nothing until finally it starts to kick in around an hour before his evening dose is due. Then he keeps going down. 2 weeks ago his nadir from the 5.30am shot came at almost 9pm, 4.5 hours after his morning dose was due!

How are we supposed to have any consistency with this?

I'm wondering if Prozinc might fix this problem as there would be no overlap and each new dose wouldn't be so dependent on the previous one.

Or is it not that simple?

 

[Rachel]

Hi there! Sorry we haven't replied yet...it tends to get a bit quiet during the day in here. It is possible that Prozinc could fix that problem. I can't say for sure...but it does make sense that since we have no depot action on Prozinc you won't see so many ups and downs. We generally don't see much if any overlap...sometimes the dose lasts longer but it's rare. You might want to check out a few SS's to see how it normally works? The good thing about Prozinc is you can adjust dose as needed...which might help when you find your numbers too low at the end of a cycle. You can give a smaller dose and hopefully with the reduction, the insulin won't last as long.

I'm not 100% sure if this helpful...I don't know much about Lantus. I do think it would be worth a try...any other questions I can answer for you?

 

[Djamila]

With Prozinc you'll see more up and down within a cycle though. You'll see highs at the beginning and end of the cycle, and lows in the middle. So instead of the occasional variation, you'll see ups and downs throughout the day. Additionally, Prozinc tends to be bouncier than Lantus, and given the amount of bouncing you're already seeing, I'm not sure you'll be happier with the results of Prozinc. There is also a multi-cycle effect - though it's not carryover like the depot with Lantus. Instead you'll see a low number nadir, followed by a number of high flat cycles (how many depends on the cat), followed by a responsive cycle, and then you adjust the dose, so it can be anywhere from three to ??? cycles (it just takes time to learn your own cat's pattern) to really evaluate a dose.

I'm wondering if Levemir might actually be a better direction for what you're seeking. There are a number of folks using it over in the Lantus forum - although since you're on Lantus already, you may have already looked into that?