Dosing advice, not sure if insulin is working

[funkyou]

Hi all,

Could someone please take a look at Meika's spreadsheet and give me some advice? I'm not sure if the insulin is actually working correctly. I've increased her dose levels twice but she just hovers around the same levels most of the time. Then she'll get a random low reading so I won't shoot, and then she'll be sky high the next day

 

[Sugar’s Mama]

Hello! Sorry that no answered you but this thread is for website/spreadsheet/tech issues... I suggest re-posting in the main Health or Lantus forum to get advice from the super-users.

The 70 at PMPS on the 9th earned you a reduction to 1.25. I'm still learning, but it looks like you aren't following the increases and decreases for SLGS. I made a very simplified version on the second tab of my spreadsheet to help me understand. Perhaps it would be helpful for you, too?

 

[Wendy&Neko]

Your insulin is working fine, but your dose is too high. Since you are following SLGS, you should reduce the dose anytime she goes below 90, such as the PMPS of the 9th. Your new dose should be 1.25 units. Every time you skip a shot, her numbers go up. Hopefully by reducing the dose, you can get better numbers so you don't have to skip shots.

You should also get some night time test, say one just before bed. Many cats go lower at night, and you want to catch those lower numbers to determine if her dose needs to be lowered.

 

[funkyou]

I creased the dose because I thought we were trying to get her numbers down lower. It's so confusing

Hello! Sorry that no answered you but this thread is for website/spreadsheet/tech issues... I suggest re-posting in the main Health or Lantus forum to get advice from the super-users.

The 70 at PMPS on the 9th earned you a reduction to 1.25. I'm still learning, but it looks like you aren't following the increases and decreases for SLGS. I made a very simplified version on the second tab of my spreadsheet to help me understand. Perhaps it would be helpful for you, too?

 

[funkyou]

Your insulin is working fine, but your dose is too high. Since you are following SLGS, you should reduce the dose anytime she goes below 90, such as the PMPS of the 9th. Your new dose should be 1.25 units. Every time you skip a shot, her numbers go up. Hopefully by reducing the dose, you can get better numbers so you don't have to skip shots.

You should also get some night time test, say one just before bed. Many cats go lower at night, and you want to catch those lower numbers to determine if her dose needs to be lowered.

So I should have given her how much instead of skipping it? I didn't want her to go hypo while I was asleep

I test her at 2pm, 8pm, and 2am

 

[Wendy&Neko]

You might want to mix up the tests a bit, and add a +10pm or so if still up then. Not all cats nadir at +6, so getting tests somewhere in the +4 to +7 range can still be interesting.

So I should have given her how much instead of skipping it? I didn't want her to go hypo while I was asleep

If you are following SLGS for dosing, you don't give a shot if they are under 70 at preshot time so you did the right thing by skipping. Unfortunately it resulting in higher numbers next day, but that was to be expected.

I creased the dose because I thought we were trying to get her numbers down lower. It's so confusing

Following the SLGS dosing method as written should help make things less confusing. It gives you a guideline of how long to hold a dose, when to decrease the dose, and when to increase. And most important, how to keep Meika safe. You only want to increase the dose if you know she's not going too low on the current dose. Some PM cycle tests will help tell you if she's doing lower then.

 

[funkyou]

Hello! Sorry that no answered you but this thread is for website/spreadsheet/tech issues... I suggest re-posting in the main Health or Lantus forum to get advice from the super-users.

The 70 at PMPS on the 9th earned you a reduction to 1.25. I'm still learning, but it looks like you aren't following the increases and decreases for SLGS. I made a very simplified version on the second tab of my spreadsheet to help me understand. Perhaps it would be helpful for you, too?

Is there a guide like the one you wrote on your spreadsheet with the numbers converted to mmol?

 

[Hendrick Cuddleclaw]

I recommend you post daily threads on the Lantus/Levenmir/Biosimilars forum for extra help on dosing and guidance on how to get the numbers down. That is what I did and people were super helpful and we got Hendrick very well regulated, and then into diabetic remission after that.

Here is a link to the Lantus/Levenmir/Biosimilars forum: https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

 

[Sugar’s Mama]

Is there a guide like the one you wrote on your spreadsheet with the numbers converted to mmol?

I stole the idea from @stannarp on Whiskey’s spreadsheet which I believe had both numbers. Hope that helps!

 

[funkyou]

You might want to mix up the tests a bit, and add a +10pm or so if still up then. Not all cats nadir at +6, so getting tests somewhere in the +4 to +7 range can still be interesting.

I already test her at 8pm. I might be able to fit in a test at 10:30am before I start work sometimes if I'm not running late (which I normally am)...?

 

[Wendy&Neko]

Is there a guide like the one you wrote on your spreadsheet with the numbers converted to mmol?

See the section on SLGS in this Sticky Note, it has the mmol/L numbers in it.
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)