First day on freestyle Libre 2. Very confused

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Brie’s Mom

Brie’s Mom

Member Since 2022
Hi everyone -

Brie was diagnosed on the 14th of Dec 2022. I switched to LC wet food (friskies and FF) immediately. Initial BG from vet was 23mmol/L but she was very stressed at the time. She had glucose present in urine at the time so neither of us saw value in a fructosamine test. She’s been on Prozinc 1iu/twice day since and has shown sooooo much improvement! Plays more, more affectionate, less water consumption and less urination. We went to the vet today and had a freestyle libre implanted as testing with the glucometer has been next to impossible. Her readings for the past 5 hours have been between 4.5-9mmol/L but generally hovering around the 5.5 mark. Is that normal? To be that regulated after only 11 days on insulin? She normally gets fed at 8:30 am/pm and has her shots at 9am/pm I have been scanning every 30 mins and will continue for a few days to get the most info but I’m starting to wonder if the vet was wrong? Any advice? Sorry I have not had time to do a spreadsheet yet - crazy time for a new diagnosis!!
 
A fructosamine test gives you a 3 week average so it’s valuable for the diagnosis as a spot check only at the vet is not conclusive. The food change could and does sometimes put cats into remission.
 
Welcome to FDMB!

Numbers at the vet's office can be artificially inflated due to stress. However, seeing glucose in the urine may be an indication that Brie's blood glucose numbers were higher than normal range. (It takes longer for glucose to show up in urine than it does to see changes in blood glucose.) One way to answer your question as to whether the vet's diagnosis was correct would be a fructosamine test.

As Ale noted, changing Brie's diet to low carb may be contributing to her lower numbers. There are some cats who become regulated/go into remission when they are switched to a low carb diet. However, keep in mind, that remission means they are diet controlled diabetics. Right now, Brie is not completely in normal range (50 - 120 mg/dL or 2.8 - 6.7 mmol/L) numbers.

I'm providing a link to some basics for you to keep track of Brie's numbers which also provides a way for us to follow along. You'll note that our signatures contain information about you and your cat and there's a link to our cat's spreadsheet.

Please let us know how we can help.
 
Hi Everyone- sorry for the late reply - I've been spooked by some high numbers this morning and have been spiralling so I made my spreadsheet. There is only a day and a half of data but I would love some input! I was so happy to see such great numbers yesterday afternoon but then was very discouraged when the numbers shot up so high this morning and have stayed high. I'm worried that her Friskies caused the spike? I normally do FF in the am and Friskies at night. But then the FF didn't level everything out this morning so I am left even more confused.

Any help would be amazing. This is so overwhelming and I'm worried that I'm not doing enough.
 
Go to your Profile Page (click on your avatar photo). Then click on the Information tab. You should see the information that's in your signature.

To create an embedded link:
  • Type out what you want to call the link -- for example, Brie's spreadsheet
  • Highlight the name of the link
  • Then, click on the the image of a paper clip that's above the text box (it's the icon that's 7th from the left side beginning with the Bold icon). A box will open.
  • Cut and paste the https link to Brie's spreadsheet into the box that you opened.
  • Click "Insert"
When you go back to one of your posts, they should all change to include the embedded link.
 
Sienne and Gabby (GA) said:
Go to your Profile Page (click on your avatar photo). Then click on the Information tab. You should see the information that's in your signature.

To create an embedded link:
  • Type out what you want to call the link -- for example, Brie's spreadsheet
  • Highlight the name of the link
  • Then, click on the the image of a paper clip that's above the text box (it's the icon that's 7th from the left side beginning with the Bold icon). A box will open.
  • Cut and paste the https link to Brie's spreadsheet into the box that you opened.
  • Click "Insert"
When you go back to one of your posts, they should all change to include the embedded link.
Click to expand...
Amazing!! Thank you!!
 
So this is where you'd have to pick a dosing methods - explanations of our method can be found here. Here are the main highlights:

Start Low Go Slow (SLGS)
- Doses are held for a week, then a curve is done at the end of the week. Alternatively, midcycle tests done throughout the week at various times (including night) also work.
- Guidelines for increases can be found in sticky linked above
- Reductions are taken when BG drops below 90
- The two preshots and a curve are the required tests

Modified ProZinc Method (MPM)
- Doses are held for 6-10 cycles, sometimes longer. Guidelines for increases and how often can be found in the sticky linked above.
- Reductions are taken below 50 on a human meter (like the Libre), or 68 on a pet meter.
- The two preshots plus one additional test each cycle - AM and PM - are required. This is because you are pushing the BG lower near hypo range, so you don't have as much cushion to work with

The main advantage to MPM is you can typically maintain a more normal (non-diabetic) BG range once they settle down and you can adjust doses more quickly to get in a good range (this is currently not an issue for you because he's already looking at reductions). It does carry a better chance at remission, though never guaranteed.

The main disadvantage to MPM is the testing required may not work with everyone's schedule, and the lower BGs can mean some long days/nights of making sure hypos don't happen.

Advantages to SLGS are more cushion from hypo, and testing typically works better with most schedules. Disadvantages are doses are held longer so it may mean more time to get to a good dose, and that the BG typically runs in a higher range.

Since you are so new to this, my suggestion would be SLGS for now. It leaves you some cushion, especially if the Libre dies. So, he would have earned a reduction to 0.75U with the 86 yesterday. You would hold the 0.75U for a week unless he earns another reduction by dropping below 90; at that point you re evaluate the dose and see if perhaps an increase is needed
 
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