? Freya’s BGs make no sense!

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SwedishLiz

SwedishLiz

Member
We’re on day 10 now but still struggling to work out the correct Lantus dose for Freya.
It seems that a dose of 2 units barely affects her BG while any dose of more than 2 units
makes her go hypo. I know that some of you think that 2 units is too high & could be
causing these issues, but husband gave her a smidge less than 2 units last night & her BG
rocketed.
Today’s low BG was as a result of the 2.25 units this morning, the following high was a
result of me panicking & feeding Freya just a few (8?) of her favourite treats (Dreamies). Now her
sugars are sky high again, I’m wondering whether it’s worth me giving her a 2.25 unit dose
tomorrow AM, then just let her go hypo (I’ll obviously keep a ridiculously close eye!) but let her
liver do its thing. Her BG would then not raise as much as if I intervene, so I can then revert to
the 2 unit maintenance dose?
I know this sounds reckless but I’m running out of ideas. Please help!
 
Larry and Kitties said:
Did you start @2 units?
Usual starting dose is 1 unit. Your SS shows a relatively flat curve when on 2 units. When you get a flat curve that means either more insulin is required or that 2 units is too high. When yoyui went to 2 ¼ units BG got too low. To me that means that 2 units is too much. I would reduce to 1 unit.
Click to expand...
Yes, 2 units was the starting dose. My husband has to preload Freya’s syringes as I’m registered blind so can only administer what I’ve been left, hence my panic! Surely reducing the dose to just 1 unit would be too radical? I’m a T1D so know something about diabetes in humans at least, so while I see your logic, this seems counterintuitive to me! Could we try 1.5U instead?
 
SwedishLiz said:
Yes, 2 units was the starting dose. My husband has to preload Freya’s syringes as I’m registered blind so can only administer what I’ve been left, hence my panic! Surely reducing the dose to just 1 unit would be too radical? I’m a T1D so know something about diabetes in humans at least, so while I see your logic, this seems counterintuitive to me! Could we try 1.5U instead?
Click to expand...
So, for the next 4 days, I’m reducing Freya’s Lantus to 1.5 units. Wish her luck! The vet (who has admitted that she knows nothing about FD) is ringing us in 4 days for an update - hopefully we can educate her!
 
Liz -

Lantus/glargine and Levemir work differently than other types of insulin. If you make frequent changes in the dose, you're likely to get less than desirable numbers. The reason is that it takes several cycles for the dose to stabilize. If you look at the post on dosing methods, you need to hold the dose for at least 3 days (6 cycles) -- longer if you opt to follow the Start Low Go Slow methods.

If you plan to reduce the dose to 1.5u, then you need to decide on which dosing method you want to follow and unless Freya's numbers drop low enough to warrant a dose reduction, you hold the dose for the indicated period of time.

Also, you want to enter the mmol/L dose on the World tab of your spreadsheet. The spreadsheet is set up to convert those numbers into mg/dL on the US tab of the spreadsheet. I'm guessing that Freya's +7 was 356, not 19.8. I'm tagging @Bandit's Mom in case there's a problem with your spreadsheet.
 
Sienne and Gabby (GA) said:
Liz -

Lantus/glargine and Levemir work differently than other types of insulin. If you make frequent changes in the dose, you're likely to get less than desirable numbers. The reason is that it takes several cycles for the dose to stabilize. If you look at the post on dosing methods, you need to hold the dose for at least 3 days (6 cycles) -- longer if you opt to follow the Start Low Go Slow methods.

If you plan to reduce the dose to 1.5u, then you need to decide on which dosing method you want to follow and unless Freya's numbers drop low enough to warrant a dose reduction, you hold the dose for the indicated period of time.

Also, you want to enter the mmol/L dose on the World tab of your spreadsheet. The spreadsheet is set up to convert those numbers into mg/dL on the US tab of the spreadsheet. I'm guessing that Freya's +7 was 356, not 19.8. I'm tagging @Bandit's Mom in case there's a problem with your spreadsheet.
Click to expand...
We’re trying the TR regime now that we know that Freya’s vet is talking nonsense (didn’t think the SLGS regime would work for Freya as she’d already started her vet-prescribed regime before we discovered you). I know that the TR recommendation is for a 3 day adjustment period, but why would I risk Freya going constantly hypo (especially overnight) when both times we’ve given her more than 2 units, she’s gone low? 2 units seems to be her threshold & with this in mind, I’m going with the advice given here that her high BG is as a result of too much insulin. Makes no sense to me as a human diabetic, but what do I know? I’ll readily admit that I’m struggling with the spreadsheet - is there a tab I’ve missed for access to the World sheet? I’d looked earlier but don’t know what I’m looking for. I have access to just 2 pages(am/pm); where/how do I access the others?
 
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SwedishLiz said:
’ll readily admit that I’m struggling with the spreadsheet - is there a tab I’ve missed for access to the World sheet? I’d looked earlier but don’t know what I’m looking for. I have access to just 2 pages(am/pm); where/how do I access the others?
Click to expand...
@Bandit's Mom
It looks like she is entering both US and World numbers in the US tab and none in the World, she's from Sweden
 
@SwedishLiz
Have you read the 2 dosing methods when using Lantus
You need to pick one and follow it, they will tell you when an increase or decrease is needed. Plus you need to stick with one dose , I see you gave 2.25 yesterday at AMPS then 2 units at PMPS then 1.50 this morning.?
Lantus likes consistently.
I'm going to tag a few members to look at you SS about what dose to stick with see her post above

@Suzanne & Darcy

@tiffmaxee

@Bandit's Mom

@Bron and Sheba (GA)

@Sienne and Gabby (GA)

@Wendy&Neko
 
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@SwedishLiz
I can now see all the US BG in the correct tab and the correct ones in the World :cat:

Here are the 2 dosing methods so you can read about them and choose one then add it to your signature and your spreadsheet up top where it asks you
 
Diane Tyler's Mom said:
@SwedishLiz
Have you read the 2 dosing methods when using Lantus
You need to pick one and follow it, they will tell you when an increase or decrease is needed. Plus you need to stick with one dose , I see you gave 2.25 yesterday at AMPS then 2 units at PMPS then 1.50 this morning.?
Lantus likes consistently.
I'm going to tag a few members to look at you SS about what dose to stick with see her post above

@Suzanne & Darcy

@tiffmaxee

@Bandit's Mom

@Bron and Sheba (GA)
Click to expand...
Yes, we’re going with the TR regime. I am getting conflicting advice between this
forum & my vet, but as I’ve stated before, my vet has admitted that she knows
nothing about FD. The vet initially prescribed Freya 2 units BiD, then a week later
we were told to increase her dose to 2.5 units. We tried this once; Freya went borderline
hypo, so rather than maintain a dangerous dose, we reverted back to 2 units that evening
(don’t want her going hypo overnight). The following morning, we tried the ‘pragmatic’
dose, 2.25 units, but Freya went massively hypo, so we’re now completely ignoring our vet &
starting at least a 3 day schedule of 1.5 units to see what impact this has on Freya’s
BG (Somogyi effect). I’m hoping that by day 3, her sugars will have started to
reduce/stabilise; at the moment they are super-scary! The difficulty here in Sweden is that if you
don’t do what the vet says, your cat can be seized by the police & shot so we have to be a little
bit careful just how far we stray from the prescribed regime unless we can show a definite
improvement. There won’t be too many blood tests until the husband is back home as my sight
issues make even seeing a spot of blood on her ear difficult (though I’ll keep trying) but Freya
deserves nothing but the best!
Thank you for all the help offered/given so far, you lot are the best!
 
Last edited:
SwedishLiz said:
The difficulty here in Sweden is that if you
don’t do what the vet says, your cat can be seized by the police & shot so we have to be a little
bit careful just how far we stray from the prescribed regime unless we can show a definite
improvement.
Click to expand...
Oh my god you've got to be kidding how awful!
You don't have to tell the vet how many units you are giving , if I listened to my vet Tyler wouldn't be in remission since 1-24-21
I took the advice from the experienced members here
 
I added this so I don't know if you saw it
You don't have to tell the vet how many units you are giving , if I listened to my vet Tyler wouldn't be in remission since 1-24-21
I took the advice from the experienced members here
 
SwedishLiz said:
Yes, we’re going with the TR regime. I am getting conflicting advice between this
forum & my vet, but as I’ve stated before, my vet has admitted that she knows
nothing about FD. The vet initially prescribed Freya 2 units BiD, then a week later
we were told to increase her dose to 2.5 units. We tried this once; Freya went borderline
hypo, so rather than maintain a dangerous dose, we reverted back to 2 units that evening
(don’t want her going hypo overnight). The following morning, we tried the ‘pragmatic’
dose, 2.25 units, but Freya went massively hypo, so we’re now completely ignoring our vet &
starting at least a 3 day schedule of 1.5 units to see what impact this has on Freya’s
BG (Somogyi effect). I’m hoping that by day 3, her sugars will have started to
reduce/stabilise; at the moment they are super-scary! The difficulty here in Sweden is that if you
don’t do what the vet says, your cat can be seized by the police & shot so we have to be a little
bit careful just how far we stray from the prescribed regime unless we can show a definite
improvement. There won’t be too many blood tests until the husband is back home as my sight
issues make even seeing a spot of blood on her ear difficult (though I’ll keep trying) but Freya
deserves nothing but the best!
Thank you for all the help offered/given so far, you lot are the best!
Click to expand...

I'm going to tag the members again so they can read this also


@Suzanne & Darcy

@tiffmaxee

@Bandit's Mom

@Bron and Sheba (GA)

@Sienne and Gabby (GA)

@Wendy&Neko
 
Diane Tyler's Mom said:
I added this so I don't know if you saw it
You don't have to tell the vet how many units you are giving , if I listened to my vet Tyler wouldn't be in remission since 1-24-21
I took the advice from the experienced members here
Click to expand...
The difficulty is each prescription is limited to a certain number of vials each year & we’re then obliged to go for
another vet visit just to get Freya’s prescription renewed. Eventually this may not be an issue, but initially…? My sight loss so
lack of being able to test Freya’s BG often enough (damn her two-tone ears!) won’t help either! Day 2 of her newTR regime
tomorrow, fingers/paws crossed that Freya’s new lower dose starts working!
 
Diane Tyler's Mom said:
By the way Freya is so adorable !
Click to expand...
Thank you! As a rescue, she’s one of the best (Adopt, don’t shop!) She grooms us all (when she’s feeling ok), she has the curliest toes I’ve ever known!
I’m so sad that it was Freya who became diabetic, yet slightly perversely pleased as she’s by far the best patient…
 
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