Glipizide - When is BG too low to give medicine?

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Kim&Buddy

Kim&Buddy

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Hi everyone,

To those who celebrate, Happy Easter!

I want you know how much I appreciate this forum and for you all being here for me. I know I'm asking a lot of questions and can't wait for the day when I can join the other side and be there for others like you have been here for me. Thank you!!

I know there aren't many people who use or have used glipizide (hopefully tomorrow Buddy gets switched to Lantus after our appointment with the new vet who knows about diabetes - thanks Kristine!). My concern has to do with the two treatments that need to take place between now and then. Buddy is on a low dose of glip (.5 ml, two times a day). His BG numbers are on the decline (YAY!!), which could be a factor of a number of things - improved diet, reduced arthritis pain so less bodily stress, etc.

I've been pouring over Lantus questions and when you guys give and don't give insulin and if I understand correctly, for newbies, under 200 means you wouldn't recommend administering insulin. As I've mentioned before, I'm kind of flying blind here because Buddy and I aren't part of the Lantus/insulin world yet. I've read information about glip, but I don't see guidelines as to when to and not to administer the medicine.

If you look at his spreadsheet, you'll see Buddy's AMPS and PMPS numbers. I'm inclined to not give him the glip if his numbers are still low tonight and tomorrow morning.

Think it's OK seeing as it could only be two doses missed before we see his new vet and he joins the insulin world?

Kim
 
Kim, why don't you do some monitoring today and see how low that .5 of Glip brings him first and then decide whether or not to do another one tonight? I doubt I would give him any in the a.m. if he is seeing a new vet. Even on Glip cats can hypo.

Also, ask the new vet to do a little bloodwork and check his liver values. Vinnie had been put on Glip at the shelter plus canned food so when he was pulled he only needed about 2 shots of Lantus and into remission he went BUT...his liver values were high from the Glip so we put him on Denosyl for a while and the values finally came down to normal.
 
I know squat about glip, so I really can't say a thing about dosing, but since you are at such a low dose of it and BG is not high at the time of shots, I think maybe you may be OK to skip the glip as you are starting Lantus tomorrow.

But I am hoping those who know about glip can say something.

With a change of diet, quite a few people notice better BG and a healthier cat too.
I am sure you will love how Lantus works and so will Buddy
 
Yeesh! Why didn't I think about mid-testing?!!! Thanks for the suggestion.

Now I'm thoroughly confused. His +6 is 192. That would put him level'ish with AMPS and PMPS levels. Given how little he's eaten since this morning, shouldn't his level be lower and not higher? And because I'm so new at this, I don't have a frame of reference. It didn't dawn on me to do any +6 readings because I've been so busy trying to get two readings a day down pat. ARGH! Wondering if this morning's reading could have been inaccurate. (I had an experience earlier in the week when test #1 showed 434 but subsequent tests showed 209 and 229 - using Relion Confirm.) Maybe I'll head out and buy a new one to play it safe and send this one back to Relion.

Thanks also for the suggestion about liver blood work. It would be so nice if he only needed to be on Lantus for a short amount of time!
 
I think of glipizide in this way:

Imagine you have a broken ankle, and you have to run a race.
glipizide would be like numbing the pain but doing nothing to prevent further damage so you may be able to run but at the end of the race, your ankle will be in worse shape and may never mend properly.

lantus or some type of insulin will be like having crutches and a cast on your ankle. You will be able to complete the race, and at the end of it all, your ankle will be mending until the day when you may be able to take the cast off and walk unaided.

Glipizide forces the poor sick pancreas to work harder instead of giving it a hand and helping it out so it can rest and heal.

Lantus says have a seat, pancreas, I know you are having a hard time with your work, so I'll help you out until you can get up and on your feet and are able to carry the load of your work.

I think that's why I would say a day with no glip till you can switch to Lantus the next day should be OK.
 
Thanks Gayle. Love the race analogy. I'm a runner so it couldn't be a better choice. :-D

It dawned on me that I took Buddy's +6 read soon after he had a vicious sneezing attack. Ever since his URI, he's prone to air gulping sneezes, as many as 10 in a row. I figured, "Hey, he's awake, I won't have to disturb him" when I probably should have said, "Hey, he just had a little traumatic event, might want to try back after he's settled down." I'm not sure how quick the whole stress/BG increase can happen, but I should have thought more. Can you tell me when the wisdom phase hits? I think I'm doing quite well with the whole dummy-you-need-to-think-things-through phase. ohmygod_smile

His +8 is right around where I expected it to be - 162.

I agree about forgoing the glip the next two times. It will be interesting to see what his level is tomorrow with his poor little pancreas having been given a break.
 
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