Glucose Dropping No Insulin

Status
Not open for further replies.
Carly E.

Carly E.

Member Since 2024
Maci hasn't had insulin in 3 days, with being strictly on Purina DM wet food her glucose has remained under 300..usually around the mid 100s low 200s. Yesterday thought she went down to the low 60s around 7hrs after eating 1/2 a can. I gave her a small scoop of the dry Purina DM to help get the numbers up a little.
Any thoughts why that happens and how I can avoid it?
 
Carly --

It looks like your spreadsheet isn't up to date. It's really hard -- at least for me -- to try to give feedback without the entire picture. Could you update your spreadsheet?
 
Sienne and Gabby (GA) said:
Carly --

It looks like your spreadsheet isn't up to date. It's really hard -- at least for me -- to try to give feedback without the entire picture. Could you update your spreadsheet?
Click to expand...

It's as up to date as of her last insulin shot 3 days ago. I can add her non insulin glucose numbers when I get home from work. It's just Yesterday she got into the 60s 7 hours after eating. Otherwise she was sitting mid 100s-low 200s. Just wondering why that may happen and how to avoid it. Again she wasn't on insulin.
 
Carly E. said:
It's as up to date as of her last insulin shot 3 days ago. I can add her non insulin glucose numbers when I get home from work. It's just Yesterday she got into the 60s 7 hours after eating. Otherwise she was sitting mid 100s-low 200s. Just wondering why that may happen and how to avoid it. Again she wasn't on insulin.
Click to expand...

The spreadsheet is more about analyzing ALL the data as opposed to tracking insulin shots alone. I'd put "NS" instead of leaving it blank when you don't give a shot (as i was advised to do, that way its obvious its not a mistake) and add any missing readings you got and I'm sure one of the many experienced posters will be able to tell you more!

If you need to edit your sheet on your mobile you can use the Google Sheets app, too
 
I would recommend you test the urine for ketones while you are figuring out what to do about the dose. To do this you will need a bottle of Ketostix from Walmart or a pharmacy if you don’t have any and you will need to collect a urine sample from your kitty.
 
I'm not sure that I understand why you're not giving insulin. Most of Maci's test data is still in the diabetic range. Do you think you're able to draw up a dose that's less than 0.5u?
 
Sienne and Gabby (GA) said:
I'm not sure that I understand why you're not giving insulin. Most of Maci's test data is still in the diabetic range. Do you think you're able to draw up a dose that's less than 0.5u?
Click to expand...
Did you not see the updated spreadsheet perhaps?? The last 3 days she has been under 170. She's highest right before her meals at the low 200s..but the Majority of her day is in the 140s. This morning she was 167 and 3.5hrs later she was at 121. So I am confused at her neediing any insulin with these numbers, I fear it would cause her to go Hypo.
I also question as why you would recommend insulin when my question was WHY did she go into the 50s WITHOUT it? Call me naive maybe as I am new to this disease but if she had insulin at that stage with her body alone getting her into the danger zone she might have died.
Normal range is 80-120, but diabetic normal range is 150-250 from my understanding.
 
Last edited:
I always look at spreadsheets!!

Ideally, you want your cat to be in normal BG numbers (50 - 120). Generally with Vetsulin, we suggest a slightly higher than 50 for the bottom of the range. You don't reduce the dose unless nadirs are less than 90. When you do reduce (or increase) the dose, it's in 0.25u amounts.

I realize you're still very new to managing Maci's diabetes and the numbers you're seeing seem low. They are good but they are not in a normal BG range. If your goal is to have Maci regulated or possibly go into remission, you will want her to be in a better range (think low blue or green numbers). Have you taken a look at the information in the Vetsulin guide?
 
If those recent numbers on the spreadsheet are on the Freestyle Libre, it often tests lower than a hand held blood glucose meter. If you can, it's good to double check the lower Libre numbers with a BG meter. The Libre is also a human meter, so it's range is lower than that of the AT you were using.
 
Wendy&Neko said:
If those recent numbers on the spreadsheet are on the Freestyle Libre, it often tests lower than a hand held blood glucose meter. If you can, it's good to double check the lower Libre numbers with a BG meter. The Libre is also a human meter, so it's range is lower than that of the AT you were using.
Click to expand...
Yes, I tested some of the numbers with the AT3 its usually 10-20 off from the Libre..I just did one now, FL-129 AT3-134
 
Yes, I did read through the Guide you provided, I did also read on the direct Vetsulin Website.
"The aim of therapy is to produce a blood glucose curve that approaches the average range and avoids potentially fatal hypoglycemia. A stable cat with diabetes exhibits a blood glucose range of around 120 to 300 mg/dL for most of a 24-hour period."

The guide you provides also states...
"
If your cat’s BG is a bit below 200 mg/dL [11 mmol/L] on a human meter, consider ‘stalling’.
  • Stalling is waiting - without feeding your cat - for 20+ minutes, then retesting to see if the BG has risen to a suitable level.
  • You are looking for a number that is rising, not falling, and is high enough to give insulin."
I know she was a bit over the 200 most days before her meal, but she quickly gets below that on her own.
 
50-120 is the normal range. Anything higher than 120 requires insulin. The below is about the preshot numbers not the numbers for the rest of the day:

If your cat’s BG is a bit below 200 mg/dL [11 mmol/L] on a human meter, consider ‘stalling’.
  • Stalling is waiting - without feeding your cat - for 20+ minutes, then retesting to see if the BG has risen to a suitable level.
  • You are looking for a number that is rising, not falling, and is high enough to give insulin."

I’d try to give her .25 instead of no insulin to see what numbers you get. If she’s going about 120, she still needs insulin
 
It’s great that switching to wet food has had such a positive impact on her numbers! It’s possible that her body may continue to heal itself with just the diet change but you should keep a close eye on her to make sure she doesn’t backslide. Test ketones if she’s not on insulin. Keep checking glucose numbers. As much as these numbers are better than they were before, she is not in remission (yet?) so it’s possible you may see her numbers creep up again. If it were me, I would try a token dose like a drop or .25u to keep her in healthy numbers.

No matter what though, you don’t need to give her kibble to keep her numbers from dropping if she’s not on insulin. 50s are healthy and good for cats not on insulin.
 
SpotsMom said:
It’s great that switching to wet food has had such a positive impact on her numbers! It’s possible that her body may continue to heal itself with just the diet change but you should keep a close eye on her to make sure she doesn’t backslide. Test ketones if she’s not on insulin. Keep checking glucose numbers. As much as these numbers are better than they were before, she is not in remission (yet?) so it’s possible you may see her numbers creep up again. If it were me, I would try a token dose like a drop or .25u to keep her in healthy numbers.

No matter what though, you don’t need to give her kibble to keep her numbers from dropping if she’s not on insulin. 50s are healthy and good for cats not on insulin.
Click to expand...

Thank you so much for giving me some positivity and answering my initial concern about her going down to the 50s with no insulin! I did reach out to her vet about going to .25 or seeing how just diet control goes, so i'm waiting on what her thoughts are.
When I first called the vet with my concern of her dropping so much on her own with just a meal they said if she gets back to the 300s start insulin back up...but I wanted there thoughts with a few days of data now...and that was before she dropped so low.
Thanks again.
 
When a cat is NOT receiving insulin injections (or has been off injections for at least a few days/week in the case of “depot” insulin such as Lantus/Levemir), then a drop in BG after eating can mean that the cat’s own body is producing insulin and that enough of it is getting into the cells to mostly “get by.” Seeing BG numbers that are above normal means that the body isn’t quite able to manage normally just yet, but is making a valiant effort. Think of a car that is sputtering and cutting out. It’s sort of running, but it’s not running properly and needs some help/maintenance/tuning.

Sometimes a change to low-carb canned food is all that is needed to allow a cat to become a “diet-controlled” diabetic. More often, however, a cat will need at least a short course of insulin shots. Think of it like this… many cats are diagnosed at middle age, often after a lifetime of high-carb dry food, and perhaps living indoor/inactive and a bit overweight. They likely didn’t become diabetic overnight, so even after removing the offending carbs, the cat’s pancreas can need a bit of a “break” and time to heal, and often that means offering support in the form of insulin shots.

My first diabetic, Chip, was in a very similar situation to your cat. Diet change made a huge difference and we did not start insulin shots. However, that was because after a week of the food change, his BG never went over 126. Had he gone much over 150 or hovered in that range, I’d have definitely started at least token doses.

To be honest, your cat probably does need a bit of assistance in the form of very small doses of insulin. However, Vetsulin would not be an insulin I’d choose to use, given how “harsh” it can be in cats (i.e., large BG swings). So if that’s the only insulin choice, I’d be very conservative in dosing.

As for normal BG numbers, please remember that “normal” depends on whether you’re using human or pet meter. Pet meters such as the AT3 often state 70-130/150 as normal, whereas human meters run lower and normal is often quoted as 50-120 or so. Point is you certainly don’t want to see a 50 on a pet meter—and if you do, you’d want to intervene immediately.

Also remember that once diabetic, always diabetic, even if exogenous insulin shots are no longer needed. If your cat achieves a true diet-controlled state (sometimes referred to as “remission”), please don’t let down your guard. Getting lax about food can trigger increased BG, as can dental problems, UTIs, other diseases, steroids, etc., so it’s wise to continue monitoring BG periodically. It’s usually harder to achieve a second remission. Two of my three diabetics went into remission, and both ended up back on insulin later in their lives due to other medical issues.

And speaking of steroids … has your cat been on steroids recently?
 
Thank you for the advice. I do agree Vetsulin would not be the right choice...it was hitting her hard and fast as it does. I do know the human and pet ones run different, thank you for the conversion. I should get the Relion for her at some point. Insulin is just so unpredictable I was getting so stressed with these lows!

No she hasn't been on them recently...its been maybe 2-3 years since the last time she was ever on it for an allergy she has.
 
Carly—how often are you feeding Maci? Some vets recommend twice a day for diabetics but it’s much better to feed multiple small meals (less stress on the pancreas) than two large ones. Human doctors tell their Type II diabetic patients the same thing. If you do happen to be feeding only two meals, try breaking them up and see if that smooths out the BG numbers.

As long as you’re not giving insulin shots, you really shouldn’t have to worry about Maci’s BG dropping too low.* I’d stick to feeding only low-carb canned food and avoid dry altogether (including D/M dry). The normal-range numbers are where the pancreas can heal.

And finally, some cats get tired of D/M. There’s really nothing magical about it (the “D” stands for “diaTetic”, not diaBetic—and yes, there’s a story regarding the wording change, lol). It’s fine to feed other low-carb canned foods than D/M.

——-
* for anyone who wants to get technical about this statement, yes, an insulinoma or other rare scenarios can cause hypoglycemia BUT they’re not worth mentioning in this case (even though I just did :rolleyes:)
 
JL and Chip said:
Carly—how often are you feeding Maci? Some vets recommend twice a day for diabetics but it’s much better to feed multiple small meals (less stress on the pancreas) than two large ones. Human doctors tell their Type II diabetic patients the same thing. If you do happen to be feeding only two meals, try breaking them up and see if that smooths out the BG numbers.

As long as you’re not giving insulin shots, you really shouldn’t have to worry about Maci’s BG dropping too low.* I’d stick to feeding only low-carb canned food and avoid dry altogether (including D/M dry). The normal-range numbers are where the pancreas can heal.

And finally, some cats get tired of D/M. There’s really nothing magical about it (the “D” stands for “diaTetic”, not diaBetic—and yes, there’s a story regarding the wording change, lol). It’s fine to feed other low-carb canned foods than D/M.

——-
* for anyone who wants to get technical about this statement, yes, an insulinoma or other rare scenarios can cause hypoglycemia BUT they’re not worth mentioning in this case (even though I just did :rolleyes:)
Click to expand...

I have been feeding her twice a day. 1/2 a can of the Purina DM in the AM and the other 1/2 at night. Feeding her more then that won't be possible most days as I work 12+hrs a day and am an hour away from home.
I know she isn't cured, and I shall continue to monitor her and be sure to not lax on her diet. I want my girl with me and healthy for as long as possible.
She was 113(Libre) this evening before her meal. She seems to be getting lower and lower right before meals so I'm hoping this is a sign of a remission. Fingers
 
Easy solution: use a programmable timed feeder to provide small meals throughout the day. Many FDMB members use such feeders. Catmate and Petsafe are two popular brands. There are one compartment feeders to feeders that do up to 5 meals. You can use two feeders if one 5 compartment feeder isn't enough. Canned food is a cooked product so it's fine to leave out all day. It might get a little dry but there are ways to prevent that such as freezing portion sizes and putting the frozen chunk into a feeder compartment to slowly defrost.
 
Carly E. said:
Really, hmm didn't think it was safe to leave wet food out like that.
Click to expand...
It’s totally fine to leave it out for half a day. If you’re concerned, some of the auto feeders come with ice packs that go under the food. Or you can freeze some into ice cubes.
 
Last edited:
Update for any who are interested....
Spoke to Vet, she said she wants to monitor her another two weeks with the Libre on no insulin. She isn't worried about Ketones as long as she is staying under 200.
For the majority of the last few days though she has been under 150 with the Libre. Will continue to closley monitor.
I have seen major improvments in her overall appearance and behavior.
-Clearer Eyes
-Cleaning herself more
-She had a runny eye that isn't running as much
-Notice slight weightloss(as she is eating less then prior to dx)
-Less Drinking
-Less Urination
-Overall better demeaner
 
Carly E. said:
Update for any who are interested....
Spoke to Vet, she said she wants to monitor her another two weeks with the Libre on no insulin. She isn't worried about Ketones as long as she is staying under 200.
For the majority of the last few days though she has been under 150 with the Libre. Will continue to closley monitor.
I have seen major improvments in her overall appearance and behavior.
-Clearer Eyes
-Cleaning herself more
-She had a runny eye that isn't running as much
-Notice slight weightloss(as she is eating less then prior to dx)
-Less Drinking
-Less Urination
-Overall better demeaner
Click to expand...
Her numbers look better every day! I’m hopeful for you :cat:
 
Status
Not open for further replies.
Back
Top