Help, "LO" only 2 hours after insulin. Dose advice for AM?

[Dyana]

It's now been 10 and 1/2 hours since you replied, so I am guessing you did not shoot 0.5 at +7 last night and did give him his regular dose of 1.5 at his normal AMPS time?
We do not recommend using Lantus like a bolus insulin at +7 because it is a depot insulin and if he received a shot at +7, then 5 hours later (at his usual +12) he would just be reaching the nadir from the last +7 dose. Does that make sense?
I hope he is feeling fine and eating well this morning. Please keep up with the daily ketone testing, and adding those tests to the Remarks section of your spreadsheet, could help us to feel a little more at ease.

 

[monty_dweezil (GA)]

Thank you! I actually did give him just about 0.4 units at 12.30am as I could see him finally rising (270) and his normal pattern is to go quite (too) high by his morning dose time.

It actually worked well! It stopped the rise but didn't drop him very much either. Just kept him steady in the yellows.

Then at 5.30am my partner saw he had gone up a little to 288 and she gave him only 1 unit, as I had told her that 0.4 would be a part of that dose overall and at some point it would be a total dose of 1.4 units with the overlap later.

I was worried at 10am when he was 106. I thought aw crap, he's going to go too low again because of me and I don't know what I'm doing. But then by noon, he was at 144 and has hovered around there most of the day.

Of course, now it's getting close to his normal next dose time (normal being 5pm-ish), and he's at 108 and slowly dropping. lol. So it will be another night of juggling and waiting.

How do you deal with a fur baby whose nadirs are at 12+ hours? Does having a late nadir automatically mean the dose is too high? Or does he just need a longer or sliding cycle? We ideally want a normal 12 hour cycle, but we simply can't do it with 12+ hour nadirs.

The delayed nadirs are only in the PM. Even if the same dose is given in the PM as the AM, at the regular 5pm time, the PM (overnight) nadir seems to be about 7-8 hours). Why might this be? Does he need more insulin overnight? I do the night dose...am I doing it less effectively?

We test every time we see him peeing and he has never had even a trace of ketones thank goodness (at home. Both times he had DKA he was not at home however). We use the keto-diastix to test for glucose too.