I THINK MY CAT NEEDS INSULIN...NEED HELP...

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Pallid

Member Since 2011
Hello,

I have 5.5 years old Siamese Cat. He got steroid shots ( depo medrol) since 6 months for his stomatitis. He got his last shot 3 weeks ago.
2 weeks ago i checked his blood sugar and it was 425. Vet doesnt want to use insulin, I changed the vet but he thinks same way. They want to wait because they think if he gets insulin once he will be addicted and it will be hard to leave. But I read forums says completely opposite things...
I really need you help. I checked his blood sugar for a week. Here is the results:

240-335-169-227-164-205-271-160-147-205-257-323-391-115-307-266-407-101- and today 123- 349- 400...

Do you think he needs to start Lantus? I live in another country and i changed 4 vets until now. I want to do right thing to my baby...


Thank You....
 
Re: I THINK MY CAT NEEDS LANTUS...

Hello Pallid,

Welcome to the best place to get the information you need! There will be more experienced people along soon who will be better able to answer your questions, but those certainly look like diabetic numbers. And insulin is not addicting. That much I do know.
 
Re: I THINK MY CAT NEEDS LANTUS...

Thank You so Much...
And I completely agree with you that insulin is not addicting and i read lots of stories about after using lantus the cats were cured completely.
But my vet still doesnt want to use it... So I will do it on my own with your help...
I am really sad at the moment because he got very high blood sugar :(
I want to do right thing for my baby.... I really need your experiences...

Thank You,
 
Re: I THINK MY CAT NEEDS LANTUS...

We'll do everything we can to help you help your baby.

My Lantus is currently being shipped to me from Turkey! It's strange that cansulin is the insulin of choice when Lantus is made there.

Hugs
 
Re: I THINK MY CAT NEEDS LANTUS...

Hi and Welcome to LantusLand! :YMHUG:

There is so much experience here, really a lot more than most vets have because we are living with FD 24/7.

What will really help here is getting the spread sheet set up so we can look at Shanga's BG numbers in the same format that is common here. This is the link to the Tech Forum where you just follow the steps to set up your spread sheet.

The way is numbers are changing so rapidly it is really necessary to know when the tests were taken and how long after he had eaten for each.

When you start lantus it is very important to test when he has had no food for at least 2 hours before giving the shot. this lets you know that his BG is not too low to safely give the insulin. It is not used for determining dose, however! That is based on the lowest point in the cycle, but we are way early to be discussing that. There are a lot of informational permanent posts at the top of the Lantus forum. Please spend time to read them, Lantus works differently than more traditional insulins and a lot of vets are not up to date on it's use.

If you are having trouble getting good low carb food in Turkey, home made is a great way to go. This site has more recipies http://www.catnutrition.org/ If you are really concerned about raw food there are cooked versions available too. Read this (sorry more reading to do) this page about halfway down on safety of raw for cats. If you are really concerned about raw food there are cooked versions available too. Also, Dr. Pierson's recipe isn't totally raw, the meat is seared in the oven to kill surface bacteria that might be on it from handling. Then it is is important to finish the food under extremely clean conditions.

Some of our most experienced members should be on soon, with more specific advice about the dose. In the meantime, read! :-D :roll: :lol: Things will get better.
 
Re: I THINK MY CAT NEEDS LANTUS...

One very basic question - can you purchase Lantus without a prescription? If you need to get a prescription from your vet, this could be a problem since your vet doesn't seem to be terribly well informed about feline diabetes. If you are able to purchace Lantus and syringes (U100 syringes that are preferably marked in half unit increments) I would encourage you to read the starred sticky notes at the top of the Board. If you need a prescription and your vet is continuing to be a problem, do you know of an MD who could write a prescription for you?

As others here and on Health have noted, there are any number of cats who develop diabetes as a result of steroids. If Shanga's BG levels aren't resolving and you've got your cat on a low carb diet, then it may be time for insulin. It may not be a matter of long term use so given that you are home testing, you will know what effect insulin is having.

I've also never heard of a FORL being treated with steroids. The method used in the US is to have the tooth extracted. The dental problem can be painful and pain can also elevate BG levels.

By any chance, did Sue & Oliver get you connected with Isil? She's also in Turkey.
 
Re: I THINK MY CAT NEEDS LANTUS...

hello and welcome to the group!

we have another member who lives in turkey. her name is isil and her kitty's name is tifil: tifil&isil.
you might want to send isil a Private Message. she may be able to help you with food choices and sources for supplies in your country.

here's a link to isil's first thread in this group: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=45776. it may be helpful to you.

the numbers you've posted are diabetic numbers. if it were me, i would want to start insulin.

please post any questions you may have. we'll do our best to help...



edited to add:
here's a link to an article recently published by the Winn feline Foundation regarding the treatment of Stomatitis: http://winnfelinehealth.blogspot.com/2011/10/treatment-of-feline-stomatitis.html.
 
Re: I THINK MY CAT NEEDS LANTUS...

First I need to thank you all... I really feel so down... Thank You being there for me. It means alot...
Shanga has wounds behind the teeth. Four vets checked his mouth and all said it was because low immune system of him. I started to use interferon since 3 weeks and his mouth is so much better now. He has no bad breathe, not sticky saliva, and less redish wounds...
I couldnt find a dental specialist here, actually I couldnt find a right vet for him. Because Shanga didnt get better in time...( He just got better after using interferon, steroids just made his situation worse) Now he has high blood sugar... Vet made a blood test last week and the results were unbelievable.... Eveything messed up. His liver enzymes need to be under 100 but he got 1008. Steroids side effects.
I read forums and I see If I start insulin early that can be cured completely. But sadly vets here thinks completely opposite. If I start to insulin once on my cat he will have to use it forever. Thats why they are waiting for a miracle. ohmygod_smile
I just want to do best thing for him. I can find Lantus tomorrow. If you all say me to use Lantus on Shanga I will do it. Because I know everyone here is experienced very well about feline diabetes. I really need help. He really needs help....
I can not sleep, my heart is hurting, i feel like i dont do my best for my baby,feel like I miss something... I keep blaming myself every sec to let vets to give him steroids... I dont know I am just so sorry....

Thank you
 
Re: I THINK MY CAT NEEDS LANTUS...

Hello Pallid and welcome!
You have come to the right place.

Don't be too hard on yourself. When my kitty was diagnosed I didn't even know a cat could have diabetes.
So many vets know very little about felline diabetes. I took my Black Kitty (BK) to 3 different vets before I found one that was at least agreeable with the protocol we use here.

My BK is FIV+ (low/compromised immune system) and had gingivitiis (infection of the gums) and many bad teeth. He experienced DKA (diabetic keto acidosis) twice, and also had IAA (extreme insulin resistance) and messed up liver values. He was at deaths door. The "final solution" was suggested by several vets on more that one occasion. I did not listen to them and with the help and support of the people here he not only survived, he thrived.

This Sunday, we will celebrate 2 years with no insulin.

It was a long journey for us, 21 months. After taking care of the DKA and the liver issues, we took care of his mouth. He had 2 dental procedures - December 2008 and May 2009. During the December 2008 denntal he had 8 extractions. Gingivitis flared up again in May andn after a thorough cleaning of his remaining teeth, his need for insulin became less and less. If you look at his spreadsheet (link is below in signature) you can see the effects of the dental procedures.

Every cat is different (ECID) and not every cat is able to heal enough to no longer need insulin. Right now Shanga needs insulin to bring his blood sugar to a normal range, for the sake of his overall health. If it is for a month, a year or forever does not matter.

Keep looking for an agreeable vet, and one that has experience with dental cleanings and extractions. And keep in touch with us here.
It will get better.
 
Re: I THINK MY CAT NEEDS LANTUS...

WElcome to lantus land--I feel your pain & know how upset you are--We also get lantus from Turkey via a Canadian Pharmacy.. As Sienne & Jill have told you, several cats have developed diabetes from steroids.
But please understand, this can be helped, your kitty can be well again. It seems overwhelming, but we will help you get started & see you through..
Almost 200 cats here have gone off insulin since 2008, so it is not addicting in the general sense, but they need it to control their blood sugar--The vets there didnt really help you much with the FD--
Please get in touch with ISIL, it is always good to have someone near you who can help & perhaps knows of a good vet..Keep asking questions and posting-OK? We are here--
BTW--What is the time difference in Turkey & the US?
 
Re: I THINK MY CAT NEEDS LANTUS...

Hi Sandy and Black Kitty
Thank you for your support... I am so happy for you and your kittie that He is doing great now. :) I hope my shanga will be ok too :)
Actually , Thankfully he eats well, plays with me,it seems like nothings wrong with him but the test results say so different.
I want to use lantus on him but my vet doesnt want to use it. I called her today and told about the results, she was still telling me to give him pill.
I am so tired to hear this. When I learned about the dose from someone here I will start to use Lantus. But noone tells me about doses...
I already changed 4 vets and nothing changed. I found one but he is so far away from me ... I dont know if it would work that way. Because I wont be able to take shanga there when I need it. Maybe I can bring shanga there just for dental treatment....
When I read your succesful stories I feel so much better and feeling happy :) Kiss your kittie for me pls... He is the hero.... :)

Helllo Roni and Moonie

Thank you so much to be there for shanga :) It means a lot...
The problem is here I want to start to use insulin ASAP but my vet doesnt want to use it ... She thinks if he takes it once he will have to use it forever...But I know thats wrong and I want to start it before its too late.... Im gonna send an email to Isil but I think she was not around lately...Hope I can hear from her soon.
I am researching for a good vet and almost talked with 50 vets in a month...Just today I talked with 10 vets... They all talk different...
I've already wasted TIME and a lot of money because of vets here... I just want to do right thing for my baby boy and believe that Insulin is the best for him for now. I just need to learn about doses...


Thank you so much

And It's 01.51 am here :)
 
If one of the vets you've spoken to reads English, perhaps this article from one of the top veterinary journals will make an impression.



The article contains the dosing strategy we use here.

Once you know you can get Lantus, we're more than happy to help you with dosing. You'll need insulin and U100, 3/10cc syringes, preferably with half unit markings.
 

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Welcome to the forum, Pallid! We are definitely here to help you with Shanga (what a lovely name for your kitty, by the way. :-D )

One question comes to mind... What food are you feeding Shanga at this time? If it's a dry food, then you'll need to switch her to a wet food diet. Some of us feed Fancy Feast, some of us feed Evo (I have my cat, Blackie, on Evo 95% Chicken and Turkey, which I have shipped directly to me most of the time), others feed a raw meat diet, where others feed other types of food for their kitties.

Diet is also another way to help get Shanga better regulated. Are you able to get any of those mentioned above in your area?

My vet is all for insulin injections. They weren't sure about the Lantus, though, and she was reluctant to even have my cat try it. However, I did it on my own, too. Now, my vet asks about Blackie, and I tell her.
 
Hellooo,

I feed Shanga with Fancy Feast Classic. Vet told me to give hill's w/d but i dont do it anymore. I know low carb wet food is so much better for my baby.Vet doesn't agree with me though.
Shanga's blood sugar is really weird. In the mornings its between 100-120 but in the afternoon it can be 200- 370... at the night time it changes...130-350...
I want to ask something... Howmany box fancy feast do i need to give him? He is 11lbs.
And thank You for the article Sienne and Gabby. :) I've just started to read :)
Btw Shanga's blood sugar was 154 this morning... Wish me luck for the afternoon results...
 
Hi Pallid,

Welcome to lantus land. I am so glad that you have found this site so you can help Shanga. Congratulations on taking his health in your control and home testing.

A friend of mine has a cat that need insulin because of a steroid shot and he is now off of it. I helped her with the knowledge I learned from here. I know it is a possibility for Shanga too.

As others have said I would set up a spread sheet. Also if he isn't already change Shanga to low carb wet food and then keep testing. His #'s should go down once he is on low carb diet so you have to test. He may be able to be diet controlled. But if he needs insulin your in good hands here. The problem is just can you get insulin where you live without a prescription? Sorry if I missed that in your post.

I wish you and Shanga luck and hope your baby feels better.

Keep in touch and let us know how things are going.
 
Hi Jan and Sara
First Thank You so much:) I feel so much better when I hear from all of you...
I changed his food from Hills w/d to fancy feast canned food. ( My vet doesnt agree with me though)
His blood sugar changes a lot... Example yesterday morning it was 123 in the afternoon it was 349 and at the night time 400.
and this morning 154. and sometimes it goes well all day long. My vet doesnt want to start insulin yet. But I want to do right thing before its too late.
And yes I can find Lantus but I dont know How to use...

I really need to thank you everyone here... :smile:
 
If you've not already done so, please read the starred, sticky notes at the top of the Board. They will provide you with the basics for how to use Lantus, links to setting up a spreadsheet, guidelines for posting, etc. An outline of the contents is as follows:
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot/shed: This is an important concept for understanding how Lantus works.
  • Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.

With regard to how much to feed, this is based on what your cat should weigh. Lisa Pierson, DVM has an excellent website on feline nutrition. (This is actually a website you might want to share with your vet since it is written by a vet who has expertise on diet and nutrition. Dr. Lisa is a BIG fan of low carb!) She provides a formula for calculating the number of calories per day that a cat will need:
Required calories per day = [13.6 X optimal lean body weight in pounds] + 70​
She notes that this is a "generous" formula, but it will give you a place to start. If the Fancy Feast cans don't have the calories on them, the calorie counts should be on the Fancy Feast website.
 
Morning, Pallid :)

First of all, would you mind starting a new thread (also known as a "condo") each morning so that those with more experienced eyes can find you quickly? You can type in the subject line: "10/22 Shanga AMPS (insert his morning preshot number here). It's commonplace around here, and like I said, it helps those with more experience get to you quickly and more easily. For example, I've started a new condo that reads in the subject line: "10/22 Blackie AMPS 107". When I do another test this evening, I'll change the subject line to read: "10/22 Blackie PMPS (and whatever her number will be at the time). I hope that it makes sense. This is done on a daily basis.

As far as feeding the amount is concerned, here's a formula that we use.

13.6 x 11 (Shanga's weight) + 70 = 219.6 calories (or 220 rounded up)

The 13.6.. I'm not sure what that number means, but the 11 is your cat's weight. The 70 at the end, again, I'm not sure what that means. However... The 219.6 (or 220 rounded up), means the amount of calories that you need to feed your cat on a daily basis to maintain his weight. What flavor of Fancy Feast are you feeding? IF you're feeding Fancy Feast Turkey & Giblet flavor, then he'll need 7 cans of food on a daily basis.

Here's the formula for figuring out the amount of food:

220 divided by 32.3 (the amount of calories per ounce of the Fancy Feast Turkey & Giblet flavor) = 6.8 (or 7 cans rounded up).

Each Fancy Feast can has 3 ounces. Each flavor has a different amount of calories.

You're doing a great thing by feeding him the Fancy Feast. That's what I did, too as my vet wanted me to feed Blackie the W/D formula. Unfortunately, it took a incident for me to change her food from the W/D to the Fancy Feast. I'm glad that I did. You're doing very well with Shanga, and with the help of this forum, you'll be much more confident. Remember, we ALL started where you're at right now. It takes a lot of time, patience, and a whole lot of practice to get where we are. You, too, will get there. :smile:
 
Yes, Sienne gave you an excellent source for the food, too. :smile: Here are 2 links with the food calories, etc., on them:

http://binkyspage.tripod.com/CanFoodNew.html

http://binkyspage.tripod.com/CanFoodOld.html

You can use these, and print them out if need be, to help you with choosing a food for Shanga. Plenty of people on here choose to feed their kitties a low carbohydrate food. Others, like myself, choose to feed a food that has no carbohydrates in it at all. Every cat is different (also known as ECID). :smile:
 
Hi, Angela & Blackie & 8 Others
Thank You so much...
I am just trying to understand How that spreadsheet works and trying to understand codes like 10/22 or something. I am a newbie :)
I feed shanga with fancy feast classic beef&chicken feast. It's calorie is 95.3. I was giving 2-3 can in the day.
In the morning, early afternoon, afternoon, evening and night... I dont know If I am doing it right way though.
I will check his blood sugar in a few min again. Some friends says dont give him insulin if his blood sugar is under 200. But It changes.
This morning it was 154 and I am gonna tell the new result in a couple of min...

Thanks :)
 
Pallid,

10/22 is the date. So Shanga daily condo would say:

The present date, [10/22] and than the AMBG [morning blood glucose reading] So the subject line would read:

10/22 Shanga AMBG 154

If you post in the Tech Forum somebody should be able to help you set up a spread sheet.

Hope this helps.
 
Sorry -- but Angela's calculations are off.

FF Turkey & Giblets is approximately 100 calories per 3 oz. can. For a cat that weighs 11 lbs, approx. 220 calories per day are required to maintain the current weight. This would be roughly 2 cans of this flavor of FF -- not 7 cans. (7 cans would be approximately 700 calories. Unless you want Shanga to balloon up into the size of a tiger cub, 7 cans is way too much food!)


We use a slightly different method of writing out the date in the US vs. in many other places in the world (we use day/month/year vs. month/day/year). You can note the date in whatever way is convenient for you -- we'll all figure it out. AM or PMPS is the AM or PM Pre-Shot. U = units of insulin. We list time based on the numbers of hours from the time that you gave your insulin injection. People are in different time zones so if you talk about what time it is in Turkey, it doesn't tell us what time it is in relationship to when you gave your shot. Instead we refer to time as +2 -- or 2 hours after your shot time (or +8 being 8 hours after you shot, etc.). When you see numbers in the subject lines on the Board, you'll see something like:
10/22 Gabby AMPS~243, +2~223​
This is today's date, the cat's name, her morning pre-shot test result, and her test result 2 hours after shot time.
 
Hello!

If you take a look at this forum and you see each kitty has 1 thread each day. We call the thread their "condo".
The title of the thread corresponds to the date and the cat and provides information on blood glucose (BG).
Lantus is injected 2 times per day - once every 12 hours.The way we track BG numbers is by the shot time and the hours that pass in between.
The morning "pre-shot" number (number before you give the injection) we call AMPS; 12 hours later is the PMPS. We measure the hours in between as follows:
+1 = 1 hour after shot
+2 = 2 hours after shot
+3 = 3 hours after shot. . .etc.
In this way it doesn't matter which time zone you are in - we have this method as a common language.

This is the way we track the BG numbers on the spreadsheet as well. To see an example of a spreadsheet, click on the link in my "signature" below for BKs Spreadsheet (ss).

Keep in mind that food will influence BG numbers.

You will need to decide on a shooting (injection) schedule that works for you so you can consistently shoot every 12 hours. Consistency is very very important, both with timing and dose.
It is best that your kitty does not eat within 2 hours of the shot times so that the PS numbers are not artificially elevated due to food.

Try and get Shangas ss set up quickly, and place whatever numbers you have on it according to the method I've described above.
That will give us a better picture of Shangas BGs during the course of the day and over time in general.
This will help us to best help you and Shanga.
 
Thank You all Guys

All helped a lot :) I have just 2 more questions... I know I am asking a lot.... ohmygod_smile

1- I talked to pharmacy and I was going to buy but I am confused... He offered me to buy Lantus Solo Star... but I read forums vial work better... Any suggestion?

2- Ok I will give him 2 shots everyday. But he has normal blood sugar in the evenings mostly. Between 100- 150... So what will I do???

Thank You So Much
I feel so happy at the moment that I can understand things better :)
 
Ask any questions you have - someone will have the answer. We all had many many questions in the beginning.

Before you start Shnga on insulin, we need to see the data (numbers you have since you have been testing him).
Get Shangas ss set up so that we can best help you.
Lantus dosing can't be determined by only one number.
Instruction are here - How to set up your ss Let us know if you have difficulty setting it up.
Someone will be able to help you.

For insulin, I believe the solostar pen is the best value - however wait for someone else to confirm that (when my BK was on insulin the choices were different).
 
Pallid said:
1- I talked to pharmacy and I was going to buy but I am confused... He offered me to buy Lantus Solo Star... but I read forums vial work better... Any suggestion?

The Lantus SoloStar looks like a fat ink pen - the cartridge is one single big barrel full of Lantus. It also comes in a set of 5 smaller cartridges which is what many of us prefer. With the smaller pen cartridges, the other cartridges can be stored and not shaken or handled a lot. I am just finishing my SoloStar pen and have the 5 cartridges ordered.

Here is a picture of the SoloStar pen:
http://www.lantus.com/solostar-insulin-pen/solostar-insulin-pen.aspx

I can't find a picture of the 5 cartridge set yet but I will keep looking.
 
Hi pallid - and welcome! glad you're here. we'll all help you.

the solostar pen would work great. before you use it the first time, read through this and watch the video on how to draw up the insulin into the syringe. you want to take care of it properly so it lasts you a long time.

if i were you i would

1. buy the solostar insulin pen (don't buy the pen needles with it, you're going to use insulin syringes/needles instead)
2. buy a box of insulin syringes u-100 - that have 1/2 unit markings if possible.
3. pick a time of day that you can give shots 12 hours apart. for example, 6am/6pm or 7am/7pm. keeping the shots 12 hours apart helps the lantus work best.

fancy feast classics are good. punkin weighs just under 14 pounds and i give him 3 cans a day.

the way Lantus works is that we figure out a dose that can be given the same morning and evening. it's important that the dose not change from dose to dose. we will help you day by day - even shot by shot. so get the lantus pen and the syringes. it sounds like you have a meter (what kind do you have?) and strips. always have extras so if you need to test often because of low numbers you have the supplies you need. i keep 50 extra lancets and strips available at home.

do you have a hypo kit set up? when we inject insulin there is always the chance that the cat's blood sugar will drop lower than is safe - we give high carb food and/or karo syrup (or honey, or any form of liquid sugar) to pull the blood sugar back up into safe numbers. you need to have a few cans of high carb food (any canned cat food with gravy will work) ready in case you need it. that's very important.

you can't ask too much. we've all been in your shoes and we understand. the more you ask, the better you will understand and the more you'll be able to help Shanga. that's what we're all here for.
 
Hello,
Thank you guys, I don't know How I would handle this if your support weren't there...
I am adding Shanga's Data now.
This morning before I fed him his blood sugar was 425 :(... I am gonna check again an hour later....
I feel so much better with you... Thank You so much :)
 
I've just checked shanga's blood sugar 2 hours after i fed him. It is 114 now.
I've realized something... In the morning if he didnt eat something its mostly high. But after I fed him his blood sugar is turning to normal.
He ate his last food at 02.00 am last night and after 7 hours Ive checked his blood sugar,It was 425. But now 114.
So what do you think about it?

Thank You,
 
hello Pallid,

Thanks for getting the ss set up - good job!

Interesting about the BG going down after a meal. I believe that is an indication that his pancreas are producing some insulin in response to the food.. that's a good sign.

Do you feed him on a regular schedule? I think that several small meals throughout the day will help him very much.
Many, if not most of us feed our kitties many small meals, it places less demand on the pancreas and helps the BG remain more even.

My BK is 11.6 lbs and eats 2 -3oz cans of FF (fancy feast) each day as follows:

AM - 1/2 can
+4 - 1/4 can
+8 - 1/4 can
PM - 1/2 can
+4 - 1/4 can
+8 - 1/4 can

I feed him the AM and PM meals myself (when he was on insulin these were the meals I gave at shot time). the small 'mini-meals" in between are fed to him by an automatic programmable timed feeder.

I have another favor to ask of you - please start opening a fresh condo (thread) each day for Shanga . Since you have not yet started insulin , instead of AMPS, use AMBG and followed by the number.
This way your daily information and questions will not get lost in all the traffic here

So for today your header will be
10/23 Shanga AMBG - 425, +2/114
 
Dear Sandy and Black Kitty,

Thank you so so so much for advices. I feed Shanga 4 Times a day. I think I will change this as you said... But i will need automatic programmable timed feeder.
I was thinking samething, his pancreas is producing some insulin in response to the food. Thats why I am confused about using insulin. It happened 114 today without insulin what if I would give insulin , he would have Hypoglycemia???
I dont know what to do anymore :(
I am just so sad when I see he has high blood sugar... Vet still says dont use insulin but I read on the forum that starting insulin early can save him from life time tratment of diabetes... So I really need advices about it ...
Thank You ,
 
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