? kit. follow-up pre-shot question. going from prozinc to lantus

JOJI and Kit

JOJI and Kit

Very Active Member
hello,
we plan to switch kit to lantus tomorrow! and are looking for guidance.
a recommendation for her starting dose (vet recommended 1U) we are also wondering if we should use SLGS or TR.
  • kit is coming up on 6yr and has been on prozinc since she was diagnosed in december 2019
  • currently (06jun2020) at 4U prozinc bid
  • no history of ketones. we test urine.
  • history of bladder crystals and uti's
  • pretty stable weight at around 11lbs
  • all wet food diet 50/50 tiki/ff
  • doing well on the P's
  • we've been using the alphatrak2 and have just started using a human meter (relion prime)


tia, joji and jw aka beans
 
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Have you looked at the two methods used here with Lantus to see which one will work best for you? You test enough to do TR. When switching insulin there can be a strong reaction so most give a slightly lower dose. I’ll tag a few people to suggest what that should be but thinking 2.5 or 3.0. I’m not familiar with prozinc so see what others say. @Wendy&Neko @Sienne and Gabby (GA) @Marje and Gracie
 
tiffmaxee said:
When switching insulin there can be a strong reaction
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thanks for the help. doing this switch feels possibly more stressful than our first days/weeks after the original diagnosis.

w prozinc we were doing SLGS and when we decided to “upgrade” method we stopped seeing any low numbers, so the reductions didn’t apply. and bc kit has a history of high dives and big bounces, we never felt like 0.5U increases were a good option for her and used the slower 0.25U
 
Read the two methods with Lantus. We increase by .25 I just don’t like the under 90 as s reduction and prefer under 50. Max was a bouncer at first. For a year actually. Then he leveled out and was tightly controlled.
 
tiffmaxee said:
When switching insulin there can be a strong reaction so most give a slightly lower dose.
Click to expand...
No, that's only true when switching from Lantus to Levemir, or the other way round. With Prozinc to the L insulins, we take the current P dose into consideration. Given the numbers you are seeing on 4 units of Prozinc, I'd do the same with Lantus. I presume you have the U-100 syringes for Lantus. Seems an odd question, but you'd be surprised how many we catch that don't.

The main differences between the two methods here is how fast you can increase (faster with TR), when you take reductions (68 for the AT with TR, 90 with SLGS), and the amount you should test. With TR, you should get a minimum of 4 tests a day, the two preshots, somewhere in the day cycle and a before bed test at night. You can also increase with TR by 0.5 units if nadirs are all over 300, or if your total dose size gets over 5 units. You are also not locked into a dosing method, you can change from one to the other as it suits you. I always say pick the method that suits your goals and your life style.
 
Wendy&Neko said:
The main differences
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tiffmaxee said:
methods with Lantus
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this question is on how to handle potentially low pre-shots given our data is only for prozinc.
we don't know if the prozinc data makes us "data ready" or if we are starting over from that perspective.

on prozinc, we were using 150 measured w AT2 as our "stop and think number."
meaning 150 or greater, and we'd shoot full dose.
for a pre-shot below 150, we would stall up to an hour.
if not showing upward trend, we would reduce the dose for that shot. or not shoot when we had less experience.

one example of that was on
06apr2020 when PMPS was 106 after two, 20 min stalls. we shot 50% of the usual dose. i.e. from 2U to 1U
we've never seen a pre-shot lower than the one for that day.

do we need to redefine our "stop and think number" in this transition from prozinc to lantus?
if yes, does our prozinc data help us in deciding what to do?
any inputs around this much appreciated.

kit's day so far (07jun2020)
using AT2. AMPS 346, +2 315, +4 301, +6 264

thanks
 
JOJI and Kit said:
do we need to redefine our "stop and think number" in this transition from prozinc to lantus?
Click to expand...
You want to follow the guidelines provided in whichever method you are using; if you are using SLGS, take a look in the Stickys and it will give you instructions on your “stop and think” number. If you are doing TR, you might want to ask for help the first few times you shoot 150 or lower; follow the instructions in How to Handle Lower Pre-Shot Numbers. The first few times you get a 150 or below, you might want to stall without feeding and post for help until you get comfortable with the Lantus depot action.
 
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