Lantus is not working?

Hello! I just wanted some advice on Lantus, Truffles started Lantus about 2 months ago after our switch from vetsulin. We started at 1 unit which took her too low too quickly so we dialed back to about 0.25 units. It was keeping her very well controlled for the first month and it seemed like even a pinch was keeping her in the 120’s-200’s for most of the day. Now we are back to struggling to get her numbers below 300 again and I am starting to feel defeated, I have bumped her insulin to .50 units and then tonight I gave her a full unit to see where it would take her (I have gravy on standby just in case). It’s at the 5 hour mark after her PM shot and she is still in the high 200’s. At first I thought maybe the insulin was going bad so I got a new pen and that definitely was not the issue. The vet has told me before she thinks Truffles is a complicated diabetic and after an entire year of doing this I can see why. Has anyone else experienced this? Is this a normal thing to happen? At first I was scared to even give her a drop of Lantus because she responded so well to it and now I feel like I’m giving her so much and it’s doing nothing? Could this be another underlying problem such as infection, organs, teeth? I will be in contact with my vet and let her know what’s going on, Truffles also wears a libre monitor because she is still all over the place so the vet can also see her numbers at all times. I will attach a picture of my libre chart for reference. Thank you!

 

She also hits her lowest points it seems right before her shot which is very strange to me. Her shots are 11am and 11pm.

 

Hi Brooke,
I just looked back at your previous posts and I can see it was suggested you set up a spreadsheet and add data to it so we can see what is happening. Are you having rouble with setting up the SS? If so I can ask @Bandit's Mom to help you.
Without that data we can’t really help as we need to see numbers, not just an isolated graph from the libre.
I don’t agree with your vet that Truffles is a complicated diabetic cat. He just needs to be monitored closely and all the data recorded on a spreadsheet so we can see what is happening and to follow a dosing method closely. He is only on a small amount of insulin.
It takes time for a cat to get regulated on insulin and unless you can see exactly what is happening, chopping and changing the dose will not solve the problem.
My advice would be to get the SS set up and put in a couple of weeks data and then ask for dosing advice. We can definitely help you.

 

What do yo feed and when/how often do you feed?
Art what time do you shoot?
I myself prefer a real curve like you provided if the above info is added

My two diabetic curves have had rooler coster curves for years and seem to be do best on about 0.5 to 0.6 units of glargine. They do good for a short period of time then go either too high or too low. My other insulin dependent cat has acromegaly and is on a hgh dose bu I can maintain BG below 130.

Another concern is that can you test your cat's BG with a hand held meter to determine if the Libre readings are usable. I currently have a Libre 3 on my Wiggles. Yesterday before shot time I was getting low BG alarms I tested with a human hand held meter and the Libre was reading way low. I had 43 on Libre and 151 on human mer and I did other tests and received similar difference. I had siilar experience the day before that. At higher BGs the Libre BGs and meter test BGs are very close together.

 

I'm going to jump on the spreadsheet bandwagon. It helps me to see the bigger picture -- when you increased the dose, what the response was, whether nadir is typically a late nadir whether you're seeing normal variability, whether what you're seeing is a bounce, if you're not waiting for doses to stabilize, if you're increasing the doses in a timely way, etc. In other words, it's really hard to give you an informed answer to your question without data.