Lantus & Levimir shots

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We are new - Advise needed! Lantus and Levemir do not need to be given with food, right? The nadir is the most important number? Now, dealing with DST & ST...can we go 13 hours when the clocks change in the fall? and skip a pm dose the night the clocks change in the spring when it would be 11 hours? Any better suggestions? :?
 
Lantus and Lev are not like the shorter acting types of insulin where you must feed before you shoot in order to offset the harsh onset of the insulin which can cause numbers to drop very quickly. However, we do suggest that you test, feed, and shoot all within a few minutes. You want to have some food on board. You will need to do a curve in order to have a better idea of when the Lantus onset is for your cat. It is less critical that all food is eaten so if your cat is a grazer, it's OK.

Actually, we will post instructions for transitioning over daylight savings time. Basically, the answer to your question is "no," don't make a full hour switch. Shifting a shot an hour earlier is like a dose increase and late shots act like a dose decrease. The maximum you should shift time is by 30 min. per day. Typically for DST/ST transitions, we move shot time by 15 min. per day so there is a negligible effect on numbers.
 
Hi Sally....the nadir is important for dosing amounts...but the preshots are also important in their own way. Once you start getting data for Mugsy, you will see how the curve is looking. What dose will you be starting with?

Maybe spend some time reading the starred stickies at the top of the page. In the one New to the Group...you will find information on Hypos and you might print that out. Also, b sure to have your Hypos kit all stocked and ready. Please come back and post any questions you might have right here in this thread.
 
Thanks Sienne and Pat...Yes, mine is a grazer but, Jake is on a schedule because he lives with four non-diabetic cats. I have read ALL the Stickies and pretty much everything else I could find here and elsewhere. I have copies of HYPOS, PROTOCOLS, CARE AND HANDLING, and I have two charts made up - my personal one is going back to the beginning (plus my daybook logs) and I have the FDMB SS for publishing which starts this coming Wednesday when I take him to the vet. Jake lives with a diabetic person so, other than relaying information it's up to them and our vet.
I will be looking for the posting about time changing. What I had been thinking was to let him go 13 hrs in the fall and when spring came skip the pm shot because it would only be 11 hours. You say no so...I won't.
PS: I'm having the vet check his weight before we set the Lantus dose.
 
I would think doing it at 12.50 & 11.50 hours during time changes would be ok.
Thats what I am planning on anyway.
 
There will be further posts as we get nearer to the day. We usually start low and go slow with the increases in dosing. Many of us have been successful starting at 1.0u and then working our way up according to the Protocol.
Were you on any insulin in the past? and are you now on anything else?
 
Pat I'm not the one on insulin - my friend's husband is. I've never dealt with this before which is why I'm "cramming". Unfortunately, my friend is not a computer user (it's her husband on his business's computer) so, I pass on what I learn (both ways). Just for the H... of it, :idea: I have contacted Lantus to see what they recommend. They have been good in the past about advising me. I'll pass on what they say. Darn the stubborn legislatures for giving us another problem to deal with!
 
Sally I'm so glad you asked about the time change. I hadn't even thought about that! Good to know to watch for coming instructions.
 
Sally, since Mugsy is currently on Vetsulin (right?), I would post with his current dose and some BG data, as well as his weight, to get advice about a starting dose. His current insulin dose should be taken into consideration when deciding on a starting dose. I see 5.0 units on his SS, is that correct?

When you get close to switching, just start a new thread with Switching insulin...starting dose? or something similar in the header.

Thanks for asking the time change question, I hadn't started thinking about it yet! I know it will take me at least 2 days to make the change, no more than 30 minutes per day...though if Tinkles is running low then, I will stretch it out more!
 
Laurie, I think I have it all in hand, now. Wednesday Mugsy will be weighed at the vet's when I have him tested and test the meter against the vet's reading. As for the time change I will use 8 am/pm in the winter months (nov-April) and 9 am/pm in the DST months (April-Nov). The weigh in will determine his current weight which may be lower than before so, I want to be sure. Meanwhile, I am waiting for a response from the Lantus manufacturer as to what they recommend. Thanks for your input. PS: his SS for online will begin with Wednesday's vet visit.
 
Sally and Mugsy said:
Laurie, I think I have it all in hand, now. Wednesday Mugsy will be weighed at the vet's when I have him tested and test the meter against the vet's reading. As for the time change I will use 8 am/pm in the winter months (nov-April) and 9 am/pm in the DST months (April-Nov). The weigh in will determine his current weight which may be lower than before so, I want to be sure. Meanwhile, I am waiting for a response from the Lantus manufacturer as to what they recommend. Thanks for your input. PS: his SS for online will begin with Wednesday's vet visit.
No much point checking your meter vs the Vet's reading, as they invariably test higher (I hear anything up to 100 higher) when at the vet's office, due to stress (aka "white coat syndrome"!). Also the cat's actual weight is not the right number to be used for determining the initial dose of Lantus, the cat's "Ideal weight" is what I understand should be usedto calculate the initial dose. Your cat's actual weight will be higher or lower in most cases than the "ideal weight" (which discounts being too fat or too thin).
You can ask Lantus of course but I'd just as soon go by the guidance of the folks here and the protocols, as to starting dose. (It's a very safe bet that the folks around here have more combined experience of using Lantus in cats than its makers do)...!
The protocol mentions starting at 0.25u BID/Kg (1 Kg - 2.2lbs) although even then, you'll probably hear advice here, to start at 1.0u, just in case...? There is no hurry here, as it has been proven over many cats and a lot of time, that it works better in the long run to use the "SLGS" (Start Low, Go Slow) approach - as we found out to our cost - we didnt know back then but our vet had raised the dosage by far too much, each time - and we were being far too impatient, expecting to see results more quickly.
HTH!
 
Thanks Perry...but, I'm still going to have him weighed because I think he's lost weight (he's pretty bony) even if he looks better than he did. He was a solid, slightly hefty cat at one time - about 16-18 pounds. Last weighing he was 11 pounds. As for starting dose, I've heard 1u to 5u. I'm going to re-read the FDMB Lantus protocol again. Just cross your fingers. Truthfully, if I knew of this site when he was diagnosed, he might never have been given insulin - just a change of diet. For all of you that read the charts posted, I have combined my charts and the one now online starts at the approximate onset through the present.
 
OK sounds good! I also, must be honest, wish that we had just started off with the diet change first too (we did both at once).
I now know also, through another mistake we (well actually, our vet!) made - that it's FAR FAR safer and wiser, to start off at too LOW a dose than to start too high / increase by too much - any wich way you look at it!
Good luck and as they say in Ireland, "SLGS" !!! (not not really I made that bit up)
 
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