Lantus numbers - what's going on? I have one more question

[Nancy&Pepper (GA)]

I recently switched from Novolin (NPH) to Lantus. My vet said don't test for two weeks after the switch, then start getting pre-shot numbers and mid-cycle numbers (6 hours after the shot). Today was the first day I tested again. On Novolin, his numbers were consistently Hi at pre-shot and in the 300's after 6 hours, despite increasing his dose to 5 units twice a day. He's now started over at 1 unit of Lantus twice a day. Yesterday was the first day I finally got all dry food out of his diet. This morning his pre-shot number was 356. I thought we were improving, but after 6 hours, the number was 327. What's up? It didn't really go down at all. Is the Lantus ineffective? It's only two weeks old, but I did inject the Lantus back into the vial once, before i knew not to do that. Did I feed him too much during the day? Is something else going on? i probably should have mentioned that he eats Fancy Feast Classics.

 

[Vicky & Gandalf (GA) & Murrlin]

Re: Lantus numbers - what's going on?

It's impossible to tell how well an insulin is working from only 2 BG tests. It's also unrealistic to expect vastly improved results after 2 weeks, especially given the dangerous advice from your veterinarian to not test during the first 2 weeks of switching to Lantus. Your cat could have had a low BG yesterday morning before you gave the shot, which could have resulted in the high and steady BGs you have seen since you began testing today.

You need a baseline of BGs on the 1U dose, which unfortunately you do not yet have even after 2 weeks using it already. You must test prior to every shot and get at least 1 midcycle test a day if not every 12 hour cycle. Lantus is dosed based on the lowest BG during a cycle and the lowest point does not magically happen at +6. Some cats don't have that point which is called peak or nadir, until 8, 9 or 10 hours after the shot. It will take testing at various times over several cycles to compile that kind of important data to determine an approximate nadir period for your cat.

I recommend visiting the Lantus Tight Regulation support group on the board and reading the stickies at the top to start and posting for help understanding how Lantus works. It is much different than NPH.

Good luck and thankfully you are home-testing, that is half the battle right there.

 

[Nancy&Pepper (GA)]

Re: Lantus numbers - what's going on?

Thank-you for your advice. I am starting to think that the people on this board know more about feline diabetes than most vets. I will certainly go to the Lantus board and read about Lantus. But if i did indeed give him a shot when his BG was low, resulting in high numbers, will his BG go back down? How will i know if that is the case?

 

[BJM]

Re: Lantus numbers - what's going on?

Its a process, not an event. You may need about 3 days to level out from a bounce (when the glucose goes low enough to trigger the liver and then generates a high).

Lantus requires you to be patient; as a depot insulin, it builds up in the system gradually. Once you determine the optimal dose, the glucose tends to have fewer sharp changes, although each cat is different (ECID).

 

[Nancy&Pepper (GA)]

Re: Lantus numbers - what's going on?

Thanks everyone. I'm learning alot from this board and I'm really thankful for all the people who take the time to help people like me and my cat.

 

[Nancy&Pepper (GA)]

Re: Lantus numbers - what's going on?

Ok, I still have a question. So, if I gave him a dose of 1 unit and it (hypothetically) lowered his BG too much and (hypothetically) triggered a bounce, and if I am still giving 1 unit twice a day because his BG is now high will his BG actually come down or will it stay elevated because the 1 unit is actually too much? How do I know?

 

[Ry & Scooter]

Re: Lantus numbers - what's going on? I have one more questi

It will likely stay elevated for at least a cycle (sometimes up to a few days) after the drop because of the hormones released by the cat's body. You may be able to catch the "bounce" happening if you test more mid-cycle, for example a big drop between the preshot and 2 hrs after the shot might signal that he's getting too much insulin.

Hopefully someone can get you set up with a spreadsheet so we can interpret the data you have. We are running in the dark right now because we don't know any numbers.