Minimum Blood Sugar Level For 12 Hour Injection

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Mark Godwin

Member Since 2023
Our cat is on 3 units of insulin, twice a day.

He has responded well to three months of treatment and is now very active and playful again.

We ear prick prior to injection and hold until blood sugar level is above 300.

Often this results in 14-16 hour intervals between injections (all times of the night and day)

Should we be injecting at a regular 12 hours interval at at a lower dosage?

What is the minimum blood sugar level to give him a full 3 unit dose at 12 hours (is the number less than 300)?

Thanks for your help and patience!

Mark
 
Thanks for the response.

He is on Insuline Glargine.

Do not recall exactly why the 300 - possibly because in his initial treatment that would be his reading after 12 hours and we were paranoid about creating a hypo episode. Early on we would get false critically low glucose alarms from a monitor he was wearing.

We are moving back to a set 12 hour interval this morning and will shoot if over 200. Also notifying the vet in case she has any concerns.

Thanks so much for your help and patience!!!

Mark
 
The Libre appears to be prone to false low alarms. Either way, glargine is dosed based on the lowest point the cat reaches during the cycle, not on the pre-shot number. Shooting every 12 hours, and running a curve once a week is going to be your best weapon in reaching the correct dose.

Eventually (not yet!), once you know how your cat responds to shooting a full dose at lower numbers, the aim with glargine is to "shoot low to stay low". It drops glucose less from lower numbers than it will from higher ones, and many in the Lantus and Levemir forum will shoot anything over 50 on a human meter (70 on a pet meter) so that their cat hangs out mostly in normal numbers all day.
 
Thanks so much for your response. The Libre was accurate in the mid-range, but varied significantly at lower readings. It would indicate less than 50 and an ear prick never showed less than 87. When that alarm would go off - sometimes in the middle of the night, we would panic.
 
I know that panic! Though I've never used the Libre. With my first diabetic, I would sometimes be so exhausted I'd set an alarm and sleep for a couple of hours. Once or twice, I switched the alarm off without ever waking up. Nothing quite like the pure terror of waking up in the morning and rushing to check to make sure my cat was still alive! It does get easier though - we fall into more of a routine and know when we need to worry and when we can relax a little more. You'll get there too - promise.
 
We have a huge amount of information available about using glargine including information on dosing methods. This is a link to the Lantus board. If you read through the sticky notes, you'll likely be overwhelmed the but the information is very helpful.

There are a couple of principles, in addition to what April noted that you may want to consider.
  • Glargine is a long-acting, gentle insulin. It begins to work (onset) about 2 hours after you give a shot.
  • The low point in the cycle (nadir) is theoretically around 6 hours after the injection. However, nadirs can and do vary. Some cats routinely have an early or late nadir.
  • Glargine is most effective if you're consistent. It's best to shoot every 12-hours. If you inject early, the early shot acts like a dose increase. If you shoot late, it acts like a dose reduction. If you need to adjust dose time to get back on schedule, you need to do so gradually.
  • Part of the issue is that glargine is a depot insulin. Every time you give a shot, the insulin forms microcrystals that are deposited in the fat tissue. There dissolve slowly over the course of the 12-hour cycle. However, not all of the insulin dissolves. A small amount remains and allows for overlap between the doses. This is why consistency with shot time is important.
With respect to a low pre-shot value, we generally recommend posting and asking for help if you're new to managing your cat's diabetes and the test value is in the 150 - 200 range. You have a couple of options. In all cases, do NOT feed your cat!
  • You can stall for 15 - 20. min and then re-test to see if numbers are rising. If blood glucose is still too low for you to comfortably shoot, repeat the process until you're at a point where you feel that you can shoot.
  • Shoot a reduced dose.
  • Skip the shot.
All of these options have an effect on the depot.
 
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