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[bagheerathediabeticcat]

Good morning, kind humans. It's been a long time since I talked to you. I wanted to let you know what's going on. The human has worked things out so that my dosing still fluctuates, but not much. He worked it out with the humans in white coats.

Here is how it works:
75-99 -- 4 units
100-150 -- 5.5 units
151- 250 -- 6 units
251+ -- 6.5 units

My blood sugar is not as low as I'd like, but we've been seeing seven day averages in the low to mid 200s.

The human thinks that my blood sugar is always going to remain a little higher than we like. Before I was diagnosed as a diabetic cat, the humans in white coats said they needed to run special tests in order to be sure I wasn't.

Well, it looks like I'll always be in that semi-diabetic state. But the human is okay with it, and I am the same playful and feisty cat that I've always been.

 

[BJM]

Would you please put the insulin in your signature? I couldn't tell if you were using Levemir, Lantus, ProZinc, or PZI.

Typically, we do not use a sliding scale with Levemir nor Lantus due to the effects of overlap. Shooting early acts like a dose increase; shooting later acts like a dose decrease.

 

[KPassa]

Welcome back! I've been wondering how you guys were doing. Mikey is now on Levemir, too! And we've seen much better results for him. :thumbup

BJ is right; with Levemir (and Lantus), sliding scales don't work too well because of the depot. This is why you've gotten some pretty low numbers (33 at PMPS! ). It seems the 6u is working out pretty well (hard to tell without any mid-cycle tests), so I would suggest dropping the 6.5u entirely off your sliding scale because every time you've given that for a few days, you have a HUGE drop into low numbers and without more tests, we don't know how often or how low Bagheera is really going. Then, Bagheera mostly likely bounces for the next couple of cycles (it can take up to 72 hours to clear a bounce) and you continue giving the 6.5u, thinking his numbers are too high and he bounces again. On the days when he's over 250, just have patience, keep giving 6u, and wait it out; he'll drop back to normal within a cycle or two vs. rebounding for several cycles.

FYI: the Levemir board doesn't see much activity these days. Most Levemir users post either in Lantus Land or the "Relaxed" Lantus forum (I'm now posting in Relaxed, as well).

 

[bagheerathediabeticcat]

Welcome back! I've been wondering how you guys were doing. Mikey is now on Levemir, too! And we've seen much better results for him. :thumbup

BJ is right; with Levemir (and Lantus), sliding scales don't work too well because of the depot. This is why you've gotten some pretty low numbers (33 at PMPS! ). It seems the 6u is working out pretty well (hard to tell without any mid-cycle tests), so I would suggest dropping the 6.5u entirely off your sliding scale because every time you've given that for a few days, you have a HUGE drop into low numbers and without more tests, we don't know how often or how low Bagheera is really going. Then, Bagheera mostly likely bounces for the next couple of cycles (it can take up to 72 hours to clear a bounce) and you continue giving the 6.5u, thinking his numbers are too high and he bounces again. On the days when he's over 250, just have patience, keep giving 6u, and wait it out; he'll drop back to normal within a cycle or two vs. rebounding for several cycles.

FYI: the Levemir board doesn't see much activity these days. Most Levemir users post either in Lantus Land or the "Relaxed" Lantus forum (I'm now posting in Relaxed, as well).

Well, the human and humans in white coats feel that since we really don't change the dosing much (only 1/2 unit among the most typical readings we see) it is okay. During the last week, we didn't see much fluctuation and my blood sugars stayed in the low to mid 200s. I will share them with you later.

 

[BJM]

We use the Roomp and Rand research study for tight regulation when using Lantus or Levemir, which have a buildup in the body. And when the nadirs are below 300 mg/dL, we adjust doses by 0.25 units due to the risks of hypoglycemia. Sometimes, folks even dose in drops.

 

[Sheila & Beau GA & Jeddie GA]

We can only do what we can do. Tight regulation is very time consuming and stressful for some people. I think others like the challenge.

Anyway, while I do think that consistency in dose amounts and times is best, it isn't always possible. And if you are on a budget testing all the time to pin point nadirs and to make sure "shooting low to stay low" is safe then I am all for using a bit of a sliding scale.

Cami is on 3.5u right now, but every once in a while she gives me a low 100 instead of mid 200 and I can't see shooting 3.5u on that so I reduce. And Beau is on a tiny dose of .4u with a host of health issues now, sometimes doesn't eat well, sometimes vomits up all his food and I just can't risk shooting his normal dose on a low PS. I either reduce or skip.

There was a time when I painstakingly dosed, tested, calculated, got up in the middle of the night, worried, worried, worried, but I just can't do that anymore with what I have on my plate. I am into year 8 now and yet when Beau recently had a "bad" night where he was restless, very unsteady (he is always unsteady from some neurological issue now), not eating, it took me two hours to realize I should test him and he was 49. I can't skate that fine line with him and I respect others who are in the same place.

Now, if someone wants "great" numbers, remission, etc., then they probably need to get things "tighter", but I don't think it is mandatory.

In this case I would agree with dropping the 6.5u dose to 6u or even 5.5u and seeing if that would hold things more steady and possibly eliminate the need to "slide" at all.