? New to Lantus forum

[Really Riley (GA)]

When I started on the FDMB I posted on the main forum and had some good people answer with information to get me started. Since I'm using Lantus for Riley I moved to this forum. I thought the "go low and go slow" method would be best since he "bounces". I started around the middle of this month and thought I saw some progress until yesterday. I increased the dose from 1.75 to 2 units this morning after 5 days instead of waiting for one whole week to pass because of a 534 glucose reading. Riley had been on 2 units about a month ago and that was going well until he "bounced". I didn't know about bouncing then and the vet wanted me to increase to 3 units. That didn't go well either. Riley's glucose readings have been all over the place and mostly too high, but that's probably because I haven't been consistent (didn't have a plan, just vet advice). Could I have pushed him into insulin resistance? Thanks for any advice you can give, Cindy.

 

[Gill & George]

Hi there Cindy, and Welcome to L and LL.
This is going to be a very short reply, it's late for me and I have an early start in the morning, hopefully this will also bump up your post and you will get more hits.
Firstly, if you select edit threadtitle, tab at top right of your screen, then prefix the title with a ?? it will catch more folks attention and you will get more visits.

Good job getting the spreadsheet up and running, and good job getting those test in. With the data that you have at the moment on the spreadsheet it's impossible to say what is going on, he may not be getting enough insulin, or he may be getting too much.
ETA too much insulin can sometimes result in high numbers.

With Lantus, we need to try and figure out how low this dose is getting him in order to make dosing decisions. Ideally you would do this by getting a couple of midcycle tests every day, in both cycles, you could start with a +2 and a +5/+6, you can move the test times from day to day, that can help you determine when the typical onset and nadir is for Riley.
If you are unable to get midcycle tests because you are out at work during the day, maybe always try to get a before bed test in the evening and run a glucose curve once a week.


Looking at the spreadsheet I keep looking at that 189 and I wonder if he went lower earlier in the cycle?? It's possible that you may have missed a much lower number on that day, we have no way of knowing.

Could I have pushed him into insulin resistance?

It is possible, but not sure it's likely, we don't know where his numbers have been between shots, if his numbers are staying high and flat, yes he may have developed some glucose toxicity, but I wouldn't be surprised if he is actually dropping low (for him) midcycle and then bouncing back up by next shot time.

My advice to you before you change anything would be to start getting some midcycle data, a few tests spread out over the course of each cycle, will shed some light on to what Riley's BG is doing.

 

[tiffmaxee]

I agree that more tests are needed. Can you at least get one before you go to bed?

 

[Chubba (GA)]

I don't have any advice. Just wanted to welcome you.

 

[Really Riley (GA)]

Thanks to all of you for getting back to me. I was excited when I saw the 189 and really wish I knew what had come before. I was wondering if I should have stayed with the dose I was using rather than backing off. I couldn't have stayed up that night to test because I was exhausted. If testing at any time during the day will help, I will do that. I kept thinking that if I missed the +6 time or near to it, there would be no sense in testing because I would have missed Riley's lows. I will try to get some tests in at other times since I'm not home for the +6 test right now. I'm retired, but my daughter is in the hospital and I'm missing mid-day testing times while at the hospital. Hopefully she will be out soon and I can actually stay at home for one whole day and get a glucose curve. Of course, as luck will have it, the day I can do a curve will be the day after Riley bounces and all results will be consistently high!

 

[Really Riley (GA)]

Hi there Cindy, and Welcome to L and LL.
This is going to be a very short reply, it's late for me and I have an early start in the morning, hopefully this will also bump up your post and you will get more hits.
Firstly, if you select edit threadtitle, tab at top right of your screen, then prefix the title with a ?? it will catch more folks attention and you will get more visits.

Good job getting the spreadsheet up and running, and good job getting those test in. With the data that you have at the moment on the spreadsheet it's impossible to say what is going on, he may not be getting enough insulin, or he may be getting too much.
ETA too much insulin can sometimes result in high numbers.

With Lantus, we need to try and figure out how low this dose is getting him in order to make dosing decisions. Ideally you would do this by getting a couple of midcycle tests every day, in both cycles, you could start with a +2 and a +5/+6, you can move the test times from day to day, that can help you determine when the typical onset and nadir is for Riley.
If you are unable to get midcycle tests because you are out at work during the day, maybe always try to get a before bed test in the evening and run a glucose curve once a week.


Looking at the spreadsheet I keep looking at that 189 and I wonder if he went lower earlier in the cycle?? It's possible that you may have missed a much lower number on that day, we have no way of knowing.

It is possible, but not sure it's likely, we don't know where his numbers have been between shots, if his numbers are staying high and flat, yes he may have developed some glucose toxicity, but I wouldn't be surprised if he is actually dropping low (for him) midcycle and then bouncing back up by next shot time.

My advice to you before you change anything would be to start getting some midcycle data, a few tests spread out over the course of each cycle, will shed some light on to what Riley's BG is doing.

I'd already given his evening shot and had increased it to 2 units before I read this - probably another mistake that Riley will have to suffer for. He was really hungry through the night and is now up to 505. Should I hold the 2 units? I thought I might get some readings today, but it looks like I'm out the door in an hour and won't be able to get a reading until around 5 or 6 pm, which will be after Riley has endured a car ride back to my house (been staying at my daughter's).