Question on Lantus, nadir or not nadir?

Julie and Honey

Julie and Honey

Member Since 2018
Saw this yesterday from a vet saying Lantus, because long acting and supposed to be more stable through the cycle, doesn’t really show typical nadir like shorter acting insulin’s that have a tendency to spike more? Thought that sounded good, but now am worried since people using Lantus are sounding like that has not been their experience? I am probably missing something, just trying to understand...

Curious to hear thoughts on this from the experienced users here, since I am still in the dark about a lot of this. Have seen people experiencing bounces and looking for nadir with Lantus, which seems to contraindicate info below?

http://veterinarycalendar.dvm360.com/diabetic-cat-proceedings

Excerpt from above link:

• Recheck the patient one week after starting insulin therapy. Perform blood glucose curve to determine nadir if using insulin other than Lantus. Adjust insulin based on these readings.
• Lantus is a peakless insulin. It is released at a relatively steady, constant rate with no pronounced peak. Blood glucose curves are not useful for cats on Lantus.
 
Absolutely not true. Just look at other spreadsheets. Max would nadir around +5-7. I would guide his curve with food. When well regulated he often had steady numbers.
 
Good to know and thank you! Starting to think people here know much more than the vets, sad I will have spent about $400 at vet in the last few weeks and have gotten better advice here and online. Was supposed to be $46 to recheck BG with a meter after it was higher than last visit. I walked out of there with a $300 bill and another $50 to show me how to fill syringe and give shot and will be another $50 next week to have them use their meter to check and my new meter (same one) to make sure mine is accurate and determine starting dose after I lowered her carbs for a week. Have not even gotten to the cost of the meter and the insulin.

I will have to try to figure out how you guys are using the spreadsheets too.
 
Hello and welcome! Gizmo was definitely not “peakless” on lantus. This group of people is extremely knowledgeable. If you need any help getting your spreadsheet up and running, just ask ... someone will help you. It is the best way for everyone here to help your kitty.
 
Ideally, a Lantus curve is flat. However, that's more the case when a cat is regulated rather than early in the process. And, some cat's don't always achieve good regulation.

It helps to keep in mind that most of us haven't a clue when our cat's pancreas stopped producing insulin. Thus, we don't know how long our cat's been diabetic. As you give insulin from an external source, your cat's body may respond in unexpected ways -- like with a bounce. This is all part of the process of your kitty beginning to return to being used to normal BG numbers again. The more your cat achieves improving regulation, the flatter the cycle will become.

It's not expected that after a few Lantus injections that the cycle will be "peakless."

I would not rely on getting accurate BG readings at the vet's office. The chances are that your kitty will experience vet stress and numbers will be higher there than at home.

 
Thank you. I have a meter, need to set it up and figure it out. Went and got 30 gauge lancets today to try on her ear, don't want to use the 28 gauges that came with the meter unless I have to. I am hoping if I rub her ears for a few days that may get the blood going there more and hoping the smaller lancet may work. She won't mind if I touch her ears, but once she figures out I am poking her, the next time she may go hide.
 
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