? Start Low, Go slow

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Red'sMomHeather

Red'sMomHeather

Member Since 2015
I'm going to be switching from Caninsulin to Levemir. I'm going over information to know, including the SLGS pin on here. I see that it says the reference numbers are when used with a human meter, but I also believe I've seen something that describes which numbers to use if you have a pet-specific meter. Does anyone know where I can find those numbers? I have an accu-chek meter.

I'm also wondering if I should start at 0.5 U? Red's been on 11 U caninsulin 2x/day so that seems way too low...
 
They are in my signature link Glucometer Notes.

You might start with about 70% of the Caninsulin dose. Levemir works very differently than Caninsulin - longer to onset, later to wear off, gentle in drop, and the effects build up over 5-7 days on the first dose level, so no adjustments unless he goes too low! (below 90 mg/dL on a human glucometer)
 
@BJM Can you explain this to me? It looks as though this is saying if I get these numbers pre-shot that "beginners" would skip the dose...

"200 mg/dL (11.1 mmol/L) 286-333 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe"
 
That is correct. If you are just starting out testing your cat and giving insulin or switching to a new insulin, so have no data to show it would be safe and you get numbers at or below those listed, you can do the following
1) skip
2) stall 30 minutes and re-test to see if the number has risen over the limit or, is rising and you'll be available to monitor, and then shoot.

The risk of shooting when you don't know how low the cat will go is that the cat could have a hypoglycemic episode. While a slight over dose may be manageable with Karo syrup and high carb food, we'd rather you didn't get dumped into that right away and had some confidence that you know how your cat responds to the insulin you are using.

And speaking of overdose, here's How to Treat a Hypo.
 
When Red was first diagnosed and at 6+ reading at 3-5 (so, I believe, 54-90 US #s?) and the vet was still having me give him the insulin he ended up going hypo at 4 in the morning. Worst night of my life so I'm versed on dealing with that, unfortunately (or fortunately since he's OK and now I know...)

Anyway, started the levemir. Got a great AMPS # after the first full day but then his numbers went back up. I believe, regardless,I should hold this dose for a week before making any increases?
 
For Levemir, generally, you hold the same dose for a minimum 5-7 days starting out and a minimum of 3-5 days for each dose change afterwards - longer for the SLGS method.
Dose changes are based on the nadir, the lowest glucose post-shot. With Levemir, this can be as late as the next pre-shot.

There's a phenomenon we call New Dose Wonkiness where a dose increase results in paradoxically increased glucose levels for a period.
 
I've been making increases of 0.5 units per shot and holding for 3-4 days. His numbers do seem to be going down little by little. Hope I'm doing this right. :)
 
My phone isn't letting me scroll your spreadsheet, so let me ask - what kind of mid-cycle test levels have you been getting with the Levemir?
If you're below 200 mg/dL, its definitely progress.
Posting in the Lantus/Levemir forum will get you more feedback.
 
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