Starting dose

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nepenthe

nepenthe

Member Since 2010
I am going to switch to Levemir from Lantus to see if there is more stability and less bouncing.

Currently his dose is typically 1.5 - 1.75U, and the Levemir sticky says to start at 1U.

Is it recommended to start at 1U even for cats that have been on other insulins (eg, a cat that might get a dose of 2U Lantus?)

Is Levemir really about 70% the strength of Lantus in your experience?
 
I believe that when you are switching depot insulins, you want to take the previous insulin dose into account. I think taking 70% of the current Lantus dose as a starting dose for the Levemir is to make sure there is some leeway to adjust, since cats may respond differently to different insulins. For example, Levemir binds to the albumin in blood and is slowly released. If a cat's albumin is low, that will affect how it works. Plus, Levemir lasts a tad longer than Lantus, so the overlap is longer. You'll tend to have a later nadir on the Levemir, too.
 
I have seen many cats respond to lev with some deep drops in the first three cycles. I would not suggest starting higher than 1u. BTW 70% of 1.5u is 1.05u so you are right there. Also, I would make the change on Sat morning or some day when you are going to be around to monitor for the day and night and maybe the next day too, just in case.
 
Sheila & Beau & Jeddie (GA) said:
I have seen many cats respond to lev with some deep drops in the first three cycles. I would not suggest starting higher than 1u. BTW 70% of 1.5u is 1.05u so you are right there. Also, I would make the change on Sat morning or some day when you are going to be around to monitor for the day and night and maybe the next day too, just in case.
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Thanks - I just gave him his first 1U to start him off.. On Lantus, there were some months that he would be stable and well regulated for a month or so and then he would start bouncing higher, typically with higher pre-shot values around 300.. I am not 100% sure of what the cause is, and am thinking its either, 1) related to his response to Lantus, 2) something wrong with the dosage, or 3) his chronic pancreatitis recurring a low level, but with just enough inflammation to affect his BG values..

I think that starting him off on 1U is a good reset, in any event.

*the hardest thing for me, and something I've been failing at: testing in the middle of the night. I have a sleep issue and need to take something for that, and am usually dead asleep overnight. I've been watching it with the testing too, because the cost of these Alpha-Trak strips is a killer.
 
The cost for AlphaTrak & supplies is the reason most of us have used much less expensive human meters and the respective glucose ranges.
 
BJM said:
The cost for AlphaTrak & supplies is the reason most of us have used much less expensive human meters and the respective glucose ranges.
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big problem I noticed with this is that the difference in range seems to be logarithmic, so a 2.7 on the AT might be 4.5 on a human, and a 8.3 on AT might be 11 on a human.. So the bigger the numbers, the broader the range. This would be ok, but there is a wide discrepancy between meters I've found, and the human meter I was using before was way off at higher #'s. A 15mmol (272) was 19mmol (342) on the AT.
 
Accuracy isn't really important at the high numbers. Anything over 300 is HI, and the specific number doesn't matter. You take corrective action by adjusting your insulin dose according to its protocol.

The FDA allow meters to be within +/- 20% of what a lab test would get. The range becomes wider as the glucose increases, hence the wider discrepancy you observed at higher numbers.
200 -> 160 - 240, range of 80 mg/dL
400 -> 320 - 480, range of 160 mg/dL

At lower numbers, there is about a 30 mg/dL difference and the reference numbers for the 2 meter types reflect this.
 
I am on my 3rd diabetic over 6 years of testing and can count the times I have tested overnight on my hands - well maybe my hands and one foot, lol! I just can't do it either, but when I knew very low numbers were possible I somehow managed to do it.

As for meters, I have used 3 kinds, all the cheapest I could buy (without shopping at Wmart). I have used a Contour for the past almost 4 years. Meters show trends. They don't need to show absolute accuracy. I have read here so many times, "Does a 20% difference in numbers higher or lower change the treatment protocol?" I honestly don't think it does. If you changed meters you probably would have to learn a new correlation of numbers to doses - NOT that the dosing would change but your brain would have learn his new ranges for a typical day: PSs, nadir, bounce, etc. The meter is just a tool to give feedback on the dosing. I pay much more attention to a 39 than a 425 anyway and there is less discrepancy in the lower numbers.
 
The topic of the strips cost for the AT came up recently on the Acro FB- I'll put here what I put down there-

I used the Relion Micro (sorry Sheila but I order the strips from ADW if that makes you feel better) with an average of 5 tests a day, 7 days a week, 4 weeks a month with a savings of $239 over the using the AT at the test same rate. For a 3/day testing the savings were $143 a month.

I never used the AT- never knew there was even a pet specific meter until after I started reading the posts here. For the 'accuracy' (with the 20% variance) is it worth the extra cost? I don't know about you but that extra $239 came in handy when I was spending $275/month on insulin alone and feeding her 20 ounces of food a day.
 
hmjohnston said:
The topic of the strips cost for the AT came up recently on the Acro FB- I'll put here what I put down there-

I used the Relion Micro (sorry Sheila but I order the strips from ADW if that makes you feel better) with an average of 5 tests a day, 7 days a week, 4 weeks a month with a savings of $239 over the using the AT at the test same rate. For a 3/day testing the savings were $143 a month.

I never used the AT- never knew there was even a pet specific meter until after I started reading the posts here. For the 'accuracy' (with the 20% variance) is it worth the extra cost? I don't know about you but that extra $239 came in handy when I was spending $275/month on insulin alone and feeding her 20 ounces of food a day.
Click to expand...

If I was to pick a human meter, I think I would go with the Relion, but someone told me that the Walmart in Canada doesn't carry it.
 
No WalMart in Canada.
If you're close enough to the border, and have the special licence plates to go across the border or a passport, it might be worth it to come down and stock up.

I don't know if ADW ships to Canada; you could ask. The Glucocard 01 is an unbranded version of the ReliOn Confirm.
 
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