? Switching from Lantus to Levemir - need dose advice

[Kerrie & Winnie]

I've decided to try Winnie on Levemir. I've read the posts suggesting that the starting dose should be 70% of the Lantus dose - that would be 0.35 units (based on the 0.5 Lantus dose she's been on for the last month). But, although her BG numbers in March suggest she wasn't doing too badly at that level (esp. March 8), her numbers today look awful. That being the case, should I start her on 0.5 units of Lantus and see how that goes?
Thank-you for any advice you can give!

 

[Tricia Cinco(GA) & Harvey]

That sounds good to me, but let's see what some of the Lev users think. @Marje and Gracie @Wendy&Neko

 

[Wendy&Neko]

although her BG numbers in March suggest she wasn't doing too badly at that level (esp. March 8), her numbers today look awful.

I'm sorry, I can't tell how you can say that from looking at the spreadsheet. I see hardly any night time tests. I don't know if you've heard this before, but many cats go lower at night. My Neko would often earn her reductions during the night and bounce during the day. If all I did was test during the day, I would think she needed an increase. Without knowing how low 0.5 U of Lantus takes Winnie, I can't suggest going to 0.5 units of Lev as the starting dose. I think you have two choices. First is to get a couple of nights worth of data on Lantus, and figure out how low this dose is really taking her. Even a before bed test like a +3 will be valuable data. The second option is to start at 0.25 units. But please make sure you start Levemir when you can monitor closely for the first couple of cycles. Many cats react strongly to the change in insulin, meaning they go low.

Yout last post here, for continuity.

 

[Marje and Gracie]

I agree wholeheartedly with Wendy. I would not put her on any more than 0.25u of Levemir if you aren’t going to test at night before the switch. You are missing half your data and the nighttime data is just as important as the day time. There is no hurry to switch to levemir so it makes more sense to me to spend a few days getting some nighttime tests so that you can target in on a good dose for her.

 

[Kerrie & Winnie]

Thanks for the above. I certainly don't have as much night time data as day time but the data I do have suggest she's as variable then as she is during the day. Last night she DID drop and, given her PMPS this morning of 168, I've kept her on the Lantus for the time being. Now she's bouncing again - 122 30 minutes after injection (and breakfast) and 326 30 minutes after that. I will do some night testing tonight as well and hope it provides some clarity. In any case, it sounds like 0.25u is a wise starting dose for the Levemir.