The evening blues/greens

[alexi456]

Hi, so just recently Fred has started going low in the evenings into numbers to dangerous to shoot we have reduced his dose back from 3.5 to 2.5 but over the last 9 days we have had to skip 5 evening doses because of him being to low. Is this normal behaviour with lantus? He seems to be acting extremely normal and happy and his water intake etc has gone way down from what it was back to normal behaviour I’m just worried as each time we skip he goes high again. I did give him a token dose of 1u the other night as he was borderline on whether to dose or not but it wasn’t enough to stop him going high again. Does anyone dose a lower amount in the evening to the morning regularly? Or does anyone only dose once a day with lantus?

 

[Sienne and Gabby (GA)]

We don't recommend shooting differing amounts at each shot time. It doesn't allow the depot to stabilize and the results are unpredictable. Likewise, once a day dosing will guarantee a wide swing in numbers since you've outlived the duration of the insulin.

I think there are a couple of issues. What constitutes "too low" of a number is relative. I followed TR. I would shoot any number above 50 (on a human meter). I would not suggest anyone do this until they are data ready and feel comfortable shooting lower numbers. Even with SLGS, you want to be able to shoot progressively lower numbers. As you start shooting lower, you should see the curve flattening out.

I do think you need to do a bit more testing. It's critical to get a pre-shot test before you shoot. A +10 is not the same as a pre-shot test. It's also important to get tests during the PM cycle. Many cat's numbers will drop lower at night. You're already seeing some evidence of this. If you are not getting at least one additional test beyond your pre-shot test during both the AM and PM cycles, you have no idea whether you may be missing a dose reduction or more importantly, it's the only way to keep Fred safe. Not testing at night means you're missing half of your data.

 

[Bron and Sheba (GA)]

I agree with everything Sienne has said .
Have you decided about using the freestyle libre meter on Fred?​