Acromegaly is a high dose condition, not a high BG condition. I've seen cats on small doses of insulim have wild swings in blood sugar or be in quite high numbers. As long as the kitty is on low carb wet or raw food, has no other conditions that can cause higher numbers (inflammation, infection, needs a dental), and has reached a dose over 6 units twice a day by increasing safely, then we suggest getting tested for high dose conditions. At that point, you keep increasing until the cat gets to the dose they need. We have acrocats with a wide range of doses currently on this board, some well regulated (mostly under 200) on quite high doses.