On veterinary websites I've seen 'regulation' described as (ideally) the cat's blood glucose being kept just below the 'renal threshold' at pre-shot, and getting down to the middle range of normal numbers at nadir.
In my experience on this forum there are fairly few cats that actually fit that model. There are so many variables. Much depends on the insulin type, the diet, whether there's any concurrent illness, how long the cat has been hyperglycemic, the caregiver's ability to monitor blood glucose, how committed the caregiver is to getting the whole thing to work optimally, oh...and the cat!
I've always found this 'regulation continuum' info from the FDMB FAQ's (that FurBabiesMama linked to above) useful as a general guide to help put things in context.
For a couple of years my cat was in the category at the bottom, "mostly above 300 (16.7) but with good clinical signs". I found his numbers very disappointing and frustrating. But it is worth remembering that it's not just about the numbers. How is the cat in himself? How are his clinical signs? Is he happy, and doing normal cat stuff?
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What is regulation?
There are different definitions of regulation. As hometesting becomes more common, we've been getting a better understanding of what cats and their humans might be capable of. Janet & Fitzgerald propose the following "regulation continuum":
- Not treated [blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs]
- Treated but not regulated [often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs]
- Regulated [generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia]
- Well regulated [generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia]
- Tightly regulated [generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin
There may also be an extra category of "mostly above 300 (16.7) but with good clinical signs" which occurs with some cats who are getting insulin. We don't know why it happens, but such a cat probably should not be considered to be regulated.
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Eliz