What is Regulation?

[Jill & Alex (GA)]

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
• Normalized - 60-120 (3.3-6.7) except perhaps directly after meals -- usually not 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. On the other end of the spectrum, it is possible for a cat who is not getting insulin to have blood glucose as low as 40 mg/dl (2.2 mmol/L) on a glucometer calibrated for humans. If you have a non-diabetic cat, try testing her with the same meter to get a safe comparison figure.