Why do we need to withhold food 2 hours pre-test

[Khnguy3n]

Hi all, this is my first post. My baby Kai was diagnosed almost 2 months ago and it's a learning curve to say the least. Kai is on Lantus 1 unit twice a day. Our vet-suggested regimen is: test then feed right away, then wait 30 minutes and administer insulin twice per day.

Our vet never mentioned anything about withholding food two hours pre-insulin but I see this pop up multiple times on this forum. I'm wondering if it's necessary in Kai's case, especially if she's on a long-acting insulin. Kai grazes on her food throughout the day so she often doesn't finish eating her food until about 1 hour before we test her/give her fresh food/administer insulin.

I don't quite understand the need to do take away her food 2 hours before. My understanding is that we want to know what her sugars look like without being influenced by what she just ate before determining if it's safe to shoot. But I would see this as more of an issue with rapid acting insulin vs. with Lantus.

I outlined two situations below. If I'm wrong with how I'm interpreting this, please let me know! As mentioned, this is all very new to me and I just want to make sure I'm doing right by my sugarcat.

Situation 1: She's has her food taken away 2 hours prior to testing and her sugars are in the green. We opt not to shoot. Her sugars likely rise as soon as her food is given to her and the number then goes up mid-day because she was not given insulin.

vs.

Situation 2: She eats like normal leading up to the test. Her sugars are in the blue when we test. We opt to shoot. Her sugars drop as expected meanwhile she continues to eat like normal throughout the day. Mid-day she hits her nadir and it's in the green.

 

[Diane Tyler's Mom GA]

Lantus 1 unit twice a day. Our vet-suggested regimen is: test then feed right away, then wait 30 minutes and administer insulin twice per day.

Hi there there is no need to wait 30 minutes after Kai eats to give the insulin with lantus.I'm going to tag more experienced members to answer you question
@Khnguy3n

 

[Diane Tyler's Mom GA]

Hi all, this is my first post. My baby Kai was diagnosed almost 2 months ago and it's a learning curve to say the least. Kai is on Lantus 1 unit twice a day. Our vet-suggested regimen is: test then feed right away, then wait 30 minutes and administer insulin twice per day.

Our vet never mentioned anything about withholding food two hours pre-insulin but I see this pop up multiple times on this forum. I'm wondering if it's necessary in Kai's case, especially if she's on a long-acting insulin. Kai grazes on her food throughout the day so she often doesn't finish eating her food until about 1 hour before we test her/give her fresh food/administer insulin.

I don't quite understand the need to do take away her food 2 hours before. My understanding is that we want to know what her sugars look like without being influenced by what she just ate before determining if it's safe to shoot. But I would see this as more of an issue with rapid acting insulin vs. with Lantus.

I outlined two situations below. If I'm wrong with how I'm interpreting this, please let me know! As mentioned, this is all very new to me and I just want to make sure I'm doing right by my sugarcat.

Situation 1: She's has her food taken away 2 hours prior to testing and her sugars are in the green. We opt not to shoot. Her sugars likely rise as soon as her food is given to her and the number then goes up mid-day because she was not given insulin.

vs.

Situation 2: She eats like normal leading up to the test. Her sugars are in the blue when we test. We opt to shoot. Her sugars drop as expected meanwhile she continues to eat like normal throughout the day. Mid-day she hits her nadir and it's in the green.

@Bandit's Mom
@Bron and Sheba (GA)
@tiffmaxee
@Wendy&Neko

 

[Diane Tyler's Mom GA]

Bumping up

 

[tiffmaxee]

Hi. I’m just seeing this so apologies that none of us saw this yesterday. Diane is correct that there’s no need to wait a half hour before insulin. That’s a method for other insulins. Most test, feed, shoot all within 5-10 minutes and saw shoot while the cat is eating. The reason for withholding food 2 hours before the shot is so the pre shot is not food influenced. Once you know how big a bump up food gives it’s not necessary. It’s for safety. Food starts to influence the bg in 20-30 minutes. You dint want to shoot if too low. Lantus usually kicks in around 2 hours after given but sine cats onset at +1 and others at +2.5 like Max did.

It would help us if you set up a signature and spreadsheet so we can better interpret what’s going on with your cat. We are very data oriented here. It sounds like you are skipping doses. Ideally you want to be able to dose every 12 hours. If you go over to the lantus forum and read the stickies at the top I think that will help. Look at the methods we use first and how depot insulin works.

 

[Diane Tyler's Mom GA]

Thanks Elise @tiffmaxee

 

[Sienne and Gabby (GA)]

Situation 1: She's has her food taken away 2 hours prior to testing and her sugars are in the green. We opt not to shoot. Her sugars likely rise as soon as her food is given to her and the number then goes up mid-day because she was not given insulin.

vs.

Situation 2: She eats like normal leading up to the test. Her sugars are in the blue when we test. We opt to shoot. Her sugars drop as expected meanwhile she continues to eat like normal throughout the day. Mid-day she hits her nadir and it's in the green.

First, without seeing a spreadsheet for your cat, it's hard to know if the scenarios you're outlining are relevant. Not all cats respond to insulin in exactly the same way.

Withholding food the 2 hours prior to shot time is, as others have noted, to be sure your cat is in numbers that are safe for giving insulin. If numbers are in the green, it also depends on what your experience is with managing your cat's diabetes. Lantus tends to yield a flat curve once a cat is better regulated. I would routinely give a shot if my cat's numbers were above 50. I realize that sounds terrifying but Gabby was diabetic for 6.5 years and I had a ton of test data. Generally, if I was shooting low, her numbers would stay low. That said, I would not recommend shooting low to anyone who is new to using Lantus or to feline diabetes. You need to be confident in your ability to manage low numbers and like most skills, it takes some time and experience to get to that point. In addition. if numbers are in the green, you have other options besides skipping the shot.

The challenge with Situation 2 is that your cat is eating prior to shot time and the numbers are in the blues. Where in the blues is your pre-shot test and where are the numbers an hour after you've fed? It's entirely possible that you shot a dropping number and numbers continue to drop. By the time the Lantus kicks in 2 hours after shot time, your cat's numbers could be plummeting down into a dangerous range.

And just to complicate matters further, not all cats have their nadir at mid-cycle. My cat's nadir was at around 2 - 3 hours after her shot. Even if your cat's nadir is usually around mid-cycle, nadirs can and do move around. Cats just do not like to be entirely predictable!