Zeus - general dosing/low and slow questions

[luna1234]

Hi folks,
I'm only about a month into this and while I have most of the mechanics down, I'm not sure how to respond to Zeus' recent readings.

Intro post on Feline Health board

I'm trying to follow the Low and Slow protocol with Lantus because I can't test as much as Tight Regulation calls for. About 2 weeks ago it seemed clear I should up the dose to 2.0, but over the last week I've been getting a lot of low pre-shot readings. Should I try to decrease to 1.75? But at the moment it's really hard to measure a dose between 1.5 and 2.0 because I only have 1/2mL syringes with 1-unit markings and the pharmacy won't sell me the 3/10mL syringes with 1/2u markings until I can get a specific prescription for them...

 

[hollyall]

Hi Crescent and Zeus! Welcome to "relaxed." My kitty Max is pretty new to Lantus, starting in December. It looks like you're doing good and starting to see some better #'s for Zeus...yay! I would say part of the answer to your question is time and testing. As you learn how Lantus works on Zeus, you'll get more comfortable with shooting low #'s, and, as BJM mentioned on Health, you can start to lower your no shoot or modify dose # as you see how Zeus does. It took me a while to work up to it, but, now, Max is doing great. I started by waiting and testing in a half hour to hour if I got a low and then shooting the full dose once the BG had gone up a little, but that started to get the shot schedule way off. I also did as you've done and shot a reduced dose if I had a low-ish pre-shot. Over time though, when I knew I would be home to monitor and test and the pre-shot wasn't way low, I started shooting the full dose and watching very closely. You want to slowly work into that though as BJM described. Caution, especially at first, is good.

Oh and I was able to order syringes online from American Diabetes Wholesale, the BD brand (31g, 3/10 cc's, 1/2 unit markings). Don't know if that might help you with your pharmacy and prescription issue. They sent the syringes pretty fast without a prescription.

 

[luna1234]

Holly,
Thanks for the reassurance and testimonial that the data and intuition will build up with time! It's good to see him in healthier ranges for more of the day, but it does mean that I have to make decisions more often about how to handle the readings.

Thanks for the tip on the website. I thought my local CVS branch was following DC law, but apparently it's just store policy to require a prescription.

Crescent

 

[RobinCot]

Yeah... it is unfortunate that we can't walk into any drugstore and get syringes unless we get our insulin there. If you can't wait for the delivery from the website, then you could get them at Walmart. I think there are six new ones in DC now... They are behind the pharmacy counter and you have to sign for them but no questions are asked. They sell the Relion brand.

 

[Deb & Wink]

Some states require a prescription for insulin syringes (New Hampshire does) other states do not (Massachusetts does not).

Here's a link to one site with some of the different requirements by state. It is not up-to date on all the changes in the laws for different states, but it's a starting point. http://www.childrenwithdiabetes.com/d_09_700.htm

 

[MommaOfMuse]

Good Morning Crescent and you too extra sweet Zeus.

Looking at your spreadsheet you're off to a great start and nice job on shooting low to stay low too. 2u might be a tiny bit high for him. I, personally would try 1.75 once you get syringes with half unit marks.

Mel and The Fur Gang

 

[KPassa]

Hi again Crescent and Zeus and welcome to Relaxed LantusLand!

One other thing I was noticing is that the times you give the shots seems to vary from day to day. Lantus works best on consistent dosing so you want to get as close to 12 hours between doses as possible (within a half hour of regular shot time). Sometimes, it can't be helped though so this is something to keep in mind.

Because of the cumulative nature of Lantus and Levemir, please be aware:
Shooting an hour or two early = that of a slight dose increase.
Shooting an hour or two late = that of a slight dose reduction.
The next shot is due 12 hours after the time of the early or late shot if you're shooting twice a day.
Oftentimes the effects of an early or late shot will not be seen until the next cycle. Please monitor carefully when shooting early.