View Full Version : On nadirs and goals for curves

08-07-2014, 12:32 PM
From a NAVC publication by Dr. Audrey Cook at Texas A&M.

The nadir is often the most critical piece of information. In a stable patient, a nadir of 80 mg/dL may be tolerated; otherwise always decrease the insulin dose by 25% if the nadir goes below 100 mg/dL. It is always inappropriate to increase the insulin dose without first establishing a reliable nadir with a BGC.

The nadir cannot be predicted by a single BG reading, because its timing may vary from day to day.

The average BG reflects both insulin responsiveness and duration of effect. As a general guideline, the target average is <250 mg/dL, which minimizes complications associated with sustained hyperglycemia, such as ketoacidosis and diabetic neuropathy.

Duration of effect is defined as the interval during which BG is less than 80% of the preinsulin concentration, and is determined primarily by insulin type (ie, lente, protamine zinc, NPH, glargine, etc). If duration is unsatisfactory, the solution is usually to switch to a different type.

I have a NAVC account login so I am not sure if you have to log in to see the following page - there are various links to information on managing pets with diabetes: