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Old 04-09-2018, 04:03 AM
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MikeMurphy MikeMurphy is offline
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Default Re: Struggling with high fastings and short duration of effect of insulin

Originally Posted by joolsp View Post
Here's a mini-curve from yesterday which is indicative of the kinds of readings we have been getting for the past few weeks. Before then his fasting readings were between 19 and 24 mmol/l (340-430) typically.

I should mention that when his fastings are very high we inject around 20-30 mins before food. I realise that is often frowned upon for valid reasons but in the past it has worked for us - gives the insulin a head-start and helps bring his BG down into a good range.

7.15 a.m (fasting) 33.9 mmol/l (610)
(inj 6.5u Novolin N at 7.30 a.m. Food at 8.00 am)

12.15 p.m 14.6 (263)

2.00 p.m 8.5 (153)
(small snack of plain chicken given)

5.00 p.m. 16.8 (302)

7.15 p.m. (fasting) 36.9 (664)

As you can see there are massive swings both down and up. Note in particular the upwards swing between 5 pm and 7 pm of nearly 20 (360) in 2 hours. Too much insulin? Or something else going on?
That’s a huge swing!

Assuming something else isn’t going on, big swings like that usually point to too much insulin. A normal starting dose of Novolin N for a 7kg (15lb) dog would be 15lbs x .2 units per lb = 3 units twice daily.

Somogyi Rebound can occur if a dog’s BG drops too low or it can occur if there is a rapid drop in BG. Going from 610 to 153 and then to 664 sure looks like rebound to me.

I would reduce insulin. The problem is how much to reduce. I know schnauzers usually require more insulin, but it might be worth a try going back to 3 units. Then you can be pretty sure you haven’t gone past the proper dose.

It’s hard to start over, but at least it would rule in/out rebound.
Lily is a 62 lb English Setter, born 07-27-2007.
Diabetes: Aug 2013 - Hypothyroidism: Dec 2013 - Cataract Surgery: Feb 2014
Insulin: Novolin R/N mix - Meter: ReliOn Prime
Nulo Adult Trim Cod & Lentils, Pumpkin, FortiFlora, Dasuquin, Thyroxine

Last edited by MikeMurphy; 04-09-2018 at 06:28 AM.
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Old 04-10-2018, 09:31 PM
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amydunn19 amydunn19 is offline
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Default Re: Struggling with high fastings and short duration of effect of insulin

Those swings are huge and I agree with Mike. I would reduce.
Maggie - 15 1/2 y/o JRT diagnosed 9/2007, Angel status on 6/20/16. Her mantra was never give up but her body couldn't keep up with her spirit. Someday, baby.......
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Old 04-12-2018, 10:00 AM
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CraigM CraigM is offline
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Default Re: Struggling with high fastings and short duration of effect of insulin

Just want to confirm you are using U-100 syringes with the Novolin-N?
Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9 years.
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