Glucose Curves

Question 1

When should a glucose curve be performed after a dose change/starting therapy?

Answer 1

No earlier than 7-10 days

Question 2

What should be performed as routine monitoring of diabetic animals when stable?

Answer 2

Clinical signs
Ideally home BGC (guidelines recommend BGC)
Fructosamine

Question 3

What things should be looked at when analysing the glucose curve?

Answer 3

Duration of insulin action
Time to peak activity
Time in the target range (4.5-14mmol/l for cats)
Peak BGCs (fasting)

Question 4

IS hypoglycaemia identified on a glucose curve always significant?

Answer 4

Yes!

Question 5

How can the insulin dose be adjusted if the nadir is <4.5mmol/l?

Answer 5

Reduce dose by 50% or consider longer acting preparation if peak BG is >14mmol/l

Question 6

How can the insulin dose be adjusted if the nadir is 4.5-14mmol/l?

Answer 6

Continue on current therapy

Question 7

How can the insulin dose be adjusted if the nadir is 4.5-8mmol/l and the peak is >14mmol/l?

Answer 7

Maintain therapy (if at beginning) and re-test in 1-2w. 
Change to longer acting
Increase dose by 0.5u/cat.

Question 8

How can the insulin dose be adjusted if the nadir is >8 and peak >14 and there are clinical signs?

Answer 8

Increase dose by 0.5-1iu/cat.

Question 9

What is the feline BGC target range?

Answer 9

4.5-14mmol/l

Question 10

What is the anticipated nadir & DoA of lente insulin (can insulin) in cats?

Answer 10

Nadir: 2-8h
DoA: 8-10h

Question 11

What is the anticipated nadir & DoA of PZI (ProZinc) in cats?

Answer 11

Nadir: 2-6h

13-24h