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Insulin Kinds of insulin, action profiles, use in dogs, where to buy, etc.

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  #11  
Old 01-04-2009, 08:58 PM
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eileen eileen is offline
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Default Re: Using R along with NPH

I am getting into this 'conversation' a bit late but just want to give my 2 cents regarding R and N. Because of Mildred's spikes from her meals I give her a small dose of R about 30-45 minutes before she eats so it will be in effect by the time she eats her food. I then follow with her N after she has completed eating. It took me several months to fine tune the dosage as the R peaks mid morning and is still in her body when the N begins to peak at approx. 6-8 hours. For quite some time there was overlap at this time until I was able to figure out the proper dose of each by constant testing. I have a chart which I go by that reminds me how much R to give according to where her fasting bg is. I have figured out how much the R will bring her down so can not always give the same dose, most often do as she is pretty consistant but will reduce if need be.It is not something that is to be done haphazardly. Altho R is said to be gone from the body in 6 hours it is found to sometimes linger up to 9. I want to caution anyone who is considering adding R to the mix as it should not be taken lightly. It is a very powerful insulin and unless testing frequently one could easily cause major problems for their pet. I know of several others who have also found R to overlap with the N which has resulted in hypo and rebound. Done properly it can be a huge success. Eileen
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Old 01-04-2009, 09:45 PM
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Default Re: Using R along with NPH

I'm going to bring up some "caution points" also. While people generally use their fast or rapid-acting insulin before eating, I would advise that anyone new to the use of R insulin with their dog refrain from this.

Whenever you are injecting an animal with ANY insulin before the meal is finished, you MUST be able to know him or her well enough to be able to predict that he or she is going to eat the meal and finish all of it.

Many people with small children who have diabetes find there are times that the child either doesn't eat the meal served or only finishes part of it. This leaves them frantic to get something into the child to "cover" the already injected insulin to prevent hypo. Some of them have to opt for less perfect blood glucose control in favor of safety and don't give the fast or rapid acting insulin until the child is done with his or her meal.

Even though R insulin has no suspension, like all the longer-acting ones that do, it can have absorption variability.

The absorption rates of insulin vary from patient to patient--some patients use the insulin more quickly than others, and some use it less quickly. Absorption rates can also vary from day to day and from injection site to injection site in the same patient; there will be times when an insulin lasts longer--and times when it doesn't.

http://diabetesindogs.wikia.com/wiki/Absorption


This is the time action profile for R insulin--while you see that it's generally working hardest at about 4 hours after it's injected, you can also see that it can still be doing some work after 6-8 hours are up. Time action profiles are averages of how the insulin worked in a number of study volunteers; it worked longer for some of them and shorter for others.

When the longer acting insulin you're also using with the R begins to work, it doesn't mean that the R steps out of the picture because the longer acting insulin has begun to work. The two of them will both be working at the same time and both of them will be doing their part to lower the blood glucose.

As Eileen has told you, using R with another longer acting insulin is a serious step and needs to be well thought out before you proceed with caution.

Kathy

Last edited by We Hope; 09-08-2009 at 06:55 PM. Reason: relinking to canine diabetes wiki
  #13  
Old 01-05-2009, 07:10 AM
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Default Re: Using R along with NPH

You are absolutely right Kathy, any insulin should not be given until after the animal has eaten, I am one to dwell that into the heads of newcomers too. I only give the R ahead of time when I know without a doubt that Mildred is acting 'normal' and hungry. I also am with Mildred 24/7 so know that if by some chance she then refuses to eat I can easily monitor her and feed into any dangerous low. R is a very unpredictable fast acting insulin, I went thru months of tweeking and recording so I can have a general idea as to how much a unit will drop her and even now it can vary from day to day. It worries me to read discussions where it is contemplated without what appears to be great thought. Others that I know who also use the R along with N have also encountered difficulties with overlap throwing their dog into a tailspin of hypo and rebound. I'll repeat what I said previously, the use of R (or Novolog and Humolog) is a very serious matter and requires a great deal of monitoring but done correctly can be of great help. Eileen
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Old 01-06-2009, 11:04 PM
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Default Re: Using R along with NPH

I thought about using the R, but now being Niki has been doing well all this time I think "If it ain't broke, don't fix it"
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Dolly & Niki passed 2010, 45 lb Border Collie Mix 8 yrs as diabetic, 13yrs old. Blind N 10.5 U 2 X * Dog is God spelled backwards*If there are no dogs in Heaven then when I die I want to go where they went. Niki's food Orijen & Turkey & Gr. Beans, See you at the bridge my beloved & cherished Niki, I miss you everyday
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