Buddy’s Nightscout curve on Friday morning at 8:00
Well, there is some up and down going on. Buddy got his last Injection of 1 IU of Glargine two days ago – Wednesday morning at 6:00.
Unless the sensor is totally crazy, here’s a pattern I am noticing: His own insulin production seems to overshoot a bit at times – he goes to 180 or even 200 mg/dl, and then comes down quite far – sensor readings of 55 mg/dl earned him a slight bit of honey on his paw from his other human yesterday. He did not have any symptoms of hypoglycemia.
My suspicion is that the Dexcom G6 is reading a bit “low” – erring on the side of “lower”. A few weeks ago I did a few side-by-side comparisons using a cat-calibrated Bloodglucose Monitor (BGM) (AlphaTrak3). For that, I compared the readings from the AlphaTrak3 – with blood taken from his ear – to the sensor values from his Dexcom – during a time when his blood sugar was in a normal range, and stable. I did four tests at Sensor readings around 105 mg/dl, and the AlphaTrak 3 readings were always slightly higher – 117, 120, 125, and 130.
I am worried about “false high blood sugar” and not much worried about systematically false low BG readings by the sensor, and so I left that as good enough. It’s stressful for Buddy to have his ear pricked, and the stress alone will raise his blood sugar, and lower his affection for me – neither is worth the trouble at that point.
“Total Accuracy” and “repeatability” are not really a thing in this BG measuring business. Aside from – “WHICH BG is actually the “right” BG?? (from whole blood? capillary blood, with blood taken exactly where??). There are many potential reasons, why in real life repeated samples vary.
Over the last 30 years, I have done hundreds of comparative BG tests – using one and more BGMs, and repeated tests. In the best case, it’s like a decent archer hitting the target: Distributed around the bull’s eye. It’s OK. I might write a bit more about this topic in another post.
But back to Buddy – Seems he’s doing a fantastic job keeping his BG under control without insulin injections. “No injection” means “no potential for human error.” That is a relief! Yay!!! (Safe Remission is the goal ...)
I am a bit uneasy about simply stopping all insulin, but at such low blood sugars, even 1 IU of Glargine seems too dangerous. I plan on giving him 1 unit of Glargine if he remains over 200 mg/dl for a few hours, but that has not yet happened. Maybe we use an Omnipod for another 3 days, to give his beta cells some support – don’t want them to get exhausted again … he still is a big 17 pound kitty, who needs to lose more weight.
This is why he’ll be running around with a sensor for quite a while yet – so I can see if he needs insulin support, and then of course – if he is on insulin – to see if he goes too low and needs an intervention. He does not seem to mind the sensor, and it gives me piece of mind.