Wallace M S, Kirk C A
Animal Medical Center, New York, New York 10021.
Probl Vet Med. 1990 Dec;2(4):573-90.
Diabetes mellitus is often a frustrating disorder to treat. Many animals appear resistant to the effects of insulin, while others, especially cats, are very sensitive to its effects and therefore prone to bouts of hypoglycemia. Because of difficulties in glucose regulation, many veterinarians have referred to the treatment of diabetes mellitus as an art rather than a science. Fear of over-regulation with resultant hypoglycemia has led to the practice of "loose control" (wide fluctuations of glucose are allowed to occur throughout the day). Fortunately, long-term side effects of poor glycemic control seen in people (eg, retinal, glomerular, vascular, and nerve problems) are uncommon in dogs and cats; however, excessive polyuria and polydipsia, weight loss, and recurrent urinary tract infection in most cases is unacceptable. This chapter will focus on many of the problems associated with regulating the uncomplicated diabetic and discuss newer glucose control techniques, the use of oral hypoglycemic agents, and the role of diet in the acute treatment and long-term management of diabetes mellitus in the dog and cat.
糖尿病常常是一种治疗起来令人沮丧的病症。许多动物似乎对胰岛素的作用有抗性，而其他动物，尤其是猫，对其作用非常敏感，因此容易出现低血糖发作。由于血糖调节存在困难，许多兽医将糖尿病的治疗视为一门艺术而非科学。对过度调节导致低血糖的担忧导致了“宽松控制”的做法（允许全天血糖出现大幅波动）。幸运的是，人类中血糖控制不佳所出现的长期副作用（如视网膜、肾小球、血管和神经问题）在犬猫中并不常见；然而，大多数情况下，过度的多尿、多饮、体重减轻和反复的尿路感染是不可接受的。本章将重点讨论与单纯性糖尿病调节相关的许多问题，并探讨更新的血糖控制技术、口服降糖药的使用以及饮食在犬猫糖尿病急性治疗和长期管理中的作用。
