Hess Rebecka S, Drobatz Kenneth J
Department of Clinical Studies-Philadelphia, Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
J Am Vet Med Assoc. 2013 Oct 15;243(8):1154-61. doi: 10.2460/javma.243.8.1154.
To evaluate the effects of twice-daily glargine insulin administration in dogs with diabetes mellitus.
Open-label, prospective clinical trial.
10 dogs with naturally occurring diabetes mellitus.
Dogs with poorly regulated or newly diagnosed diabetes mellitus were enrolled if their owners agreed to return them to the hospital at 1- to 3-week intervals for 4 follow-up visits. During each follow-up visit, blood glucose concentrations were measured every 2 hours for at least 10 hours after feeding a diet high in insoluble fiber and after administration of glargine insulin (time 0). The initial glargine insulin dosage was 0.5 U/kg (0.23 U/lb) SC twice daily.
All dogs had well-regulated diabetes mellitus at a mean ± SD of 38 ± 14 days (median, 43 days; range, 7 to 55 days) following study enrollment. At the time diabetes mellitus was well regulated, mean glargine insulin dosage was 0.5 ± 0.15 U/kg (0.23 ± 0.068 U/lb; median, 0.5 U/kg; range, 0.32 to 0.67 U/kg [0.15 to 0.30 U/lb]) twice daily, and 3 dogs were receiving a dosage < 0.4 U/kg (0.18 U/lb). In dogs with well-regulated diabetes mellitus, the mean minimum blood glucose concentration (163 ± 89 mg/dL; 95% confidence interval, 100 to 227 mg/dL) was detected 2 hours after administration of glargine insulin and the mean maximum blood glucose concentration (230 ± 95 mg/dL; 95% confidence interval, 64 to 323 mg/dL) was detected 12 hours after administration of glargine insulin. There was no significant difference between mean minimum and mean maximum blood glucose concentrations nor were there significant differences between blood glucose concentrations measured at other time points. Blood glucose concentration < 80 mg/dL was measured at least once in 7 of 10 dogs.
Results of the present study suggested that, in diabetic dogs fed a diet high in insoluble fiber, glargine insulin is a peakless insulin that does not induce a distinct blood glucose concentration nadir. For glargine insulin, 0.3 U/kg (0.136 U/lb) SC twice daily is recommended as an initial dosage.
评估每日两次注射甘精胰岛素对糖尿病犬的疗效。
开放标签的前瞻性临床试验。
10只自然发生糖尿病的犬。
如果糖尿病控制不佳或新诊断的糖尿病犬的主人同意每隔1至3周将犬带回医院进行4次随访，则将其纳入研究。在每次随访期间，在喂食高不溶性纤维饮食后以及注射甘精胰岛素（时间0）后，每2小时测量一次血糖浓度，至少测量10小时。甘精胰岛素的初始剂量为0.5 U/kg（0.23 U/lb），皮下注射，每日两次。
在研究入组后平均±标准差38±14天（中位数，43天；范围，7至55天）时，所有犬的糖尿病均得到良好控制。在糖尿病得到良好控制时，甘精胰岛素的平均剂量为0.5±0.15 U/kg（0.23±0.068 U/lb；中位数，0.5 U/kg；范围，0.32至0.67 U/kg [0.15至0.30 U/lb]），每日两次，3只犬的剂量<0.4 U/kg（0.18 U/lb）。在糖尿病得到良好控制的犬中，甘精胰岛素注射后2小时检测到平均最低血糖浓度（163±89 mg/dL；95%置信区间，100至227 mg/dL），注射后12小时检测到平均最高血糖浓度（230±95 mg/dL；95%置信区间，64至323 mg/dL）。平均最低和平均最高血糖浓度之间无显著差异，在其他时间点测量的血糖浓度之间也无显著差异。10只犬中有7只至少有一次血糖浓度<80 mg/dL。
本研究结果表明，在喂食高不溶性纤维饮食的糖尿病犬中，甘精胰岛素是一种无峰值的胰岛素，不会引起明显的血糖浓度最低点。对于甘精胰岛素，建议初始剂量为每日两次皮下注射0.3 U/kg（0.
