a Webster Groves Animal Hospital , 8028 Big Bend Blvd., Webster Groves , MO 63119 USA.
Vet Q. 2014;34(3):132-6. doi: 10.1080/01652176.2014.924057. Epub 2014 Jun 25.
The object of this retrospective study was to compare the effect on remission rates of a near euglycemic paradigm (NEP) to a traditional paradigm (TP) of glycemic control in cats with newly diagnosed diabetes mellitus. Medical records of 54 cats with naïve diabetes mellitus managed with low carbohydrate, high protein prescription diets, and twice daily subcutaneous glargine insulin injections were reviewed. Cats were assigned to an NEP or TP group based on frequency of evaluation of blood glucose concentration and the criteria used to assess glycemic control. The two groups were compared with regard to the incidence of clinical and biochemical hypoglycemia and remission rates. Multiple logistic regression was used to evaluate the association between remission and independent variables. Fourteen of 18 cats (78%) in the NEP group achieved remission, whereas five of the 36 (14%) of the TP group achieved remission (p < 0.001). For the NEP group, biochemical hypoglycemia was noted in 8/18 (44%) and clinical hypoglycemia was documented in 2/18 (11%) of the cats. In the TP group, biochemical hypoglycemia was noted in 12/36 (33%) cats and 5/36 (14%) had clinical hypoglycemia. In conclusion, management of newly diagnosed diabetic cats using an NEP of glycemic control results in higher remission rates without an increased incidence of observed clinical or biochemical hypoglycemia. Although an NEP appears to have benefit it should be evaluated further with regard to its overall and long term effects on health and quality of life as well as its overall cost effectiveness.
这项回顾性研究的目的是比较新诊断为糖尿病的猫采用接近正常血糖的治疗方案(NEP)与传统血糖控制方案(TP)对缓解率的影响。对 54 例接受低碳水化合物、高蛋白处方饮食和每日两次皮下甘精胰岛素注射治疗的新诊断为糖尿病的猫的病历进行了回顾性分析。根据血糖浓度评估的频率和评估血糖控制的标准,将猫分为 NEP 或 TP 组。比较两组间临床和生化低血糖的发生率和缓解率。采用多因素逻辑回归分析评估缓解与独立变量之间的关系。NEP 组 18 例猫中有 14 例(78%)达到缓解,而 TP 组 36 例猫中有 5 例(14%)达到缓解(p<0.001)。NEP 组 8/18(44%)只猫出现生化性低血糖,2/18(11%)只猫出现临床低血糖。TP 组 12/36(33%)只猫出现生化性低血糖,5/36(14%)只猫出现临床低血糖。总之,采用 NEP 控制血糖管理新诊断的糖尿病猫可提高缓解率,而不会增加观察到的临床或生化性低血糖的发生率。虽然 NEP 似乎有益,但应进一步评估其对健康和生活质量的整体和长期影响及其总体成本效益。