Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Swiss Veterinary Association, Berne, Switzerland.
J Vet Intern Med. 2020 Nov;34(6):2287-2295. doi: 10.1111/jvim.15915. Epub 2020 Oct 1.
Glycemic variability (GV) is an indicator of glycemic control and can be evaluated by calculating the SD of blood glucose measurements. In humans with diabetes mellitus (DM), adding a glucagon-like peptide-1 (GLP-1) analogue to conventional therapy reduces GV. In diabetic cats, the influence of GLP-1 analogues on GV is unknown.
To evaluate GV in diabetic cats receiving the GLP-1 analogue exenatide extended release (EER) and insulin.
Thirty client-owned cats with newly diagnosed spontaneous DM.
Retrospective study. Blood glucose curves from a recent prospective placebo-controlled clinical trial generated 1, 3, 6, 10, and 16 weeks after starting therapy were retrospectively evaluated for GV. Cats received either EER (200 μg/kg) or 0.9% saline SC once weekly, insulin glargine and a low-carbohydrate diet. Mean blood glucose concentrations were calculated and GV was assessed by SD. Data were analyzed using nonparametric tests.
In the EER group, GV (mean SD [95% confidence interval]) was lower at weeks 6 (1.69 mmol/L [0.9-2.48]; P = .02), 10 (1.14 mmol/L [0.66-1.62]; P = .002) and 16 (1.66 mmol/L [1.09-2.23]; P = .02) compared to week 1 (4.21 mmol/L [2.48-5.93]) and lower compared to placebo at week 6 (3.29 mmol/L [1.95-4.63]; P = .04) and week 10 (4.34 mmol/L [2.43-6.24]; P < .000). Cats achieving remission (1.21 mmol/L [0.23-2.19]) had lower GV compared to those without remission (2.96 mmol/L [1.97-3.96]; P = .01) at week 6.
The combination of EER, insulin, and a low-carbohydrate diet might be advantageous in the treatment of newly diagnosed diabetic cats.
血糖变异性（GV）是血糖控制的一个指标，可以通过计算血糖测量的标准差来评估。在患有糖尿病（DM）的人类中，添加胰高血糖素样肽-1（GLP-1）类似物可降低 GV。在患有糖尿病的猫中，GLP-1 类似物对 GV 的影响尚不清楚。
评估接受 GLP-1 类似物 exenatide 延长释放（EER）和胰岛素治疗的糖尿病猫的 GV。
30 只新诊断为自发性 DM 的患宠猫。
回顾性研究。从最近的一项前瞻性安慰剂对照临床试验中生成的血糖曲线，在开始治疗后 1、3、6、10 和 16 周进行回顾性评估，以评估 GV。猫每周接受一次 EER（200μg/kg）或 0.9%生理盐水 SC 注射，同时给予甘精胰岛素和低碳水化合物饮食。计算平均血糖浓度，并通过标准差评估 GV。使用非参数检验进行数据分析。
在 EER 组中，第 6 周（1.69mmol/L [0.9-2.48]；P=0.02）、第 10 周（1.14mmol/L [0.66-1.62]；P=0.002）和第 16 周（1.66mmol/L [1.09-2.23]；P=0.02）时 GV 低于第 1 周（4.21mmol/L [2.48-5.93]），与第 6 周（3.29mmol/L [1.95-4.63]；P=0.04）和第 10 周（4.34mmol/L [2.43-6.24]；P<0.000）时的安慰剂组相比也较低。达到缓解（1.21mmol/L [0.23-2.19]）的猫与未缓解（2.96mmol/L [1.97-3.96]；P=0.01）的猫相比，第 6 周时的 GV 更低。
EER、胰岛素和低碳水化合物饮食的联合治疗可能对新诊断的糖尿病猫有益。
