Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy.
Animal Diabetes Australia, Mulgrave, VIC, Australia.
J Feline Med Surg. 2022 Feb;24(2):168-176. doi: 10.1177/1098612X211013018. Epub 2021 May 19.
The study aimed to evaluate the efficacy and safety of insulin glargine 300 U/ml (IGla-U300) in cats with variable duration of diabetes mellitus (DM).
Thirteen client-owned cats with DM completed a prospective clinical trial. Four cats were highly suspected of hypersomatotropism and excluded from the insulin efficacy evaluation. All cats were treated with IGla-U300 SC at a starting dosage of 0.5 U/kg q12h and fed with a low carbohydrate diet. Cats were monitored for 8 weeks with a once-weekly at-home 16 h blood glucose curve (BGC) and a questionnaire evaluating the presence of DM-related clinical signs. In-clinic evaluations, including serum fructosamine measurement, were scheduled within 3 days of the first, third, sixth and eighth BGC. Glycemic variability was assessed by calculating the SD of each BGC.
Excluding four cats suspected of hypersomatotropism, at the time of the eighth BGC, improved or absent polyuria, polydipsia, polyphagia, weight loss, lethargy and improved or normal general demeanor were reported in 8/9 (88%), 8/9 (88%), 7/9 (77%), 7/9 (77%), 7/9 (77%) and 8/9 (88%) cats, respectively. Two cats achieved remission after 29 and 53 days. Another two cats went into remission after the end of the study (days 82 and 96). All cats that achieved remission were newly diagnosed diabetics. Median (range) serum fructosamine concentration significantly decreased when comparing the time of enrollment (604 [457-683] µmol/l) with the eighth week of treatment (366 [220-738] µmol/l) ( = 0.02). In all 13 cats, biochemical hypoglycemia (blood glucose <60 mg/dl; <3.3 mmol/l) was detected in 13/104 (12.5%) BGCs, while clinical signs suggesting hypoglycemic episodes were not reported. Glycemic variability was significantly lower at the fifth BGC when comparing cats that achieved remission with cats that did not achieve remission ( = 0.02).
IGla-U300 seems effective and safe for the treatment of feline diabetes, but more long- term and comparative clinical trials are needed.
本研究旨在评估胰岛素甘精 300U/ml(IGla-U300)在糖尿病持续时间不同的猫中的疗效和安全性。
13 只患有糖尿病的患宠猫参与了一项前瞻性临床试验。其中 4 只猫高度怀疑存在生长激素过多症,因此被排除在胰岛素疗效评估之外。所有猫均接受 SC 注射 IGla-U300,起始剂量为 0.5U/kg,q12h,并喂食低碳水化合物饮食。在 8 周内,每周进行一次在家中进行的 16 小时血糖曲线(BGC)监测,并通过问卷评估是否存在糖尿病相关的临床症状。在第一次、第三次、第六次和第八次 BGC 的 3 天内,安排了门诊评估,包括血清果糖胺测量。血糖变异性通过计算每个 BGC 的标准差来评估。
排除 4 只怀疑生长激素过多症的猫后,在第八次 BGC 时,8/9(88%)的猫报告多尿、多饮、多食、体重减轻、嗜睡和一般状态改善或正常,7/9(77%)的猫报告改善或不存在,7/9(77%)的猫报告改善或正常。2 只猫在 29 天和 53 天后达到缓解。另外 2 只猫在研究结束后(第 82 天和第 96 天)达到缓解。所有达到缓解的猫均为新诊断的糖尿病猫。与入组时(604[457-683]μmol/L)相比,治疗第 8 周时(366[220-738]μmol/L)的血清果糖胺浓度显著降低( = 0.02)。在所有 13 只猫中,在 13/104(12.5%)的 BGC 中检测到生化性低血糖(血糖<60mg/dl;<3.3mmol/l),但未报告提示低血糖发作的临床症状。与未缓解的猫相比,缓解的猫在第 5 次 BGC 时的血糖变异性显著降低( = 0.02)。
IGla-U300 似乎对治疗猫糖尿病有效且安全,但需要更多长期和对照临床试验。