Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Vet Intern Med. 2024 May-Jun;38(3):1353-1358. doi: 10.1111/jvim.17053. Epub 2024 Mar 25.
The utility of sodium-glucose cotransporter 2 inhibitors (SGLT2i) has not been reported in insulin-treated diabetic dogs.
Canagliflozin, a PO-administered SGLT2i, decreases interstitial glucose concentration (IG) in insulin-treated diabetic dogs.
Five insulin-treated diabetic dogs.
Uncontrolled open label longitudinal study. Canagliflozin (2-4 mg/kg/day PO) was added to an unchanged insulin dose for 7 days. Fractional excretion of glucose was calculated by dividing the product of urine glucose and serum creatinine concentrations by the product of serum glucose and urine creatinine concentrations. Hypoglycemia was defined as IG <60 mg/dL.
Median IG in 2869 measurements obtained while dogs were treated with insulin and canagliflozin was 87 mg/dL (range, 40-500 mg/dL) and was significantly lower than median IG in 1426 measurements obtained while dogs were treated with insulin alone (212 mg/dL; range, 41-500 mg/dL; P < .001). Median fractional excretion of glucose when dogs were treated with insulin and canagliflozin was 1.1% (range, 0.9%-2.0%), significantly higher than when dogs were treated with insulin alone (0.3%; range, 0.01%-1.0%; P = .04). The frequency of hypoglycemia was higher in dogs treated with insulin and canagliflozin (544 of 2869 IG measurements, 19%) compared with the frequency of hypoglycemia in dogs treated with insulin alone (52 of 1426 IG measurements, 4%; P < .001).
Canagliflozin may have a role in improving glycemic control in insulin-treated diabetic dogs, but the dose of insulin should be decreased when adding canagliflozin to insulin treatment.
钠-葡萄糖共转运蛋白 2 抑制剂（SGLT2i）在接受胰岛素治疗的糖尿病犬中的应用尚未见报道。
口服 SGLT2i 卡格列净可降低接受胰岛素治疗的糖尿病犬的间质葡萄糖浓度（IG）。
5 只接受胰岛素治疗的糖尿病犬。
非对照开放标签纵向研究。在不改变胰岛素剂量的情况下，每天给犬口服卡格列净（2-4mg/kg/天），7 天。通过将尿葡萄糖和血清肌酐浓度的乘积除以血清葡萄糖和尿肌酐浓度的乘积来计算葡萄糖的分数排泄率。低血糖定义为 IG<60mg/dL。
在犬接受胰岛素和卡格列净治疗期间，2869 次测量的中位数 IG 为 87mg/dL（范围为 40-500mg/dL），明显低于犬单独接受胰岛素治疗时 1426 次测量的中位数 IG（212mg/dL；范围为 41-500mg/dL；P<0.001）。犬接受胰岛素和卡格列净治疗时葡萄糖的分数排泄率中位数为 1.1%（范围为 0.9%-2.0%），明显高于犬单独接受胰岛素治疗时（0.3%；范围为 0.01%-1.0%；P=0.04）。在接受胰岛素和卡格列净治疗的犬中，低血糖的频率（2869 次 IG 测量中的 544 次，19%）高于单独接受胰岛素治疗的犬（1426 次 IG 测量中的 52 次，4%；P<0.001）。
卡格列净可能在改善接受胰岛素治疗的糖尿病犬的血糖控制方面发挥作用，但在将卡格列净加入胰岛素治疗时，应减少胰岛素剂量。
