Goossens M M, Nelson R W, Feldman E C, Griffey S M
Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis 95616, USA.
J Vet Intern Med. 1998 Jan-Feb;12(1):1-6. doi: 10.1111/j.1939-1676.1998.tb00489.x.
Medical records of 104 cats with diabetes mellitus were reviewed. Information from 54 cats that had multiple blood glucose concentrations evaluated at least 5 times over a minimum of 3 months, beginning at the time insulin treatment was initiated, was used to evaluate the efficacy of insulin in treating diabetes mellitus. Fourteen of 54 cats were treated with protamine zinc insulin (PZI), 26 with ultralente insulin, and 14 with lente insulin. Six, 29, and 19 cats had good, mediocre, and poor glycemic control, respectively, based on mean blood glucose concentrations, whereas 31, 21, and 2 owners thought clinical response was good, mediocre, and poor, respectively. No significant difference was found in glycemic control among cats treated with PZI, ultralente, or lente insulin. Glycemic control was significantly (P < .05) better in 33 cats without than in 21 cats with concurrent disease. All 104 cats were used to calculate survival data. Fifty-one of 104 cats were alive at the time of the study. Mean (+/- standard deviation [SD]) and median survival times were 24 (+/- 16) and 20 months, respectively, in the 51 cats still alive at the end of the evaluation, and 25 (+/- 4) and 17 months, respectively, in the 53 cats that had died during the period of evaluation. Pancreatic abnormalities identified in 37 cats that underwent necropsy included chronic pancreatitis (n = 17), acute to subacute pancreatitis (n = 2), exocrine pancreatic adenocarcinoma (n = 7) and adenoma (n = 1), islet cell atrophy and vacuolar degeneration (n = 27), and islet amyloidosis (n = 8). No association was found between glycemic control and islet amyloidosis or exocrine pancreatic neoplasia, or between survival time and chronic pancreatitis, islet amyloidosis, or exocrine pancreatic neoplasia. In conclusion, diabetic cats evaluated in this study showed a variable response to exogenously administered insulin, ranging from excellent to poor. By maintaining mean blood glucose concentrations under 300 mg/dL, clinical signs were improved, and owners were satisfied with insulin treatment. Concurrent potentially insulin-antagonistic diseases were common and deleteriously affected glycemic control and survival time.
回顾了104只糖尿病猫的病历。从54只猫中获取信息，这些猫从开始胰岛素治疗起，在至少3个月的时间里多次测量血糖浓度，至少测量5次，用于评估胰岛素治疗糖尿病的疗效。54只猫中，14只接受精蛋白锌胰岛素（PZI）治疗，26只接受超长效胰岛素治疗，14只接受长效胰岛素治疗。根据平均血糖浓度，6只、29只和19只猫的血糖控制分别为良好、中等和较差，而31只、21只和2只猫的主人认为临床反应分别为良好、中等和较差。接受PZI、超长效胰岛素或长效胰岛素治疗的猫在血糖控制方面未发现显著差异。33只无并发疾病的猫的血糖控制明显（P <.05）优于21只患有并发疾病的猫。所有104只猫都用于计算生存数据。在研究时，104只猫中有51只存活。在评估结束时仍存活的51只猫中，平均（±标准差[SD]）生存时间和中位生存时间分别为24（±16）个月和20个月，在评估期间死亡的53只猫中，分别为25（±4）个月和17个月。在37只接受尸检的猫中发现的胰腺异常包括慢性胰腺炎（n = 17）、急性至亚急性胰腺炎（n = 2）、外分泌性胰腺腺癌（n = 7）和腺瘤（n = 1）、胰岛细胞萎缩和空泡变性（n = 27）以及胰岛淀粉样变（n = 8）。在血糖控制与胰岛淀粉样变或外分泌性胰腺肿瘤之间，以及生存时间与慢性胰腺炎、胰岛淀粉样变或外分泌性胰腺肿瘤之间未发现关联。总之，本研究中评估的糖尿病猫对外源性胰岛素的反应各不相同，从极好到极差。通过将平均血糖浓度维持在300 mg/dL以下，临床症状得到改善，主人对胰岛素治疗感到满意。并发的潜在胰岛素拮抗疾病很常见，对血糖控制和生存时间有不利影响。
