From ACVIM Web Abstracts, ABSTRACT #63

INSULIN GLARGINE AND A HIGH PROTEIN-LOW CARBOHYDRATE DIET ARE ASSOCIATED WITH HIGH REMISSION RATES IN NEWLY DIAGNOSED DIABETIC CATS.

RD Marshall1,2, JS Rand1 1Centre for Companion Animal Health, University of Queensland, 2Creek Rd Cat Clinic, Brisbane, Australia.

Insulin glargine is a new human synthetic insulin analogue that is very long-acting. Its pharmacokinetics and pharmacodynamics were determined in healthy cats, and this is the first report of its use in diabetic cats.

Six newly-diagnosed diabetic cats (2 male, 4 female) were treated with glargine and fed a high protein-low carbohydrate diet (Purina DM canned). Cats were allowed to eat ad lib for the first 2 weeks, and then calories fed were adjusted to achieve optimal body weight. Initial dose of glargine was 0.5U/kg BID S/C, rounded to the nearest unit. Insulin dose was then adjusted based on serial blood glucose curves and water intake. At diagnosis, mean age was 10.7+sem0.8yrs, body weight was 6+0.7kg and body condition score was 6.8+0.7 (scale 1-9). Three cats were Burmese and 3 were Domestic Shorthair. No diabetogenic drugs were known to have been administered to any cat in the preceding 12 months. Four cats presented with a plantegrade stance, and 1 cat presented with signs associated with an infected tooth root. Four cats were initially ketotic and 3 of these were also acidotic. Mean glucose concentration at diagnosis was 478+45mg/dl (range=351-648mg/dl), and mean fructosamine concentration was 552 + 27µmol/L. All cats were still eating at presentation, and were treated with subcutaneous injections of glargine from the time of diagnosis.

Mean 12hr glucose concentration 10 days after beginning glargine was 265+63mg/dl and at day 17 was 178+65mg/dl. All 6 cats treated with glargine went into diabetic remission within 4 months of beginning treatment, and 5 cats went into remission within 4 weeks (mean=4.5+1.9 weeks, median=2.5 weeks). Five cats remained in remission at the time of publication (mean remission time=7.6+2.1 months, range=3-15 months). Body weight at time of remission was 5.9+0.6kg, which was not significantly different to initial weight. All cats had fructosamine concentrations within the reference range once in remission (246+14µmol/L). Only 1 cat required an increase in insulin dose above 0.5U/kg BID, and was given 0.7U/kg BID. Mean insulin dose at day 10 of treatment was 0.26U/kg (range=0.2-0.6U/kg) BID, and range at day 17 was =0.25-0.73U/kg BID (n=2). Total insulin dose per cat during the trial ranged from 1U SID to 4U BID. No cat experienced clinical hypoglycemia with glargine.

In conclusion, glargine was safe and very effective for the treatment of newly diagnosed diabetic cats. When combined with a high protein-low carbohydrate diet, it resulted in a very high remission rate in newly diagnosed diabetic cats. The relative euglycemia achieved with glargine was assumed responsible for rapid reversal of beta cell glucose toxicity and early diabetic remission.

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N.B. In the United States, glargine insulin is called Lantus.

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Last updated 01/25/2005