I’m sad as its looking like little will be a “lifer” regardless since it’s been a year since diagnosis and all I can think of is that Levemir is the only thing I haven’t tried. Anyone ever seen a long term kitty go into remission?
My Alice hit a year this month too. It’s frustrating because I would love to give her the gift of a break from pokes.... but if it doesn’t happen, that’s okay, because to me it’s still pretty amazing that she is alive. I think about the fact that insulin was not introduced into medicine all that long ago, historically. But it is still frustrating. A little disappointing to think about it being “forever.” Statistically though, it is not impossible for a cat to still go OTJ.
“
Treatment and monitoring
The aim of therapy in newly diagnosed diabetic cats is to maximize the chance of remission by strict glycemic control (72 to <180 mg/dL; 4 to <10 mmol/L), while avoiding hypoglycemia. Diabetic remission is defined as persistent euglycemia without the requirement for exogenous insulin or oral hypoglycemic therapy in cats previously requiring treatment to control diabetic signs.
13,
38,
44 For long-term diabetic cats that do not achieve remission (≥6 months), the aim is to control clinical signs and avoid clinical hypoglycemia. Remission may occur in a small proportion even after 2 years of insulin treatment, if rigorous glycemic control is maintained.
In newly diabetic cats, early effective glycemic control can resolve glucotoxicity before there is permanent loss of sufficient β cells to maintain euglycemia, which increases the probability of remission. A protocol aimed at strict glycemic control within 6 months of diagnosis showed that 84% of cats achieved diabetic remission compared with 35% (
p<0.001) when strict glycemic control was not instituted for ≥6 months after diagnosis.
45
Besides early institution of tight glycemic control, factors associated with remission include a low-carbohydrate diet (12% versus 26% of energy from carbohydrate), long-acting insulin (glargine versus PZI or lente), higher age (suggesting possible slower disease progression), lower maximum dose of insulin (mean maximum dose of glargine of 0.4 U/kg versus 0.7 U/kg or <3 U/cat versus >3 U/cat), lower mean blood glucose after treatment with insulin, and lower cholesterol concentrations.
13,
44–
47 Corticosteroid administration in the 6 months before diagnosis of diabetes is associated with significantly higher remission rates.
45 Peripheral neuropathy at diagnosis is associated with decreased probability of remission. This is likely because diabetic neuropathy presents later in the course of disease, so these cats have been diabetic for longer period of time and have greater β-cell damage.
45”
From:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6053045/accessed 10/7/19 17:40CST.
