Predictors of remission from feline diabetes

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Robert and Echo

Robert and Echo

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From the Winn Feline Foundation:

Predictors of Remission in Cats with Diabetes

Zini E, Hafner M, Osto M et al: Predictors of clinical remission in cats with diabetes mellitus, J Vet Intern Med 24:1314, 2010.

Diabetes mellitus (DM) is one of the most common endocrine diseases found in cats. Insulin therapy is the most effective means to achieve blood glucose control. Clinical remission is not an uncommon finding in cats with well-controlled diabetes, though few studies have explored predictors of remission. Data was retrieved from the medical records of 90 cats with newly diagnosed diabetes. The data collected included history, signalment, physical examination findings, hematology, biochemical profile, and the occurrence and duration of remission. Remission was defined as normoglycemia without insulin longer than 4 consecutive weeks. The reason why remission occurs in some cats is uncertain. It is hypothesized that adequate control of blood glucose levels with insulin may reverse glucose toxicity to feline beta-cells in the pancreas. Owners of diabetic cats may be more motivated to treat their cats if there is better anticipation of remission. In this study, 45 of 90 (50%) diabetic cats achieved clinical remission and the majority achieved remission within 6 months from diagnosis. Results from this study indicate that remission was more likely with higher age, and less likely in cats with elevated serum cholesterol. Remission was longer with higher body weight, and shorter in cats with higher serum glucose. [VT]

Related articles:
Roomp K, Rand J: Intensive blood glucose control is safe and effective in diabetic cats using home monitoring and treatment with glargine, J Feline Med Surg 11:668, 2009.
 
Ok ... Im confused. Is this saying that mainly older cats have an easier time going into remission over younger cats? I would have thought that was the opposite .. or am I reading this wrong? (and that wouldn't surprise me)
 
The most important thing about remission is that it mainly occurs within 6 months of diagnosis. And, yes, it does say older cats (though without the entire paper I don't know how this is defined) tend to go into remission more. Maybe this is because the diabetes may be due to a temporary pancreatitis, steroid treatment of other illnesses, etc. rather than a genetic problem with the pancreas. Just speculation on my part, though.

_R
 
HI just downloaded and read the entire paper - it's correct that older cats are more likely to achieve remission (defined as maintaining normoglycemia without insulin for 4 weeks or more) . In the analyis, age was included as a continuous measure in the statistical model - rather than determing a cut off - e.g older than 10 year vs younger than 10 years. When factors are evaluated as contiuous predictors it's a little hard to interpret but here's what the authors say : "For each additional year of age at 1st diagnosis, remission was 25% more likely", which is based on an adjusted odds ratio of 1.25 for age for those of you familiar with that sort of thing. It would have been nice if the median ages for the remission vs non remission groups had been included in the article, I was quite surprized by that omission. No association between age and duration of remission was found.

The article did not have a good explanation for the finding of more likely remission in older cats, but cited a study that showed that humans diagnosed with type 2 diabetes at age 65 or older had lower fasting blood glucose levels. They also cite articles which showed that younger type 1 human diabetes patients progress more rapidly to insulin dependency.

The authors also conjecture the possiblity that older cats have "owners being disposed to provide better care in older animals".

Hope this is helpful
 
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