Comparison of time-action profiles of insulin Glargine and NPH insulin in normal and diabetic dogs

Abstract

Intermediate insulin injections are commonly used for glycemic control in insulin dependent diabetic dogs acting as a replacement for natural insulin. Neutral Protamin Hagedorn (NPH) insulin and insulin glargine are two types of injectable insulin preparations commonly used in humans. In our study, we investigated the time-action profiles of both aforementioned insulin preparations in normal dogs in order to determine whether co-administration of NPH and glargine would be of benefit to insulin dependent diabetic dogs as it is for humans suffering from insulin dependent diabetes. Time-action profiles of NPH insulin and insulin glargine in normal dogs demonstrated a clear difference between both insulin preparations confirming that NPH insulin is an intermediate-acting preparation whereas insulin glargine is a long-lasting preparation. In addition, co-administration of NPH insulin and insulin glargine resulted in tight glycemic control as compared to NPH insulin alone in insulin dependent diabetic dogs. However, co-administration result in hypoglycemia at the dosages tested.

Update on insulin treatment of dogs and cats with non-complicated diabetes mellitus

“…al., 2007). Differences in the biological effects among insulin preparations depend on the origin of insulin (recombinant human, porcine or bovine), addition of zinc or protamine [lente, neutral protamine Hagedorn (NPH) or isophane, protamine zinc insulin (PZI)] and changes of insulin's molecular structure (glargine, detemir) (Zerrenner et al, 2007;Mori et al, 2008;Fleeman et al, 2009;Clark et al, 2012).…”

“…Insulin NPH contains zinc and protamine (a strongly basic protein extracted from salmon testes) that both prolong the duration of action and result in a solution of free and protamine-bound insulin (Zerrenner et al, 2007;Mori et al, 2008). Currently, only recombinant human insulin NPH is available since porcine and bovine-origin preparations have been withdrawn from the market (Zerrenner et al, 2007;Palm et al, 2009).…”

“…Currently, only recombinant human insulin NPH is available since porcine and bovine-origin preparations have been withdrawn from the market (Zerrenner et al, 2007;Palm et al, 2009). Similarly to insulin lente, pharmacokinetics and pharmacodynamics exhibit considerable dog to dog variation, the peak activity occurs at 5h (1-10h in individual dogs) and the duration of action ranges from 4-24h (average 5.5h) (Mori et al, 2008;Palm et al, 2009;Clark et al, 2012). In cats, due to its short duration of action, insulin NPH results in poor glycemic control when administered BID (Zerrenner et al, 2007).…”

Successful Intensive Insulin Treatment of Type 1 Diabetic Dogs Leads to Restoration of Peripheral Leukocyte Insulin Signaling Gene Expression and Enzyme Activities

“…In the first phase (Days 1-14), diabetic dogs were injected with different amounts of NPH insulin (average 0.40 (0.19-0.66) IU/ kg) provided as a single injectable administration twice daily. Since the normal recommended dose of NPH for diabetic doses ranges between 0.5-0.7 IU/kg twice a day [36], the first phase was carried out to worsen glycemic control. In the second phase (Days 15-28), co-administration of insulin glargine (average 0.29 (0.19-0.53) IU/kg) and NPH insulin (average 0.5 (0.19-0.84) IU/kg) was performed twice daily.…”

“…Currently, the benefits of intensive glycemic control treatment for type 1 DM dogs have yet to be reported in the literature. In addition, a major risk associated with intensive insulin treatment in diabetic dogs is recurrent hypoglycemia [36].…”