Pharmacokinetics and pharmacodynamics of porcine insulin zinc suspension in eight diabetic dogs

Fleeman, L. M.; Rand, Jacquie; Morton, John M.

doi:10.1136/vr.164.8.232

Cited by 25 publications

(28 citation statements)

References 24 publications

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“…Porcine insulin has exactly the same amino acid sequence with canine insulin but differs from feline insulin by three amino acids (Rios and Ward, 2008;Fleeman et al, 2009). The closest available insulin to that of cats is bovine insulin because it differs by only one amino acid; also bovine insulin has quite similar molecular structure with that of canine insulin with differences in two amino acids (Davison et al, 2008;Rios and Ward, 2008) (Table 1).…”

Section: Types Of Insulin For Dogs and Cats With Non-complicated Diabmentioning

confidence: 99%

Section: Types Of Insulin For Dogs and Cats With Non-complicated Diabmentioning

confidence: 99%

“…At least in theory, two peaks in the action and thus in the glucose lowering effect are to be expected, one occurring soon after subcutaneous (SC) administration and attributed to the amorphous insulin part and the second occurring later due to the crystalline insulin part of insulin lente (Cook, 2007;Zerrenner et al, 2007;Fleeman et al, 2009). However, the pharmacokinetics and pharmacodynamics exhibit considerable between-patient as well as day-to-day variation (Fleeman et al, 2009). For example, in a group of eight dogs with stable DM, onset of action occurred 1.5-6h (average: 3h) after SC administration, time to nadir (lowest blood glucose concentration) ranged from 4 to 22h (average: 8h) and the time period that blood glucose concentrations were bellow renal threshold varied from 10h to more than 24h (average: 14h) (Fleeman et al, 2009).…”

Section: Types Of Insulin For Dogs and Cats With Non-complicated Diabmentioning

confidence: 99%

“…Recombinant human, porcine and bovine insulins are effective in lowering blood glucose concentrations of diabetic dogs and cats. Therefore, the importance of insulin origin is related to the potential of anti-insulin antibodies production due to administration of a heterologous protein (Fleeman et al, 2009). A mixed bovine-porcine PZI and a bovine lente insulin may induce anti-insulin antibodies in dogs (Cook, 2007;Zerrenner et al, 2007;Davison et al, 2008) and such antibodies were detected more frequently in diabetic dogs treated with bovine PZI (85%) or bovine lente (56%) insulin compared to those treated with a porcine lente insulin (12%), whereas there was no difference between the latter and the control group that included both healthy dogs and non-diabetic sick dogs (Davison et al, 2008).…”

Section: Types Of Insulin For Dogs and Cats With Non-complicated Diabmentioning

confidence: 99%

“…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).…”

Section: Types Of Insulin For Dogs and Cats With Non-complicated Diabmentioning

confidence: 99%

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

Saridomichelakis

Chatzis

2018

J Hellenic Vet Med Soc

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ABSTRACT. Diabetes mellitus is a common endocrine disease of dogs and cats. Treatment is mainly based on insulin administration and dietary modifications. The aim of this review is to provide updated information on insulin treatment of dogs and cats with non-complicated diabetes mellitus. During the last years, there has been significant progress in the management of this disease, thanks to the use of long-acting insulin preparations that do not cause pronounced fluctuations of blood glucose concentrations (insulin glargin and detemir) and because of the widespread use of home glucose monitoring by the owners of diabetic pets. Home glucose monitoring is based on capillary blood sampling from the ear pinnae or the foot pad and measurement of blood glucose concentration with a portable blood glucose meter. This can be done periodically (e.g. every week) to replace the traditional in-clinic blood glucose curve; in this case, blood glucose concentration is measured just before the morning insulin administration and then every 1-2 hours until the next dose (usually for 12 hours). Furthermore, especially for the cat, home glucose monitoring can be performed 3-5 times per day, on a daily basis, in order to safely adjust insulin dose and achieve tight control of hyperglycemia (i.e. blood glucose concentration between 50 and 200 mg dl -1 throughout the day). The combination of dietary management, of insulin glargine or detemir administration and of the tight control of hyperglycemia has substantially increased the proportion of cats that enter into temporal or permanent diabetic remission and can be further managed without insulin. Another important achievement is the use of continuous glucose monitoring systems to monitor interstitial fluid glucose concentrations. These devices can be used in the clinic and at home and they can measure glucose concentration every 5 minutes for up to 72 consecutive hours, thus facilitating optimal adjustment of insulin treatment.

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Section: Types Of Insulin For Dogs and Cats With Non-complicated Diabmentioning

confidence: 99%

Section: Types Of Insulin For Dogs and Cats With Non-complicated Diabmentioning

confidence: 99%

Section: Types Of Insulin For Dogs and Cats With Non-complicated Diabmentioning

confidence: 99%

Section: Types Of Insulin For Dogs and Cats With Non-complicated Diabmentioning

confidence: 99%

Section: Types Of Insulin For Dogs and Cats With Non-complicated Diabmentioning

confidence: 99%

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

Saridomichelakis

Chatzis

2018

J Hellenic Vet Med Soc

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Canine Diabetes Mellitus

Fleeman¹,

Rand²

2013

Clinical Endocrinology of Companion Animals

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PathogenesisK Diabetes mellitus is caused by absolute or relative insulin deficiency. K In populations in which female dogs are routinely neutered, the majority of cases have type 1 diabetes mellitus caused by immune destruction of pancreatic β cells. K In approximately 30%, diabetes is due to extensive pancreatic damage from chronic pancreatitis. K In intact bitches, a form analogous to human gestational diabetes can occur during diestrus or pregnancy. K Canine diabetes also occurs in association with corticosteroid therapy, hyperadrenocorticism, or progesterone-induced acromegaly. Classical SignsK Most diabetic dogs are over 5 years of age with the highest prevalence occurring between 8 and 12 years of age. K Intact females are at increased risk, especially if they are also overweight. K Typical signs are polydipsia, polyuria, lethargy, weight loss, polyphagia, poor hair coat, and reduced immunity. DiagnosisK Hyperglycemia (blood glucose concentration >200 mg/dL [ >11 mmol/L]) with glucosuria and consistent clinical signs. TreatmentK The two primary goals of therapy for diabetic dogs are:1. Resolution of all clinical signs. 2.Avoidance of insulin-induced hypoglycemia. K An additional goal is diabetic remission for those dogs with reversible causes of insulin resistance such as diestrus, pregnancy, or progesterone-induced acromegaly. K Lifelong exogenous insulin therapy is usually required unless there is prompt diabetic remission. Clinical Endocrinology of Companion Animals I. PathogenesisA. In dogs, multiple underlying pathological processes result in diabetes and the most common are type 1, other specific types of diabetes, and diestrual. B. In populations in which female dogs are routinely neutered, at least 50% of diabetic dogs have type 1 diabetes based on histological and autoantibody evidence of immune destruction of β cells:1. Clinical and epidemiological factors in dogs closely match those of human patients with the human latent autoimmune diabetes of adults (LADA) form of type 1 diabetes. Type 1 diabetes is due to absolute insulin deficiency caused by immune destruction of pancreatic b cells.3. Evidence is mounting for a genetic basis for canine diabetes mellitus. 4. The association with the major histocompatibility complex alleles on the dog leukocyte antigen gene strongly suggests that the immune response has a role in pathogenesis. Multiple environmental factors likely initiate b-cell autoimmunity:a. Once begun, β-cell destruction proceeds by common pathogenic pathways. b. A seasonality to the diagnosis of canine diabetes, with the incidence peaking in winter, suggests that environmental influences might have a role in disease progression just prior to diagnosis. C. Diestrual or gestational diabetes:1. Results from a relative insulin deficiency associated with insulin resistance. 2.Diabetes diagnosed in a bitch during either pregnancy or diestrus is comparable to human gestational diabetes.3. The periodic influence of diestrus-associated insulin resistance likely contributes to the increased risk o...

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Long‐term field study of lispro and neutral protamine Hagedorn insulins treatment in dogs with diabetes mellitus

Kuzi

Mazaki‐Tovi

Hershkovitz

et al. 2023

Veterinary Medicine & Sci

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Background The long‐term clinical and biofhemical effects of basal‐bolus insulin treatment with lispro and NPH in dogs with diabetes mellitus are undocumented. Objectives To perform a prospective pilot field study of the long‐term effects of lispro and NPH on clinical signs and serum fructosamine concentrations (SFC) in dogs with diabetes mellitus. Methods Twelve dogs received combined lispro and NPH insulins treatment twice a day and were examined every 2 weeks for 2 months (visits 1–4), and every 4 weeks for up to 4 additional months (visits 5–8). Clinical signs and SFC were recorded at each visit. Polyuria and polydipsia (PU/PD) were scored as absent (0) or present (1). Results Median (range) PU/PD scores of combined visits 5–8 (0, 0–1) were significantly lower than median scores of combined visits 1–4 (1, 0–1, p = 0.03) and at enrolment (1, 0–1, p = 0.045). Median (range) SFC of combined visits 5–8 (512 mmol/L, 401–974 mmol/L) was significantly lower than SFC of combined visits 1–4 (578 mmol/L, 302–996 mmol/L, p = 0.002) and at enrolment (662 mmol/L, 450–990 mmol/L, p = 0.03). Lispro insulin dose was significantly and negatively, albeit weakly, correlated with SFC concentration during visits 1 through 8 (r = –0.3, p = 0.013). Median duration of follow up was 6 months (range 0.5–6) and most dogs (8, 66.7%) were followed for 6 months. Four dogs withdrew from the study within 0.5–5 months because of documented or suspected hypoglycaemia, short NPH duration or sudden unexplained death. Hypoglycaemia was noted in 6 dogs. Conclusions Long‐term lispro and NPH combination therapy may improve clinical and biochemical control of some diabetic dogs with comorbidities. Risk of hypoglycaemia should be addressed with close monitoring.

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Pharmacokinetics and pharmacodynamics of porcine insulin zinc suspension in eight diabetic dogs

Cited by 25 publications

References 24 publications

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

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

Canine Diabetes Mellitus

Long‐term field study of lispro and neutral protamine Hagedorn insulins treatment in dogs with diabetes mellitus

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