Predictors of Clinical Remission in Cats with Diabetes Mellitus

Abstract

Background: Clinical remission is frequent in cats with well-controlled diabetes mellitus, but few studies explored predictors of this phenomenon.Hypothesis: Data retrieved from medical records at admission might be valuable to identify likelihood of remission and its duration in diabetic cats.Animals: Ninety cats with newly diagnosed diabetes, followed-up until death or remission. Methods: Retrospective cohort study. Data were collected from records at admission, including history, signalment, physical examination, haematology, and biochemical profile, and the occurrence and duration of remission, defined as normoglycemia without insulin for !4 weeks. Predictors of remission were studied with univariate and multivariate logistic regression. Factors associated with remission duration were analyzed with Kaplan-Meier and Cox proportional hazard models.Results: Forty-five (50%) cats achieved remission, after a median time of 48 days (range: 8-216). By study end, median remission duration was 114 days (range: 30-3,370) in cats that died and 151 days (range: 28-1,180) in alive cats. Remission was more likely with higher age (OR: 1.23, 95% CI: 1.04-1.46; P 5 .01) and less likely with increased serum cholesterol (OR: 0.36, 95% CI: 0.11-0.87; P 5 .04). Remission was longer with higher body weight (HR: 0.65, 95% CI: 0.42-0.99; P 5 .04) and shorter with higher blood glucose (HR: 1.01, 95% CI: 1.00-1.02; P 5 .02).Conclusions and Clinical Importance: Age, body weight, cholesterol, and glucose levels are suggested for prediction of remission or its duration in diabetic cats. Older cats developing diabetes may have a better outcome, possibly suggesting a slower disease progression.

Glycemic Status and Predictors of Relapse for Diabetic Cats in Remission

“…The relapse incidence of 30% in our study is consistent with previous reports of 26–29% 6, 7. Our findings suggest that serial monitoring of cats in diabetic remission is warranted to detect deterioration of glucose tolerance and impending relapse.…”

Factors associated with clinical remission in cats with diabetes mellitus

“…However, the results reported in previous studies are inconsistent (Goossens et al 1998;Nelson et al 1999;Zini et al 2010). Although ALT activities were elevated, ketonuria and pancreatitis were not associated with survival time or remission in our study, and concurrent chronic renal failure was negatively associated with survival time.…”

“…This condition is characterized by hyperglycaemia, which results from an absolute or relative deficiency of insulin. Feline type 2 DM is associated with inadequate insulin secretion and concurrent conditions that induce insulin resistance or diabetogenic drugs that are associated with the development of DM (Zini et al 2010). Clinical remission of this condition can be achieved by improving the residual β-cell function and restoring euglycaemia, for example, good glycaemic control during the early stage of the disease (Roomp and Rand 2009).…”

“…Researchers have investigated the predictors of clinical remission in cats with diabetes mellitus, including age, serum cholesterol concentrations, strict glycaemic control, and the method of insulin replacement (Marshall et al 2009;Zini et al 2010). However, predictors of survival in cats with diabetes mellitus were not fully explored.…”

“…Feline type 2 DM is associated with inadequate insulin secretion and concurrent conditions that induce insulin resistance or diabetogenic drugs that are associated with the development of DM (Zini et al 2010). Clinical remission of this condition can be achieved by improving the residual β-cell function and restoring euglycaemia, for example, good glycaemic control during the early stage of the disease (Roomp and Rand 2009).Researchers have investigated the predictors of clinical remission in cats with diabetes mellitus, including age, serum cholesterol concentrations, strict glycaemic control, and the method of insulin replacement (Marshall et al 2009;Zini et al 2010). However, predictors of survival in cats with diabetes mellitus were not fully explored.…”