The effect of experimentally induced chronic hyperglycaemia on serum and pancreatic insulin, pancreatic islet IGF-I and plasma and urinary ketones in the domestic cat (Felis felis)

Link, Karl; Allio, Ileana; Rand, J. S.; Eppler, Elisabeth

doi:10.1016/j.ygcen.2013.04.029

Cited by 27 publications

(27 citation statements)

References 52 publications

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“…Glucotoxicity is considered to be the major cause of loss of β‐cell function and mass . Similar to findings in humans, hyperglycemia has been shown to induce early and severe dysfunction and loss of β cells via apoptosis in healthy cats . Thus, eliminating the detrimental effects of hyperglycemia using initial intensive infusion of insulin may improve β‐cell viability in diabetic cats, ultimately decreasing insulin requirements for the maintenance of glycemic control.…”

Section: Discussionmentioning

confidence: 83%

Intensive Intravenous Infusion of Insulin in Diabetic Cats

Hafner

Dietiker-Moretti

Kaufmann

et al. 2014

Veterinary Internal Medicne

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BackgroundRemission occurs in 10–50% of cats with diabetes mellitus (DM). It is assumed that intensive treatment improves β‐cell function and increases remission rates.HypothesisInitial intravenous infusion of insulin that achieves tight glycemic control decreases subsequent insulin requirements and increases remission rate in diabetic cats.AnimalsThirty cats with newly diagnosed DM.MethodsProspective study. Cats were randomly assigned to one of 2 groups. Cats in group 1 (n = 15) received intravenous infusion of insulin with the goal of maintaining blood glucose concentrations at 90–180 mg/dL, for 6 days. Cats in group 2 (n = 15) received subcutaneous injections of insulin glargine (cats ≤4 kg: 0.5–1.0 IU, q12h; >4 kg 1.5–2.0 IU, q12h), for 6 days. Thereafter, all cats were treated with subcutaneous injections of insulin glargine and followed up for 6 months. Cats were considered in remission when euglycemia occurred for ≥4 weeks without the administration of insulin. Nonparametric tests were used for statistical analysis.ResultsIn groups 1 and 2, remission was achieved in 10/15 and in 7/14 cats (P = .46), and good metabolic control was achieved in 3/5 and in 1/7 cats (P = .22), respectively. Overall, good metabolic control or remission occurred in 13/15 cats of group 1 and in 8/14 cats of group 2. In group 1, the median insulin dosage given during the 6‐month follow‐up was significantly lower than in group 2 (group 1: 0.32 IU/kg/day, group 2: 0.51 IU/kg/day; P = .013).Conclusions and Clinical ImportanceInitial intravenous infusion of insulin for tight glycemic control in cats with DM decreases insulin requirements during the subsequent 6 months.

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Section: Discussionmentioning

confidence: 83%

Intensive Intravenous Infusion of Insulin in Diabetic Cats

Hafner

Dietiker-Moretti

Kaufmann

et al. 2014

Veterinary Internal Medicne

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“…Maintaining blood glucose below the renal threshold (~14 mmol/l [252 mg/dl] in most cats) 31 avoids osmotic diuresis, may reduce the risk of glucose toxicity, 32 and should help minimise metabolic derangements associated with DM, including the risk of DKA. Further, exogenous insulin therapy and good control of glycaemia may result in reduced endogenous insulin requirements and 'resting' of the β-cells, which may increase their capacity to regain insulin-secreting ability and ameliorate the effects of glucose toxicity.…”

Section: Controlling Hyperglycaemiamentioning

confidence: 99%

ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats

Sparkes

Cannon²,

Church

et al. 2015

Journal of Feline Medicine and Surgery

110

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Practical relevance: Diabetes mellitus (DM) is a common endocrinopathy in cats that appears to be increasing in prevalence. The prognosis for affected cats can be good when the disease is well managed, but clinical management presents challenges, both for the veterinary team and for the owner. These ISFM Guidelines have been developed by an independent, international expert panel of clinicians and academics to provide practical advice on the management of routine (uncomplicated) diabetic cats. Clinical challenges: Although the diagnosis of diabetes is usually straightforward, optimal management can be challenging. Clinical goals should be to limit or eliminate clinical signs of the disease using a treatment regimen suitable for the owner, and to avoid insulin-induced hypoglycaemia or other complications. Optimising bodyweight, feeding an appropriate diet and using a longer acting insulin preparation (eg, protamine zinc insulin, insulin glargine or insulin detemir) are all factors that are likely to result in improved glycaemic control in the majority of cats. There is also some evidence that improved glycaemic control and reversal of glucose toxicity may promote the chances of diabetic remission. Owner considerations and owner involvement are an important aspect of management. Provided adequate support is given, and owners are able to take an active role in monitoring blood glucose concentrations in the home environment, glycaemic control may be improved. Monitoring of other parameters is also vitally important in assessing the response to insulin. Insulin adjustments should always be made cautiously and not too frequently -unless hypoglycaemia is encountered. Evidence base: The Panel has produced these Guidelines after careful review of the existing literature and of the quality of the published studies. They represent a consensus view on practical management of cats with DM based on available clinical data and experience. However, in many areas, substantial data are lacking and there is a need for better studies in the future to help inform and refine recommendations for the clinical management of this common disease.

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“…Hyperglycemia is an additional factor, which has a negative impact on b-cell function and survival in cats, a phenomenon known as glucotoxicity (Link et al 2013). There is little doubt whether glucotoxicity is a secondary event, as hyperglycemia becomes apparent only after b-cells start to fail.…”

Section: Type 2 Diabetes Mellitus: Catsmentioning

confidence: 99%

ANIMAL MODELS OF DISEASE: Classification and etiology of diabetes in dogs and cats

Nelson

Reusch

2014

Journal of Endocrinology

148

107

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Diabetes mellitus is a common disease in dogs and cats. The most common form of diabetes in dogs resembles type 1 diabetes in humans. Studies suggest that genetics, an immune-mediated component, and environmental factors are involved in the development of diabetes in dogs. A variant of gestational diabetes also occurs in dogs. The most common form of diabetes in cats resembles type 2 diabetes in humans. A major risk factor in cats is obesity. Obese cats have altered expression of several insulin signaling genes and glucose transporters and are leptin resistant. Cats also form amyloid deposits within the islets of the pancreas and develop glucotoxicity when exposed to prolonged hyperglycemia. This review will briefly summarize our current knowledge about the etiology of diabetes in dogs and cats and illustrate the similarities among dogs, cats, and humans.

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The effect of experimentally induced chronic hyperglycaemia on serum and pancreatic insulin, pancreatic islet IGF-I and plasma and urinary ketones in the domestic cat (Felis felis)

Cited by 27 publications

References 52 publications

Intensive Intravenous Infusion of Insulin in Diabetic Cats

Intensive Intravenous Infusion of Insulin in Diabetic Cats

ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats

ANIMAL MODELS OF DISEASE: Classification and etiology of diabetes in dogs and cats

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