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Effect of insulin dosage on glycemic response in dogs with diabetes mellitus: 221 cases (1993–1998)

Rebecka S. HessDepartment of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010.

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 DVM, DACVIM
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Cynthia R. WardDepartment of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010.

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 VMD, PhD, DACVIM

Abstract

Objective—To evaluate glycemic response to insulin treatment in dogs with diabetes mellitus.

Design—Retrospective study.

Animals—221 dogs with diabetes mellitus.

Procedure—Type and dosage of insulin used, minimum and maximum blood glucose concentrations, time of blood glucose concentration nadir, and optimal duration of action of insulin were determined on the basis of data obtained prior to initial examination at the teaching hospital (127 dogs), at the time of initial examination (212 dogs), at the time a second follow- up blood glucose curve was performed (59 dogs), and at the time of clinical control of diabetes mellitus (83 dogs).

Results—Prior to examination, 69 of 127 dogs (54%) received 1 SC insulin injection daily. Thirty-one dogs (24%) received a high dose of insulin (ie, > 1.5 U/kg [0.7 U/lb] of body weight); 27 of these dogs (87%) received 1 injection/d. Eleven of 16 dogs (69%) that were hypoglycemic (blood glucose concentration < 80 mg/dl) also received 1 injection/d. However, optimal duration of action of insulin was > 12 hours in only 5 of 83 dogs (6%) evaluated at the time diabetes mellitus was clinically controlled. At that time, only 1 dog (1%) received a high dose of insulin, and the dog received 2 injections/d. Moreover, 8 of 10 dogs (80%) with hypoglycemia received 1 injection/d.

Conclusions and Clinical Relevance—Most dogs with diabetes mellitus are clinically regulated with 2 daily insulin injections. Administration of a high dose of insulin or development of hypoglycemia may be more common in diabetic dogs that receive insulin once daily, compared with dogs that receive insulin twice daily. ( J Am Vet Med Assoc 2000;216:217–221)

Abstract

Objective—To evaluate glycemic response to insulin treatment in dogs with diabetes mellitus.

Design—Retrospective study.

Animals—221 dogs with diabetes mellitus.

Procedure—Type and dosage of insulin used, minimum and maximum blood glucose concentrations, time of blood glucose concentration nadir, and optimal duration of action of insulin were determined on the basis of data obtained prior to initial examination at the teaching hospital (127 dogs), at the time of initial examination (212 dogs), at the time a second follow- up blood glucose curve was performed (59 dogs), and at the time of clinical control of diabetes mellitus (83 dogs).

Results—Prior to examination, 69 of 127 dogs (54%) received 1 SC insulin injection daily. Thirty-one dogs (24%) received a high dose of insulin (ie, > 1.5 U/kg [0.7 U/lb] of body weight); 27 of these dogs (87%) received 1 injection/d. Eleven of 16 dogs (69%) that were hypoglycemic (blood glucose concentration < 80 mg/dl) also received 1 injection/d. However, optimal duration of action of insulin was > 12 hours in only 5 of 83 dogs (6%) evaluated at the time diabetes mellitus was clinically controlled. At that time, only 1 dog (1%) received a high dose of insulin, and the dog received 2 injections/d. Moreover, 8 of 10 dogs (80%) with hypoglycemia received 1 injection/d.

Conclusions and Clinical Relevance—Most dogs with diabetes mellitus are clinically regulated with 2 daily insulin injections. Administration of a high dose of insulin or development of hypoglycemia may be more common in diabetic dogs that receive insulin once daily, compared with dogs that receive insulin twice daily. ( J Am Vet Med Assoc 2000;216:217–221)