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

Abstract 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 fructo...

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Main Authors: Sharon Kuzi, Michal Mazaki‐Tovi, Shai Hershkovitz, Einat Yas, Rebecka S. Hess
Format: Article
Language:English
Published: Wiley 2023-03-01
Series:Veterinary Medicine and Science
Subjects:
Online Access:https://doi.org/10.1002/vms3.1077
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author Sharon Kuzi
Michal Mazaki‐Tovi
Shai Hershkovitz
Einat Yas
Rebecka S. Hess
author_facet Sharon Kuzi
Michal Mazaki‐Tovi
Shai Hershkovitz
Einat Yas
Rebecka S. Hess
author_sort Sharon Kuzi
collection DOAJ
description Abstract 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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spelling doaj.art-d24583396df04cb087ca6e5362f9cfd62023-03-21T15:53:53ZengWileyVeterinary Medicine and Science2053-10952023-03-019270471110.1002/vms3.1077Long‐term field study of lispro and neutral protamine Hagedorn insulins treatment in dogs with diabetes mellitusSharon Kuzi0Michal Mazaki‐Tovi1Shai Hershkovitz2Einat Yas3Rebecka S. Hess4Department of Small Animals Internal Medicine Koret School of Veterinary Medicine Hebrew University of Jerusalem Rehovot IsraelDepartment of Small Animals Internal Medicine Koret School of Veterinary Medicine Hebrew University of Jerusalem Rehovot IsraelDepartment of Small Animals Internal Medicine Koret School of Veterinary Medicine Hebrew University of Jerusalem Rehovot IsraelDepartment of Small Animals Internal Medicine Koret School of Veterinary Medicine Hebrew University of Jerusalem Rehovot IsraelDepartment of Clinical Sciences & Advanced Medicine School of Veterinary Medicine University of Pennsylvania Pennsylvania PhiladelphiaAbstract 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.https://doi.org/10.1002/vms3.1077basal‐bolus insulin treatmentcaninehypoglycaemiapost‐prandial hyperglycaemia
spellingShingle Sharon Kuzi
Michal Mazaki‐Tovi
Shai Hershkovitz
Einat Yas
Rebecka S. Hess
Long‐term field study of lispro and neutral protamine Hagedorn insulins treatment in dogs with diabetes mellitus
Veterinary Medicine and Science
basal‐bolus insulin treatment
canine
hypoglycaemia
post‐prandial hyperglycaemia
title Long‐term field study of lispro and neutral protamine Hagedorn insulins treatment in dogs with diabetes mellitus
title_full Long‐term field study of lispro and neutral protamine Hagedorn insulins treatment in dogs with diabetes mellitus
title_fullStr Long‐term field study of lispro and neutral protamine Hagedorn insulins treatment in dogs with diabetes mellitus
title_full_unstemmed Long‐term field study of lispro and neutral protamine Hagedorn insulins treatment in dogs with diabetes mellitus
title_short Long‐term field study of lispro and neutral protamine Hagedorn insulins treatment in dogs with diabetes mellitus
title_sort long term field study of lispro and neutral protamine hagedorn insulins treatment in dogs with diabetes mellitus
topic basal‐bolus insulin treatment
canine
hypoglycaemia
post‐prandial hyperglycaemia
url https://doi.org/10.1002/vms3.1077
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