Cats: Monitoring and controlling diabetes mellitus
Insulin control
Insulin resistance
Stress, infections, and obesity
Stress or infections (eg, urinary tract infections or pyoderma) can trigger a decline in the sensitivity of target tissues to insulin. Obese animals have reduced insulin sensitivity.
Other hormones
Also, endogenous or exogenous hormones may reduce insulin’s effects. When treating an animal for diabetes mellitus, discontinue medication with progestogens immediately. Spay intact females.
If animals are being treated with corticosteroids, pursue alternative treatments. If this is not feasible, minimize the corticosteroid dose.
See the following graph for an example of a blood glucose curve in a case of insulin resistance. The graph is based on canine SID dosing and should be used as a guideline only. Insulin was injected at time=0 hours.
Blood glucose curve
Blood glucose measured in mg/dL
Click on icon for full image:
Solution
- Investigate cause, eg, Cushing’s disease, hyperprogesteronism, owner issues, injection issues, or use of the wrong type of syringe
- Consider Somogyi overswing, which can present as persistent hyperglycemia for a few days following the hypoglycemic event
Problem—the duration of action of insulin is less than desired (10–12 hours for BID administration). See the following graph for an example of a blood glucose curve in a case of rapid metabolism of insulin. The graph is based on canine SID dosing and should be used as a guideline only. Insulin was injected at time=0 hours.
Blood glucose curve
Blood glucose measured in mg/dL
Click on icon for full image:
Solution
- Change to a longer-acting preparation
See About glucose curves for details on making a glucose curve.