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Application of surrogate indicators of insulin sensitivity to critically ill cats
Author(s) -
Chan D. L.,
Freeman L. M.
Publication year - 2005
Publication title -
journal of animal physiology and animal nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.651
H-Index - 56
eISSN - 1439-0396
pISSN - 0931-2439
DOI - 10.1111/j.1439-0396.2005.00611_11.x
Subject(s) - cats , quantitative insulin sensitivity check index , insulin , insulin resistance , medicine , endocrinology , critically ill , diabetes mellitus , blood sugar regulation , insulin sensitivity
Hyperglycaemia associated with critical illness is a common finding in non‐diabetic human patients and has important implications for nutritional support. The aetiology of the hyperglycaemia is multi‐factorial but believed to involve alterations in hormones regulating glucose metabolism and the development of insulin resistance. We have previously demonstrated that hyperglycaemia in critically cats similarly involves alterations in circulating concentrations of insulin, glucagon, and cortisol. Namely, with critical illness cats had hypoinsulinaemia, hyperglucagonaemia, and hypercortisolaemia. However, direct determinations of insulin sensitivity in critically ill cats have remained untested due to the complexity of calculations and frequent blood sampling required. Such techniques have, therefore, been limited to experimental models. In the interest of studying insulin sensitivity in clinical cases, surrogate indicators of insulin sensitivity, e.g, Homeostasis Model Assessment (HOMA), and Quantitative Insulin Check Index (QUICKI), have been recently applied to cats and shown to correlate to more traditional insulin sensitivity testing. HOMA is calculated ([insulin]x[(glucose)/22.5]), while QUICKI is (1/ [log insulin + log glucose]).The goal of this study was to apply the HOMA and QUICKI indices to hyperglycaemic critically ill cats and compare them to those of euglycaemic critically ill cats and controls. Twenty‐six critically ill, and 21 healthy control cats were evaluated. Groups were matched for age, weight, and body condition. Of the critically ill cats, 10 were euglycaemic, and 14 were hyperglycaemic (glucose > 180 mg/dL). As compared to euglycaemic critically ill cats, HOMA was found to be significantly greater in hyperglycaemic cats [median 5.30 (range 0.90 – 25.14) vs. [2.19 (0.69 – 7.33); p = 0.016], while QUICKI was significantly lower in hyperglycaemic cats [median 0.30 mg/dl (0.25 – 0.39 mg/dl) vs. [0.34 mg/dl (0.29 – 0.38 mg/dl); p = 0.039]. Higher HOMA and lower QUICKI indices are consistent with an insulin resistant state. However, HOMA and QUICKI were not significantly different between hyperglycaemic and control cats. While the application of these indices may prove useful in determining insulin sensitivity in critically ill cats, future studies are needed to resolve discrepancies demonstrate in the current study.