Open AccessGlycemic variability in newly diagnosed diabetic cats treated with the glucagon‐like peptide‐1 analogue exenatide extended release
Author(s) -
Krämer Anna L.,
Riederer Angelina,
Fracassi Federico,
Boretti Felicitas S.,
SieberRuckstuhl Nadja S.,
Lutz Thomas A.,
Contiero Barbara,
Zini Eric,
Reusch Claudia E.
Publication year - 2020
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/jvim.15915
Subject(s) - medicine , exenatide , glycemic , cats , glucagon , diabetes mellitus , endocrinology , insulin , glucagon like peptide 1 , placebo , gastroenterology , confidence interval , type 2 diabetes , alternative medicine , pathology
Background Glycemic variability (GV) is an indicator of glycemic control and can be evaluated by calculating the SD of blood glucose measurements. In humans with diabetes mellitus (DM), adding a glucagon‐like peptide‐1 (GLP‐1) analogue to conventional therapy reduces GV. In diabetic cats, the influence of GLP‐1 analogues on GV is unknown. Objective To evaluate GV in diabetic cats receiving the GLP‐1 analogue exenatide extended release (EER) and insulin. Animals Thirty client‐owned cats with newly diagnosed spontaneous DM. Methods Retrospective study. Blood glucose curves from a recent prospective placebo‐controlled clinical trial generated 1, 3, 6, 10, and 16 weeks after starting therapy were retrospectively evaluated for GV. Cats received either EER (200 μg/kg) or 0.9% saline SC once weekly, insulin glargine and a low‐carbohydrate diet. Mean blood glucose concentrations were calculated and GV was assessed by SD. Data were analyzed using nonparametric tests. Results In the EER group, GV (mean SD [95% confidence interval]) was lower at weeks 6 (1.69 mmol/L [0.9‐2.48]; P = .02), 10 (1.14 mmol/L [0.66‐1.62]; P = .002) and 16 (1.66 mmol/L [1.09‐2.23]; P = .02) compared to week 1 (4.21 mmol/L [2.48‐5.93]) and lower compared to placebo at week 6 (3.29 mmol/L [1.95‐4.63]; P = .04) and week 10 (4.34 mmol/L [2.43‐6.24]; P < .000). Cats achieving remission (1.21 mmol/L [0.23‐2.19]) had lower GV compared to those without remission (2.96 mmol/L [1.97‐3.96]; P = .01) at week 6. Conclusions and Clinical Importance The combination of EER, insulin, and a low‐carbohydrate diet might be advantageous in the treatment of newly diagnosed diabetic cats.