采用低成本、中等强度的家庭监测方案和每日两次注射甘精胰岛素（来得时）时，猫的糖尿病缓解频率、缓解预测因素和生存率

摘要来源：

二校：kenda

编辑：百可事乐

摘要

本研究旨在通过回顾性分析，评估在猫专科诊所中使用中等强度、低成本的家庭血糖监测和胰岛素调整方案来管理糖尿病猫的缓解率和生存率，并确定缓解、复发或生存的预测因素。

利用猫专科诊所的记录，确定174只新确诊糖尿病的猫，根据为客户提供的旨在将胰岛素注射前血糖维持在 6.5-11.9mmol/L（117-214mg/dl）的方案，仅使用胰岛素注射前的家庭血糖测量值来调整胰岛素剂量。有以下情况的猫被排除在外：记录中随访不足、记录中宠主不配合、正在接受针对其他疾病的持续性皮质类固醇治疗、确诊时被安乐死，或者被诊断患有肢端肥大症或库欣综合征。

仅使用胰岛素注射前的家庭血糖测量值来调整胰岛素剂量，以保持血糖在6.5-11.9 mmol/L范围内，47%的猫实现缓解，但其中40%的猫复发。少数（16%）猫因低血糖住院治疗。缓解的猫和缅甸猫的生存时间显著更长。

治疗糖尿病猫的成本和时间负担可能导致一些客户选择安乐死而非治疗。虽然新确诊的糖尿病猫在使用高强度长效胰岛素方案和低碳水化合物饮食治疗的研究中表现出最高的糖尿病缓解率，但这些方案并不适合所有客户。几乎50%的新诊断糖尿病猫通过这种低成本、中等强度的胰岛素剂量方案实现缓解。由于缓解与生存时间显著相关，讨论治疗中优化缓解的因素很重要，但为客户提供多种选择也很重要。在本研究中开始接受治疗的猫中，没有一只因为主人不愿意继续治疗糖尿病而被安乐死。

原文：

Frequency of diabetic remission, predictors of remission and survival in cats using a low-cost, moderate-intensity, home-monitoring protocol and twice-daily glargine

Abstract

Objectives

The aim of the present study was to retrospectively assess remission rates and survival in diabetic cats managed using a moderate-intensity, low-cost protocol of home blood glucose measurements and insulin adjustment by clients of a cat-only practice, and to determine if predictors of remission, relapse or survival could be identified.

Methods

The records of a cat-only practice were used to identify 174 cats with newly diagnosed diabetes managed using only pre-insulin home blood glucose measurements for insulin dose adjustments based on a protocol provided to clients aimed at maintaining pre-insulin blood glucose in the range of 6.5–11.9 mmol/l (117–214 mg/dl). Cats were excluded for the following reasons: insufficient follow-up in the records; a lack of owner compliance was recorded; they were receiving ongoing corticosteroids for the management of other conditions; they were euthanased at the time of diagnosis; or they were diagnosed with acromegaly or hyperadrenocorticism.

Results

Using only pre-insulin blood glucose measurements at home to adjust the insulin dose to maintain glucose in the range of 6.5–11.9 mmol/l, 47% of cats achieved remission, but 40% of those cats relapsed. A minority (16%) of cats were hospitalised for hypoglycaemia. The survival time was significantly longer in cats in remission and Burmese cats.

Conclusions and relevance

The cost and time burden of treating diabetic cats may cause some clients to choose euthanasia over treatment. While the highest rates of diabetic remission have been reported in studies of newly diagnosed cats treated with intensive long-acting insulin protocols and low carbohydrate diets, these protocols may not be suitable for all clients. Nearly 50% of cats with newly diagnosed diabetes achieved remission with this low-cost, moderate-intensity, insulin dosing protocol. As remission was significantly associated with survival time, discussing factors in treatment to optimise remission is important, but it is also important to offer clients a spectrum of options. No cats that started treatment in this study were euthanased because the owner did not wish to continue the diabetes treatment.