DOI
https://doi.org/10.18849/ve.v6i3.407Abstract
PICO question
In cats with diabetes mellitus, do protamine zinc insulin (PZI) and glargine show a similar effect in reducing clinical signs and hypoglycaemia episodes?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
The number and type of study designs that were critically appraised was one. This study was a non-randomised retrospective trial. A systematic review was also found, which analyses the influence of insulin in diabetic remission
Strength of evidence
Weak
Outcomes reported
Compared to PZI, using glargine in recently diagnosed diabetic cats fed exclusively an ultra-low carbohydrate-high protein canned diet, may result in lower fructosamine and mean 12 hour blood glucose concentrations as well as less episodes of hypoglycaemia
Conclusion
In view of the strength of evidence and the outcomes from the study the following conclusion is made: in cats with diabetes mellitus where currently licensed insulin fails to result in a good glycaemic control, glargine may be considered
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
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Marshall, R. D., Rand, J. S. & Morton, J. M. (2009). Treatment of Newly Diagnosed Diabetic Cats with Glargine Insulin Improves Glycaemic Control and Results in Higher Probability of Remission than Protamine Zinc and Lente Insulins. Journal of Feline Medicine and Surgery. 11(8), 683–691. DOI: https://doi.org/10.1016/j.jfms.2009.05.016
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Saini, N. K., Wasik, B., Pires, J., Leale, D. M., Quach, N., Culp, W. T. N., Samms, R. J., Johnson, A. E., Owens, J. G. & Gilor, C. (2020). Comparison of pharmacodynamics between insulin glargine 100 U/mL and insulin glargine 300 U/mL in healthy cats. Domestic Animal Endocrinology. 75. DOI: https://doi.org/10.1016/j.domaniend.2020.106595
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