Glargine versus regular insulin protocol in feline diabetic ketoacidosis.
J Vet Emerg Crit Care (San Antonio)
; 31(4): 459-468, 2021 Jul.
Article
en En
| MEDLINE
| ID: mdl-33945208
ABSTRACT
OBJECTIVES:
To determine whether basal-bolus administration of glargine insulin is a safe and effective alternative treatment compared to the standard continuous rate infusion (CRI) protocol.DESIGN:
Prospective randomized clinical trial.SETTING:
University teaching hospital. ANIMALS Twenty cats diagnosed with diabetic ketoacidosis (DKA).INTERVENTIONS:
The cats were block-randomized to either a CRI protocol using regular insulin (CRI-group; n = 10) or a basal-bolus SC and IM glargine protocol (glargine-group, n = 10). Baseline blood gases, electrolytes, glucose, and ß-hydroxybutyrate (ß-OHB) concentrations were measured at the time of admission and later at predefined intervals until reaching the primary endpoint of the study, defined as a ß-hydroxybutyrate concentration < 2.55 mmol/L. MEASUREMENTS AND MAINRESULTS:
The main outcome measure was time (h) to resolution of ketonemia. Secondary outcome measures were time until first improvement of hyperglycemia and ketonemia, decrease of glucose to ≤13.9 mmol/L (250 mg/dL), resolution of acidosis, consumption of first meal, and discharge from hospital. Additionally, occurrence of treatment-associated adverse events and death were compared. Seventeen cats (85%) survived to discharge, with no difference in survival between groups (P = 1.0). Median times to ß-OHB < 2.55 mmol/L were 42 (CRI-group) and 30 (glargine-group) hours, respectively (P = 0.114). Median times to first improvement of hyperglycemia (glargine-group 2 h; CRI-group 6 h; P = 0.018) and until discharge from hospital (glargine-group 140 h; CRI-group 174 h; P = 0.033) were significantly shorter in the glargine-group. No significant differences were observed in any other parameter under investigation (P > 0.05).CONCLUSIONS:
Basal-bolus administration of glargine insulin appears to be an effective and safe alternative to the current standard CRI-protocol for the management of DKA in cats. The positive outcomes and simplicity make it a viable option for the treatment of feline DKA.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_diabetes
/
6_endocrine_disorders
Asunto principal:
Enfermedades de los Gatos
/
Cetoacidosis Diabética
/
Hiperglucemia
Tipo de estudio:
Guideline
/
Observational_studies
/
Risk_factors_studies
Límite:
Animals
Idioma:
En
Revista:
J Vet Emerg Crit Care (San Antonio)
Asunto de la revista:
MEDICINA DE EMERGENCIA
/
MEDICINA VETERINARIA
/
TERAPIA INTENSIVA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Austria