Evaluation of fructosamine concentration as an index marker for glycaemic control in diabetic dogs

Ex Vivo Immune Function and Modulatory Effects of Calcitriol in Dogs with Naturally Occurring Diabetes Mellitus

Human patients with type 1 diabetes mellitus (T1DM) are susceptible to several long-term complications that are related to glycemic control and immune dysregulation. Immune function remains relatively unexplored in dogs with naturally occurring diabetes mellitus (NODM). Calcitriol improves various aspects of immune function in a variety of species, but its effect in diabetic dogs remains unexplored. Therefore, the objectives of this study were to (i) evaluate immune function in dogs with NODM and determine if differences exist based on the level of clinical control and (ii) assess the immunomodulatory effects of calcitriol. Twenty diabetic dogs (clinically controlled, n = ten, not controlled, n = ten) and 20 non-diabetic, healthy control dogs were included in this prospective, case-control study. Whole blood was incubated with calcitriol (10-7 M) or negative control, after which the samples were divided for phagocytosis and leukocyte cytokine response experiments. The phagocytosis of opsonized Escherichia coli (E. coli) was evaluated with flow cytometry. The samples for leukocyte cytokine response evaluations were stimulated with lipopolysaccharide (LPS), lipoteichoic acid (LTA), or phosphate buffer solution (PBS; negative control), and tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, and IL-10 were measured in supernatant using a canine-specific multiplex bead-based assay. The leukocytes from diabetic dogs produced higher concentrations of IL-10 (p = 0.01), IL-6 (p < 0.0001), and IL-8 (p < 0.0001) than the control dogs while controlling for the intervention and stimulant. Calcitriol decreased the supernatant concentrations of TNF-α (p < 0.001) and IL-8 (p = 0.04) with concomitant increases in IL-6 (p = 0.005). Diabetic dogs had a lower percentage of leukocytes undergoing phagocytosis (p < 0.0001) but a higher number of bacteria phagocytized per cell (p = 0.001) when compared to the control dogs. Calcitriol had no effect on phagocytic capacity. Lastly, the status of clinical control in diabetic dogs did not yield differences in immune function. These results support that dogs with NODM exhibit immune dysregulation and warrant additional investigation.

Diagnostic performance of glycated haemoglobin (HbA1c) for diabetes mellitus in dogs

The objective of this study was to determine the diagnostic performance of glycated haemoglobin (HbA1c) for canine diabetes mellitus (DM) and compare it with that of serum fructosamine. Aliquots of blood samples collected for diagnostic purposes from adult dogs were used. HbA1c was measured using a previously validated capillary electrophoresis assay. The dogs were allocated into four groups: (1) DM; (2) hyperadrenocorticism (HAC); (3) long-term corticosteroid therapy (CST); and (4) various chronic diseases (VD). In total, 88 dogs were included as follows: DM (n = 11), HAC (n = 10), CST (n = 14), and VD (n = 53). Fructosamine was measured in all four groups as follows: DM (n = 6), HAC (n = 7), CST (n = 9), and VD (n = 42). Median (range) serum glucose concentration was higher (P < 0.001) in the DM group (22.8 mmol/L; range, 15.6-29.3 mmol/L) compared to HAC (5.9 mmol/L; range, 4.2-6.8 mmol/L), CST (5.6 mmol/L; range, 4.3-23.3 mmol/L), and VD (5.5 mmol/L; range, 4.1-9.4 mmol/L) groups. Mean (± standard deviation) HbA1c was higher (P < 0.001) in the DM group (6.3% ± 1.5%) compared to HAC (1.9% ± 0.5%), CST (1.7% ± 0.5%), and VD (1.9% ± 0.5%) groups. All diabetic dogs and none of the other dogs had HbA1c levels above the cut-off value for DM (3.3%), indicating an accuracy of 100% in diagnosing DM. Significant differences (P < 0.01) were observed in median fructosamine between the DM group (389 μmol/L; range, 348-865 μmol/L) and the HAC (306 μmol/L; range, 167-348 μmol/L) and the VD (316 μmol/L; range, 189-500 μmol/L) groups. Fructosamine had an accuracy of 84.4% for the diagnosis of DM. When used for the diagnosis of canine DM, HbA1c measured with this specific assay had excellent diagnostic accuracy and was superior to serum fructosamine.

Successful Insulin Glargine Treatment in Two Pet Guinea Pigs with Suspected Type 1 Diabetes Mellitus

Simple Summary

This is the first case report of two guinea pigs with insulin-dependent diabetes mellitus (DM) successfully treated with long-acting basal insulin glargine. Both animals presented with typical symptoms and laboratory changes like polyphagia, glucosuria and highly elevated blood glucose levels that suggested the presence of a diabetes mellitus. One of the guinea pigs had asymmetric bilateral cataracts. Mostly, a disorder resembling type II-DM in humans seems to be prevalent in guinea pigs. In this case, the animals did not respond to the standard treatment of a dietary change but responded promptly to insulin treatment. The diabetes has remained controlled for over 1.5 years now. Thus far, there is only sparse scientific information on spontaneous type I diabetes mellitus and treatment modalities in pet guinea pigs. We discuss the current literature including up to date diagnosis, treatment, monitoring with the evaluation of different glucometers and long-time follow-up. Moreover, individual ophthalmic abnormalities and management regarding suspected diabetic cataracts are described in detail.

Abstract

Scientific information on spontaneous type I diabetes mellitus (DM) and treatment modalities in guinea pigs is scarce. As most diabetic guinea pigs are overweight and respond to dietary changes, a disorder resembling type II-DM in humans seems to be most prevalent in this species. In the present report, a nine-month-old female intact guinea pig (GP1) was presented because of a cataract and polyphagia. The physical examinations in GP1 and its littermate, GP2, were unremarkable. Laboratory tests revealed hyperglycemia, hyperlipidemia, elevated fructosamine concentrations, and glucosuria in GP1 and GP2. Not responding to dietary changes, an insulin-dependent diabetes mellitus was suspected in both animals. Treatment with 0.5 IU of glargine insulin (Lantus^®) per guinea pig subcutaneously (s.c.) once daily was initiated in both animals. Monitoring included repeated clinical evaluations and the measurement of plasma glucose and fructosamine concentrations. Capillary glucose concentration was measured using a glucometer, and glucosuria was monitored by dipstick. Blood glucose concentrations decreased quickly in both GPs, and glucosuria resolved. Including several dose adjustments, DM remained controlled for over 1.5 years. Bilateral cataracts and lens-induced uveitis in GP1 were medically managed with only slight progression. This is the first report of guinea pigs with insulin-dependent diabetes mellitus that were successfully treated with long-acting basal insulin glargine.