Insulin degludec 100 U/mL for treatment of spontaneous diabetes mellitus in dogs

Abstract

Background: The advantages of insulin degludec 100 U/mL (IDeg100) in the treatment of diabetes mellitus (DM) include consistent release, predictable glucose-lowering effect, and minimal day-to-day variability.

Hypothesis/objectives: To describe the use of IDeg100 in dogs with DM, level of diabetic control and adverse effects.

Animals: Thirty-three client-owned dogs with DM.

Methods: A prospective, multi-institutional, uncontrolled study of newly diagnosed or previously insulin-treated, with or without comorbidities and with or without concurrent medications. Clinical signs and continuous glucose monitoring data were monitored and guided insulin dose adjustments. A per-protocol analysis was performed.

Results: The final dose of IDeg100 in dogs was 1.3 U/kg (median, range, 0.4-2.2) achieved in 14 days (median, range, 3-32). Seventy-nine percent (26/33) of the dogs had comorbidities with 42% (11/26) having more than 1 comorbidity. Sixty-four percent (21/33) of dogs were receiving concurrent medications with 62% (13/21) receiving more than 1 non-insulin medication. Seventy-six percent (25/33) were scored as having excellent/very good DM control. From baseline to study exit, dogs showed improvements in both ALIVE DM clinical score (from 3 [0-8, 96.49% CI (2-5)] to 1 [0-7, 96.49% CI (1-2)]; P = .0007) and average 3-day interstitial glucose (from 332.8 ± 68.7 mg/dL, 95% CI [308.8-357.2] to 229.0 ± 56.3 mg/dL [CI 209.0 - 248.9]; P < .0001).

Conclusions and clinical importance: Insulin degludec 100 U/mL is effective for the treatment of dogs with DM. Eighty-four percent (28/33) of dogs responded to once daily dose of IDeg100 with low frequency of clinical hypoglycemia.

Keywords: basal insulin; canine; continuous glucose monitoring; diabetes mellitus; once‐daily insulin; tresiba.

FIGURE 1

Example of consistent IG pattern in the dog receiving IDeg100. On July 16, the dog received an IDeg100 dose that increased by 20% from the day before. The dog starts to exhibit a consistent response to IDeg100 on July 17. Over the next few days, the time and magnitude of the nadir and postprandial peaks become becomes more consistent with each day. There was no adjustment in insulin dose after July 16. Time of insulin administration is represented by black arrows, time of meals by green arrows, and IG nadirs by red arrows.

FIGURE 2

Flow diagram of enrollment of treatment of dogs with diabetes mellitus with insulin degludec.

FIGURE 3

Violin plots of pre‐ and post‐ALIVE diabetic clinical score in all (A), non‐naïve (B), and naïve (C) dogs with diabetes mellitus treated with insulin degludec U100. The upper and lower dashed lines represent upper and lower confidence limits. The middle‐dashed line represents the median score. (P = .0007).

FIGURE 4

Mean 3‐day average interstitial glucose at baseline and after treatment with insulin degludec 100 in dogs with diabetes mellitus. The box and whiskers plots represent the average mean 3‐day interstitial glucose at baseline and after treatment with insulin degludec 100 in dogs with diabetes. The lower and upper lines of the box represent the upper and lower 95% confidence interval of the mean. The middle line represents the mean average 3‐day interstitial glucose (P < .0001).