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DIABETES mellitus in dogs is caused by absolute or relative insulin deficiency and successful management typically requires lifelong monitoring and regular reappraisal of the treatment regimen. The two primary goals of therapy are: resolution of all clinical signs; and avoidance of insulin-induced hypoglycaemia. Resolution of all clinical signs is best achieved using a regimen of fixed daily insulin doses and feeding consistent meals. Avoidance of insulin-induced hypoglycaemia is very important as the condition can result in irreversible brain damage or death. A conservative approach to insulin dosing, twice daily insulin administration, and complementary nutritional strategies can greatly reduce the risk.
Important advantages of continuous subcutaneous glucose monitoring systems over intermittent blood glucose measurement are that they facilitate detection of brief periods of hypoglycaemia and provide information overnight. This is highlighted in a paper summarised in this issue of Veterinary Record on home-based subcutaneous glucose monitoring in diabetic dogs (Affenzeller and others 2011). A pattern consistent with the Somogyi effect, nocturnal hypoglycaemia, or a brief episode of hypoglycaemia were identified in three of the 10 dogs studied using a new continuous glucose monitoring system (Affenzeller and others 2011). In human diabetic patients continuous subcutaneous glucose monitoring has revealed that nocturnal hypoglycaemia is more common than previously recognised, especially …