Diabetes Mellitus Flashcards
What are some of the functions of insulin?
Decrease peripheral lipolysis - Decrease muscle catabolism - Decrease hepatic gluconeogenesis - Decrease ketone body production
Increase lipogenesis - Increase intracellular K influx - Increase peripheral glucose intake
How does diabetes mellitus present in patients?
Weight loss with increased appetite - PD and PU - Bright and happy (unless ketoacidosis = vomiting)
What type of diabetes is most prevalent in dogs?
Type 1 - normal sensitivity to insulin but loss of islets
What type of diabetes is most prevalent in cats?
Type 2 - insulin resistance with normal/increased insulin production
How can insulin resistance reduce secretary capacity of insulin from the islets?
Increased insulin in blood - accelerate insulin production - increased apoptosis - islet underactivity and ‘exhaustion’
What can cause insulin resistance?
Obesity - Oestrus - Pregnancy - Anxiety - Altered metabolites (increased FA) - Hypercortisolaemia - Endocrinopathies
What two endocrinopathies cause insulin resistance in cats?
Hyperadrenocorticism - Acromegaly (hypersomatotrophism)
How does acromegaly cause insulin resistance?
Increased GH released from pituitary - Interferes with insulin production and increase Insulin-like Growth Factor-1 (IGF-1)
What is a common clinical sign in dogs with diabetes?
Cataracts
What is the clinical pathology of an animal with diabetes mellitus?
Fasting hyperglycaemia - Fasting hyperlipaemia and maybe ketonaemia - Glucosuria and ketonuria - Elevated fructosamine and glycosylated haemoglobin - Elevated ALP and ALT - Maybe metabolic acidosis - Altered Potassium and Phosphate
What is fructosamine? What can it tell us about an animal?
Compound dreated when glucose binds irreversibly to albumin (non-enzymatically) - Reflects average blood glucose if albumin levels are stable
What insulin treatment is the only one available at the moment for dogs and cats?
Caninsulin
Why is insulin glargine preferred for some cats?
Has a peakless effect so good for ‘grazing’ cats
How often do insulin injections have to be administered?
Twice daily generally
When will caninsulin peak in the blood? When will blood glucose peak after a meal? What does this implicate?
4 to 6 hours - 30mins to 1 hours - Need to coordinate injections of caninsulin with feeding times to get maximum effect
