Glargine
From Felipedia
Glargine is the standard insulin used for the treatment of feline diabetes mellitus.
Glargine is a synthetic insulin analogue and is produced using recombinant DNA technology utilizing Escherichia coli. The insulin molecule is modified by replacing asparagine at position 21 with glycine, and by adding two arginines at the terminal portion of the B chain. This modification shifts the isoelectric point, producing a molecule that is completely soluble at a pH of 4. However, in subcutaneous tissues, the acidic solution is neutralized, leading to microprecipitates, which are the fundamental aspect of their long-acting activity[1].
Usage
Start at 0.25 - 0.5 U/kg bid; do not dilute glargine as its action is dependent upon its pH. Opened vials can be used for >6 months although the label recommendation is for one month. Dose changes can be made based on pre-insulin glucose concentration, nadir (lowest) glucose concentration, daily water consumption and urine glucose concentration. Better glycaemic control is achieved with twice daily dosing rather than once daily. More accurate dosing can be achieved using 0.3 ml U-100 insulin syringes. Glargine (Lantus) must not be diluted or mixed as this affects the peak effect.
In healthy cats, there is evidence of a carry-over effect when given once dauily, despite its mean duration effect occurring for about 14 hours[2].
References
- ↑ Rand, JS (2010) Use of long-acting insulin in the treatment of diabetes mellitus. In August, JR (Ed): Consultations in feline internal medicine. Vol 6. Elsevier Saunders, Philadelphia. pp:286
- ↑ Marshall, RD & Rand, JS (2008) Insulin glargine has a long duration of effect following administration either once daily or twice daily in divided doses in healthy cats. JFMS 10:488
