Veterinary Medicine - May 2008 - (Page c12) Figure 2. Peak activity of Vetsulin Amorphous insulin peak Crystalline insulin peak 0 3 6 10 12 Time (hours) 16 20 24 Insulin concentration Blood glucose concentration Upper/lower limits for adequate glucose regulation curves and the means of the blood glucose nadir concentrations during 12-hour glucose curves for all dogs: • Before beginning insulin therapy (time 0) • At the end of the insulin dose determination period (time 1) • 30 days after time 1 (time 2) • 60 days after time 1 (time 3). Researchers also evaluated clinical variables (e.g., results of physical examinations and historic information, including presence or absence of polyuria, polydipsia, and ketonuria) at each time point. They based the adequacy of hyperglycemia control on 12-hour blood glucose curves and improvement in the clinical variables. Safety was evaluated by owner questionnaire and the performance of physical examination, complete blood count, serum chemistry pro le, and urinalysis. The means of the blood glucose concentrations during 12-hour glucose curves and the means of the blood glucose nadir concentrations during 12 12-hour glucose curves for all dogs at times 1, 2, and 3 were signi cantly lower compared with time 0 (P < .0001). The proportion of dogs with polyuria, polydipsia, and ketonuria reduced 82%, 86%, and 80%, respectively. All the dogs had adequate glycemic control at time 1, 66% at time 2, and 75% at time 3. At time 3, 66% of dogs required insulin injections every 12 hours. Other than hypoglycemia, no important adverse e ects of insulin administration were reported. In my experience, greater than 90% of diabetic dogs require twice-a-day dosing to attain clinical and laboratory evidence of glycemic control. While some pet owners may wish to try oncedaily dosing initially, the majority may be dissatis ed as a result of poor control of clinical signs and progression of diabetic cataracts. If glycemic control has not been obtained within four weeks of initiating once-daily dosing, I would encourage the use of Vetsulin twice a day. See Strategies for monitoring diabetes
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