Management of Postprandial Hyperglycemia in Diabetic Dogs Treated with Basal Insulin Formulations

Presentation Description / Summary: Insulin therapy in diabetic dogs should ideally mimic a basal-bolus pattern. However, in most diabetic dogs, good control of clinical signs can be achieved when using a basal insulin formulation alone. The criteria for an effective and safe basal insulin include the requirement that insulin action is roughly the same every hour of the day. Therefore, goals regarding glycemic control are very different for protocols using basal insulin in dogs compared with those for traditional intermediate-acting insulin. A basal insulin formulation is administered irrespective of food consumption. Blood glucose is then expected to rise following the meals and decline back to baseline when carbohydrate absorption has subsided. The resulting blood glucose fluctuations might or might not remain below the renal threshold, depending on the type of food and the frequency of feeding. Continuous interstitial glucose monitoring has revealed considerable within-day, day-to-day, and inter-dog variability of postprandial hyperglycemia relating to feeding in diabetic dogs treated with basal insulin. Excessive postprandial hyperglycemia can be identified by reviewing continuous glucose data over several days while the dog is fed the usual diet with the usual feeding routine. This can often be effectively managed by changing the diet or the feeding routine for one or more of the dog’s daily meals. In a small minority of dogs, bolus insulin administration at the time of at least one meal per day may be added to optimize glycemic control.