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Tardo AM, Fleeman LM, Fracassi F, Berg AS, Guarino AL, Gilor C. A dose titration protocol for once-daily insulin glargine 300 U/mL for the treatment of diabetes mellitus in dogs. J Vet Intern Med 2024. [PMID: 38831362 DOI: 10.1111/jvim.17106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/01/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND In purpose-bred dogs, insulin glargine 300 U/mL (IGla300) has long duration of action, peakless time-action profile, and low potency, making it suitable for use as a basal insulin. HYPOTHESIS To evaluate IGla300 in client-owned diabetic dogs monitored using a flash glucose monitoring system (FGMS). ANIMALS Ninety-five client-owned diabetic dogs, newly diagnosed or previously treated with other insulin formulations, with or without concurrent diseases. METHODS Prospective multi-institutional study. Clinical signs and standardized assessment of FGMS data, using treatment and monitoring guidelines established a priori, guided dose adjustments and categorization into levels of glycemic control. RESULTS The initial IGla300 dose was 0.5 U/Kg q24h for newly diagnosed dogs and (median dose [range]) 0.8 U/Kg (0.2-2.5) q24h for all dogs. Glycemic control was classified as good or excellent in 87/95 (92%) dogs. The IGla300 was administered q24h (1.9 U/kg [0.2-5.2]) and q12h (1.9 U/kg/day [0.6-5.0]) in 56/95 (59%) and 39/95 (41%) dogs, respectively. Meal-time bolus injections were added in 5 dogs (0.5 U/kg/injection [0.3-1.0]). Clinical hypoglycemia occurred in 6/95 (6%) dogs. Dogs without concurrent diseases were more likely to receive IGla300 q24h than dogs with concurrent diseases (72% vs 50%, respectively; P = .04). CONCLUSIONS AND CLINICAL IMPORTANCE Insulin glargine 300 U/mL can be considered a suitable therapeutic option for once-daily administration in diabetic dogs. Clinicians should be aware of the low potency and wide dose range of IGla300. In some dogs, twice-daily administration with or without meal-time bolus injections may be necessary to achieve glycemic control. Monitoring with FGMS is essential for dose titration of IGla300.
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Affiliation(s)
- Antonio Maria Tardo
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | | | - Federico Fracassi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Alisa Saule Berg
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Aria L Guarino
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
- BluePearl Pet Hospital, Rockville, Maryland, USA
| | - Chen Gilor
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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Fleeman L, Gilor C. Insulin Therapy in Small Animals, Part 1: General Principles. Vet Clin North Am Small Anim Pract 2023; 53:615-633. [PMID: 36906469 DOI: 10.1016/j.cvsm.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Understanding the pharmacology of insulin and how it relates to the pathophysiology of diabetes can lead to better clinical outcomes. No insulin formulation should be considered "best" by default. Insulin suspensions (NPH, NPH/regular mixes, lente, and PZI) as well as insulin glargine U100 and detemir are intermediate-acting formulations that are administered twice daily. For a formulation to be an effective and safe basal insulin, its action should be roughly the same every hour of the day. Currently, only insulin glargine U300 and insulin degludec meet this standard in dogs, whereas in cats, insulin glargine U300 is the closest option.
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Affiliation(s)
- Linda Fleeman
- Animal Diabetes Australia, Melbourne, Victoria, Australia.
| | - Chen Gilor
- Small Animal Internal Medicine, Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 Southwest 16th Avenue, Gainesville, FL 32608, USA
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Davis CL, Bugbee AC, Ward C. The effect of postprandial exercise on mean blood glucose concentrations following high and maintenance carbohydrate content meals in healthy dogs. Res Vet Sci 2022; 150:144-148. [PMID: 35839707 DOI: 10.1016/j.rvsc.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 04/18/2022] [Accepted: 05/23/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To compare the effect of 15 min of exercise 30 min post-meal on mean blood glucose concentrations in 5 well-conditioned versus 5 over-conditioned dogs. To compare the effect of exercise on glycemic control in dogs eating their maintenance diet as compared to a high carbohydrate meal. ANIMALS Ten healthy staff or student owned dogs, five well- and five over-conditioned. PROCEDURES This was a crossover study over 5 days. Continuous glucose monitors (CGM) were placed on day 1. On days 2 and 3, dogs received their maintenance diet and a high carbohydrate meal, respectively and were walked on the treadmill for 15 min following each meal. On day 4, dogs were given their maintenance diet in hospital without treadmill activity. On day 5, the CGM were removed. The mean blood glucose 30 min post-meal, during exercise, 15 min after completing exercise, and the 1-3 h period after completing the exercise were compared to detect any effect of exercise, diet composition, or body condition. RESULTS Dogs consuming a high carbohydrate meal had a significantly higher mean blood glucose 15 min post-exercise. Mean glucose values at all time points following a high carbohydrate meal were significantly higher than mean glucose values on the non-exercise day. CONCLUSIONS AND CLINICAL RELEVANCE No impact of post-prandial exercise on glucose concentrations were identified in this study, however, the carbohydrate content of the meal impacted post-prandial glycemic responses in healthy dogs regardless of body condition. Evaluating the impact of post-prandial exercise in insulin-dependent or glucose-intolerant dogs is warranted to determine if these findings persist.
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Affiliation(s)
- Chelsea L Davis
- University of Georgia College of Veterinary Medicine, 2200 College Station Road, Athens, GA 30602, United States of America
| | - Andrew C Bugbee
- University of Georgia College of Veterinary Medicine, 2200 College Station Road, Athens, GA 30602, United States of America.
| | - Cynthia Ward
- University of Georgia College of Veterinary Medicine, 2200 College Station Road, Athens, GA 30602, United States of America
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Gilor C, Fleeman LM. One hundred years of insulin: Is it time for smart? J Small Anim Pract 2022; 63:645-660. [PMID: 35560042 DOI: 10.1111/jsap.13507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/10/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022]
Abstract
Smarter understanding of diabetes pathophysiology and pharmacology of insulin therapy can lead to better clinical outcomes. Rather than looking for an insulin formulation that is considered "best" for a general population, it could be appropriate to seek the "smart" insulin choice, tailored to the specific clinical situation. Different treatment goals should be considered, with pros and cons to each. Ideally, insulin therapy in most diabetic dogs should mimic a "basal-bolus" pattern. The "intermediate"-acting insulin formulations might provide better "bolus" treatment in dogs than the rapid-acting formulations used in people. In patients with some residual beta cell function such as many diabetic cats, administering only a "basal" insulin might lead to complete normalisation of blood glucose concentrations. Insulin suspensions (neutral protamine Hagedorn, neutral protamine Hagedorn/regular mixes, lente and protamine zinc insulin) as well as insulin glargine U100 and detemir are "intermediate"-acting formulations that are administered twice daily. For a formulation to be an effective and safe "basal" insulin, its action should be roughly the same every hour of the day. Currently, only insulin glargine U300 and insulin degludec meet this standard in dogs, whereas in cats, insulin glargine U300 is the closest option.
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Affiliation(s)
- C Gilor
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - L M Fleeman
- Animal Diabetes Australia, Melbourne, Victoria, Australia
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Miller M, Pires J, Crakes K, Greathouse R, Quach N, Gilor C. Day-to-day variability of porcine lente, insulin glargine 300 U/mL and insulin degludec in diabetic dogs. J Vet Intern Med 2021; 35:2131-2139. [PMID: 34241910 PMCID: PMC8478047 DOI: 10.1111/jvim.16178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/05/2021] [Accepted: 05/14/2021] [Indexed: 11/27/2022] Open
Abstract
Background Day‐to‐day variability impacts safety of insulin therapy and the choice of monitoring strategies. Side‐by‐side comparisons of insulin formulations in diabetic dogs are scarce. Hypothesis/Objectives Insulin glargine 300 U/mL (IGla300) and insulin degludec (IDeg) are associated with less day‐to‐day glucose variability compared to porcine lente (PL) in diabetic dogs. Animals Seven intact male purpose‐bred beagles with toxin‐induced diabetes. Methods In this repeated measured study, PL, IGla300 and IDeg were compared in 2 phases: once‐daily (q24h) and twice‐daily (q12h) administration. Interstitial glucose concentrations (IG) were measured continuously throughout the study. For each formulation, maximal q24h dose was determined using the same algorithm (while avoiding hypoglycemia) and then maintained for 72 hours. In phase 2, 70% of the maximal q24h dose was administered q12h and maintained for 5 days regardless of hypoglycemia. Coefficient of variation (CV) and glycemic variability percentage (GVP) were calculated to determine day‐to‐day and intraday variability, respectively. Results There was no difference in day‐to‐day variability between PL, IGla300, and IDeg in the q24h phase. In the q12h phase, day‐to‐day variability was higher (P = .01) for PL (CV = 42.6 ± 6.8%) compared to IGla300 and IDeg (CV = 30.1 ± 7.7%, 25.2 ± 7.0%, respectively). The GVP of PL was lower (P = .02) compared to IGla300. There was no difference between PL, IGla300 and IDeg in %time IG < 70 mg/dL. Conclusions and Clinical Importance Insulin degludec and IGla300 administered q12h were associated with lower day‐to‐day variability, which might be advantageous in minimizing monitoring requirements without increasing the risk of hypoglycemia.
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Affiliation(s)
- Michelle Miller
- Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Jully Pires
- Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Katti Crakes
- Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Rachel Greathouse
- Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Nina Quach
- Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Chen Gilor
- Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA.,Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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Fenofibrate promotes PPARα-targeted recovery of the intestinal epithelial barrier at the host-microbe interface in dogs with diabetes mellitus. Sci Rep 2021; 11:13454. [PMID: 34188162 PMCID: PMC8241862 DOI: 10.1038/s41598-021-92966-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/14/2021] [Indexed: 11/08/2022] Open
Abstract
Diabetes mellitus (DM) is associated with a dysfunctional intestinal barrier and an increased risk for systemic infection and inflammation in people, though the pathogenic mechanisms leading to this are poorly understood. Using a canine model of DM, we showed that the peroxisomal proliferator-activated receptor-α agonist fenofibrate modulates plasma lipid profiles and markers of intestinal barrier function. A 3-week course of fenofibrate reduced fasting interstitial glucose and inflammatory cytokine IL-8 and TNF-α concentrations, which correlated with reduced triglyceride levels. The lipidomic profile exhibited significantly lower levels of triacylglycerols, phosphatidylethanolamines, diacylglycerols, and ceramides following fenofibrate administration. On histopathological analysis, we observed an aberrant amount of intraepithelial CD3+ T lymphocytes (IEL) in the small intestine of dogs with spontaneous and induced-DM. Fenofibrate reduced IEL density in the duodenum of dogs with DM and enhanced markers of intestinal barrier function in vivo and in vitro. There were minimal changes in the intestinal microbial composition following fenofibrate administration, suggesting that repair of intestinal barriers can be achieved independently of the resident microbiota. Our findings indicate that lipid metabolism is critical to functionality of the intestinal epithelium, which can be rescued by PPARα activation in dogs with DM.
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Briens JM, Subramaniam M, Kilgour A, Loewen ME, Desai KM, Adolphe JL, Zatti KM, Drew MD, Weber LP. Glycemic, insulinemic and methylglyoxal postprandial responses to starches alone or in whole diets in dogs versus cats: Relating the concept of glycemic index to metabolic responses and gene expression. Comp Biochem Physiol A Mol Integr Physiol 2021; 257:110973. [PMID: 33933629 DOI: 10.1016/j.cbpa.2021.110973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 10/21/2022]
Abstract
Species differences between domestic cats (Felis catus) and dogs (Canis familiaris) has led to differences in their ability to digest, absorb and metabolize carbohydrates through poorly characterized mechanisms. The current study aimed to first examine biopsied small intestine, pancreas, liver and skeletal muscle from laboratory beagles and domestic cats for mRNA expression of key enzymes involved in starch digestion (amylase), glucose transport (sodium-dependent SGLTs and -independent glucose transporters, GLUT) and glucose metabolism (hexokinase and glucokinase). Cats had lower mRNA expression of most genes examined in almost all tissues compared to dogs (p < 0.05). Next, postprandial glucose, insulin, methylglyoxal (a toxic glucose metabolite) and d-lactate (metabolite of methylglyoxal) after single feedings of different starch sources were tested in fasted dogs and cats. After feeding pure glucose, peak postprandial blood glucose and methylglyoxal were surprisingly similar between dogs and cats, except cats had a longer time to peak and a greater area under the curve consistent with lower glycolytic enzyme expression. After feeding starches or whole diets to dogs, postprandial glycemic response, glycemic index, insulin, methylglyoxal and d-lactate followed reported glycemic index trends in humans. In contrast, cats showed very low to negligible postprandial glycemic responses and low insulin after feeding different starch sources, but not whole diets, with no relationship to methylglyoxal or d-lactate. Thus, the concept of glycemic index appears valid in dogs, but not cats. Differences in amylase, glucose transporters, and glycolytic enzymes are consistent with species differences in starch and glucose handling between cats and dogs.
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Affiliation(s)
- Jennifer M Briens
- Toxicology Graduate Program, University of Saskatchewan, Saskatoon, SK S7N 5B3, Canada
| | - Marina Subramaniam
- Veterinary Biomedical Sciences, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada
| | - Alyssa Kilgour
- Veterinary Biomedical Sciences, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada
| | - Matthew E Loewen
- Veterinary Biomedical Sciences, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada
| | - Kaushik M Desai
- Pharmacology & Physiology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Jennifer L Adolphe
- Veterinary Biomedical Sciences, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada
| | - Kyla M Zatti
- Animal & Poultry Science, University of Saskatchewan, Saskatoon, SK S7N 5A8, Canada
| | - Murray D Drew
- Animal & Poultry Science, University of Saskatchewan, Saskatoon, SK S7N 5A8, Canada
| | - Lynn P Weber
- Toxicology Graduate Program, University of Saskatchewan, Saskatoon, SK S7N 5B3, Canada; Veterinary Biomedical Sciences, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada.
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Teshima E, Brunetto MA, Teixeira FA, Gomes MDOS, Lucas SRR, Pereira GT, Carciofi AC. Influence of type of starch and feeding management on glycaemic control in diabetic dogs. J Anim Physiol Anim Nutr (Berl) 2021; 105:1192-1202. [PMID: 33904623 DOI: 10.1111/jpn.13556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/01/2021] [Accepted: 03/22/2021] [Indexed: 01/16/2023]
Abstract
The present study evaluated the effects of two diets with different starch sources and two feeding methods on the glycaemic control in dogs with diabetes mellitus. The diets had similar nutrient contents (40% starch and 16% dietary fibre), one formulated with 46% of broken rice and the other with 42% sorghum and 10% lentils (as-fed). Ten client-owned diabetic dogs were fed with each diet for 2 months, in a crossover design. Five dogs received NPH human insulin and food every 12 h (feeding method 1), and the other five received insulin every 12 h but were fed three times a day (feeding method 2). In feeding method 2, morning insulin was higher than the evening dose and dogs received the second meal after 4 to 5 h of the morning insulin and meal. Parameters evaluated included insulin dosage, 12- and 8-h glycaemic curves, complete blood count, biochemical profile and urinalysis. Glycaemic curves were analysed by ANOVA with repeated measures. Glycaemic control parameters (fasting, mean, minimum and maximum glycaemia and serum fructosamine) and glucose area under the curve (AUC) were calculated and analysed by paired t test (p < 0.05). In feeding method 1, dogs fed the sorghum-based diet presented lower mean (p = 0.04) and minimum blood glucose concentrations (p = 0.03), and a tendency to lower maximum blood glucose (p = 0.06) and glucose AUC (p = 0.08) than when fed the rice-based diet. When food was provided twice a day, the ingestion of the rice-based diet resulted in higher post-prandial glucose response than the diet with sorghum and lentil. In feeding method 2, there was no effect of diet on the assessed parameters (p > 0.05). No differences in insulin dosage were observed between groups or feeding methods (p > 0.05). Providing two meals a day followed by insulin administration associated with the sorghum- and lentil-based diet improved glycaemic control in diabetic dogs.
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Affiliation(s)
- Eliana Teshima
- School of Agricultural and Veterinarian Sciences, São Paulo State University (UNESP), Jaboticabal, SP, Brazil.,Farmina Pet Foods, Bragança Paulista, SP, Brazil
| | - Marcio Antonio Brunetto
- School of Veterinary Medicine and Animal Science, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Fabio Alves Teixeira
- School of Veterinary Medicine and Animal Science, University of São Paulo (USP), São Paulo, SP, Brazil
| | | | - Silvia Regina Ricci Lucas
- School of Veterinary Medicine and Animal Science, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Gener Tadeu Pereira
- School of Agricultural and Veterinarian Sciences, São Paulo State University (UNESP), Jaboticabal, SP, Brazil
| | - Aulus Cavalieri Carciofi
- School of Agricultural and Veterinarian Sciences, São Paulo State University (UNESP), Jaboticabal, SP, Brazil
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Shea EK, Hess RS. Assessment of postprandial hyperglycemia and circadian fluctuation of glucose concentrations in diabetic dogs using a flash glucose monitoring system. J Vet Intern Med 2021; 35:843-852. [PMID: 33522022 PMCID: PMC7995415 DOI: 10.1111/jvim.16046] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Postprandial hyperglycemia (PPH) and circadian glucose concentration fluctuations recorded in the home environment of dogs with naturally occurring diabetes mellitus (DM) have not been reported. OBJECTIVES To determine if a flash glucose monitoring system (FGMS; FreeStyle Libre) can detect PPH and circadian fluctuations in glucose concentrations in dogs with variably controlled DM. ANIMALS Fourteen client-owned dogs with DM. METHODS Prospective observational study. Interstitial glucose (IG) concentrations measured by the FGMS during a 13-day study period were analyzed. RESULTS A total of 17, 446 FGMS IG concentrations were analyzed. For all dogs analyzed together, median IG concentration measured within 30 (288 mg/dL), 60 (286 mg/dL), 90 (285 mg/dL), and 120 (285 mg/dL) minutes of meals was each significantly higher than the median IG concentration at all other times (260 mg/dL, 259 mg/dL, 258 mg/dL, and 257 mg/dL, respectively; range, 40-500 mg/dL; P < .001 for each). Median night-time IG concentration measured from all dogs on 3,547 samples recorded between 1:00 am and 6:00 am (268 mg/dL; range, 40-500 mg/dL) was significantly higher than median IG measured on 13, 899 samples at all other time points (259 mg/dL; range, 40-500 mg/dL; P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE The FGMS can be used for future studies of PPH and circadian fluctuations of glucose concentrations in dogs with DM in their home environment.
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Affiliation(s)
- Emily K. Shea
- Department of Clinical Sciences and Advanced MedicineSchool of Veterinary Medicine, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Rebecka S. Hess
- Department of Clinical Sciences and Advanced MedicineSchool of Veterinary Medicine, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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Teixeira FA, Machado DP, Jeremias JT, Queiroz MR, Pontieri CFF, Brunetto MA. Starch sources influence lipidaemia of diabetic dogs. BMC Vet Res 2020; 16:2. [PMID: 31900155 PMCID: PMC6942337 DOI: 10.1186/s12917-019-2224-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 12/25/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Hyperlipidaemia is considered a cause of other diseases that are clinically important and potentially life threatening. Combination of pea and barley as exclusive starch sources is known to interfere with glycemic control in diabetic dogs, but their effect on lipid profile of hiperlipidaemic dogs is yet to be evaluated. Twelve adult diabetic dogs were fed three dry extruded diets with different starch sources and different fat levels: peas and barley (PB), maize (Mi), and peas, barley and rice (Ba) with 15.7, 15.6 and 9.0% of their dry matter as fat, respectively. Plasmatic cholesterol and triglycerides concentration curves over 10 h were obtained after 60 days on each diet and with the same NPH insulin dose. ANOVA test or Friedman test were used to compare the dietary effects on triglycerides and cholesterol variables among the diets. RESULTS Dogs presented lower mean (p = 0.05), fasting (p = 0.03), and time 8-h postprandial (p = 0.05) triglyceridemia after PB diet period than Ba diet period and time 4-h postprandial (p = 0.02) lower after PB than Mi diet. Cholesterolemia mean, minimum, maximum, area under the cholesterol curve and times points: 2, 4, 6, 8 and 10-h postprandial, had lower values after PB ingestion in comparison to Mi, without difference to Ba diet. CONCLUSION Inclusion of pea and barley, as exclusive starch sources, in therapeutic diets for diabetic dogs can minimize plasmatic triglycerides and cholesterol concentration at fasting and at different postprandial time, compared to the maize diet or diet with lesser fat content.
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Affiliation(s)
- Fabio Alves Teixeira
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, Av. Prof. Orlando Marques de Paiva, 87 - Butantã, São Paulo, 05508-010 Brazil
| | - Daniela Pedrosa Machado
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, Av. Prof. Orlando Marques de Paiva, 87 - Butantã, São Paulo, 05508-010 Brazil
| | | | - Mariana Ramos Queiroz
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, Av. Prof. Orlando Marques de Paiva, 87 - Butantã, São Paulo, 05508-010 Brazil
| | | | - Marcio Antonio Brunetto
- School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo/Pirassununga, Av. Prof. Orlando Marques de Paiva, 87 - Butantã, São Paulo, 05508-010 Brazil
- Department of Animal Nutrition and Production, School of Veterinary Medicine and Animal Science, São Paulo University, Av. Duque de Caxias Norte, 255, Pirassununga, SP Brazil
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12
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Teixeira FA, Machado DP, Jeremias JT, Queiroz MR, Pontieri CFF, Brunetto MA. Effects of pea with barley and less-processed maize on glycaemic control in diabetic dogs. Br J Nutr 2018; 120:777-786. [PMID: 30132436 DOI: 10.1017/s000711451800171x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The source of starch may interfere with glycaemic control in dogs, but few studies have evaluated these aspects in diabetic dogs. This study compared the effects of two isonutrient diets with different starch sources, peas and barley (PB) v. maize (Mi), on diabetic dogs. The Mi diet was processed in order to generate a lower starch gelatinisation index. In all, fifteen adult diabetic dogs without other conditions were included. The animals were fed two dry extruded rations with moderate levels of fat and starch and high levels of protein and fibre using a random, double-blind cross-over design. Glycaemic curves over 48 h were developed via continuous glucose monitoring after 60 d on each diet and with the same neutral protamine Hagedorn (NPH) insulin dosage. The following were compared: fasting, mean, maximum and minimum blood glucose, maximum and minimum glycaemia difference, glycaemic increment, area under the glycaemic curve, area under the glycaemic increment curve and serum fructosamine concentration. Paired t tests or Wilcoxon signed-rank tests were used to compare the amount of food and nutrients ingested and the dietary effects on glycaemic variables between the diets. Dogs fed the PB diet presented a lower average mean interstitial glucose (P=0·01), longer mean hypoglycaemic time (P<0·01), shorter mean hyperglycaemic time (P<0·01) and smaller difference between maximum and minimum blood glucose levels (P=0·03). Thus, the processing applied to the Mi diet was not sufficient to achieve the same effects of PB on glycaemic control in diabetic dogs.
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Affiliation(s)
- Fabio A Teixeira
- 1School of Veterinary Medicine and Animal Science,University of São Paulo,87 Professor Doutor Orlando Marques de Paiva Avenue,São Paulo, SP, 05508-270,Brazil
| | - Daniela P Machado
- 2Grandfood Industria e Comercio LTDA,Luiz Augusto de Oliveira Hwy, km 204, Dourado, SP, 13590-000,Brazil
| | - Juliana T Jeremias
- 2Grandfood Industria e Comercio LTDA,Luiz Augusto de Oliveira Hwy, km 204, Dourado, SP, 13590-000,Brazil
| | - Mariana R Queiroz
- 1School of Veterinary Medicine and Animal Science,University of São Paulo,87 Professor Doutor Orlando Marques de Paiva Avenue,São Paulo, SP, 05508-270,Brazil
| | - Cristiana F F Pontieri
- 2Grandfood Industria e Comercio LTDA,Luiz Augusto de Oliveira Hwy, km 204, Dourado, SP, 13590-000,Brazil
| | - Marcio A Brunetto
- 1School of Veterinary Medicine and Animal Science,University of São Paulo,87 Professor Doutor Orlando Marques de Paiva Avenue,São Paulo, SP, 05508-270,Brazil
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Gottlieb S, Rand J. Managing feline diabetes: current perspectives. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2018; 9:33-42. [PMID: 30050865 PMCID: PMC6053045 DOI: 10.2147/vmrr.s125619] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Diabetes mellitus is a common endocrine disease in cats. While type 2 diabetes is the most common form seen in cats, other underlying causes may contribute to insulin resistance. Guidelines for diagnosis vary and often do not take into account prediabetic cats. The goals of treatment are to maximize the chance of remission, while minimizing the risks of hypoglycemia. This article presents a further overview of current treatment and monitoring recommendations for diabetic cats.
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Affiliation(s)
- Susan Gottlieb
- The Cat Clinic, Brisbane, QLD, Australia,
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia,
| | - Jacquie Rand
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia,
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André A, Leriche I, Chaix G, Thorin C, Burger M, Nguyen P. Recovery of insulin sensitivity and optimal body composition after rapid weight loss in obese dogs fed a high-protein medium-carbohydrate diet. J Anim Physiol Anim Nutr (Berl) 2018. [PMID: 28627053 DOI: 10.1111/jpn.12744] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study investigated the effects of an experimental high-protein medium-carbohydrate diet (protein level, 46% metabolizable energy, ME). First, postprandial plasma glucose and insulin kinetics were determined in steady-state overweight/obese Beagle dogs (28%-41% excess body weight) for an experimental high-protein medium-carbohydrate diet (protein level, 46% ME) and a commercial high-carbohydrate medium-protein diet (protein level, 24%ME) in obese dogs. Secondly, all the dogs were included in a weight loss programme. They were fed the high-protein medium-carbohydrate diet, and the energy allocation was gradually reduced until they reached their optimal body weight. Insulin sensitivity and body composition were evaluated before and after weight loss using a euglycaemic-hyperinsulinaemic clamp and the deuterium oxide dilution technique respectively. For statistical analysis, linear mixed effect models were used with a significance level of 5%. Postprandial plasma glucose and insulin concentrations were substantially lower with the high-protein medium-carbohydrate diet than the high-carbohydrate medium-protein diet. These differences can be explained mainly by the difference in carbohydrate content between the two diets. Energy restriction (35% lower energy intake than in the obese state) resulted in a 2.23 ± 0.05% loss in body weight/week, and the dogs reached their optimal body weight in 12-16 weeks. Weight loss was associated with a significant increase in insulin sensitivity. The high-protein medium-carbohydrate diet allowed fat-free mass preservation despite a relatively high rate of weekly weight loss. The increase in insulin sensitivity indicated improved control of carbohydrate metabolism, possible due to weight loss and to the nature of the diet. Thus, a high-protein medium-carbohydrate diet is a good nutritional solution for managing the weight of overweight dogs. This diet may improve glycaemic control, which could be beneficial for preventing or managing impaired glucose tolerance in obese dogs and for safe and successful weight loss while preserving lean body mass.
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Affiliation(s)
- A André
- UBL, Oniris, National College of Veterinary Medicine, Food Science and Engineering Nantes-Atlantic, Nutrition, Physiopathology and Pharmacology Unit (NP3), Nantes, France
| | | | - G Chaix
- Virbac Medical Department, Carros, France
| | - C Thorin
- UBL, Oniris, National College of Veterinary Medicine, Food Science and Engineering Nantes-Atlantic, Nutrition, Physiopathology and Pharmacology Unit (NP3), Nantes, France
| | - M Burger
- UBL, Oniris, National College of Veterinary Medicine, Food Science and Engineering Nantes-Atlantic, Nutrition, Physiopathology and Pharmacology Unit (NP3), Nantes, France
| | - P Nguyen
- UBL, Oniris, National College of Veterinary Medicine, Food Science and Engineering Nantes-Atlantic, Nutrition, Physiopathology and Pharmacology Unit (NP3), Nantes, France
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Coradini M, Rand JS, Filippich LJ, Morton JM, O'Leary CA. Associations between meal size, gastric emptying and post-prandial plasma glucose, insulin and lactate concentrations in meal-fed cats. J Anim Physiol Anim Nutr (Berl) 2014; 99:757-66. [PMID: 25545403 DOI: 10.1111/jpn.12280] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 11/10/2014] [Indexed: 01/21/2023]
Abstract
Plasma glucose and insulin concentrations are increased for 12-24 h in healthy cats following moderate- to high-carbohydrate meals. This study investigated associations between gastric emptying time and post-prandial plasma glucose, insulin and lactate concentrations in cats fed an extruded dry, high-carbohydrate, moderate-fat, low-protein diet (51, 28, 21% metabolizable energy, respectively) once daily by varying meal volume. Eleven healthy, non-obese, neutered adult cats were enrolled in a prospective study and fed to maintain body weight. Ultrasound examinations were performed for up to 26 h, and blood collections over 24 h after eating meals containing approximately 100% and 50% of the cats' daily caloric intake (209 and 105 kJ/kg BW, respectively). Gastric emptying time was increased after a meal of 209 kJ/kg BW compared with 105 kJ/kg BW (median gastric emptying times 24 and 14 h, respectively; p = 0.03). Time for glucose to return to fasting was longer after the 209 kJ/kg BW meal (median 20 h; 25th and 75th percentiles 15 and 23 h, respectively) than the 105 kJ/kg BW meal (13, 12 and 14 h; p < 0.01); however, peak glucose was not higher after the 209 kJ/kg BW meal compared with the 105 kJ/kg BW meal [(mean ± SD) 6.6 ± 0.6 and 7.8 ± 1.2 mmol/l, respectively, p = 0.07]. Times for insulin to return to fasting were not significantly longer after the 209 kJ/kg BW meal than the 105 kJ/kg BW meal (p = 0.29). d- and l-lactate concentrations were not associated with gastric emptying time or post-prandial blood glucose and insulin. Based on results obtained, prolonged gastric emptying contributes to prolonged post-prandial hyperglycemia in cats meal fed a high-carbohydrate, low-protein, dry diet and fasting times for cats' meal-fed diets of similar composition should be 14-26 h, depending on meal size.
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Affiliation(s)
- M Coradini
- School of Veterinary Science, The University of Queensland, Gatton, Qld, Australia
| | - J S Rand
- School of Veterinary Science, The University of Queensland, Gatton, Qld, Australia
| | - L J Filippich
- School of Veterinary Science, The University of Queensland, Gatton, Qld, Australia
| | - J M Morton
- School of Veterinary Science, The University of Queensland, Gatton, Qld, Australia
| | - C A O'Leary
- School of Veterinary Science, The University of Queensland, Gatton, Qld, Australia
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Singh R, Rand JS, Coradini M, Morton JM. Effect of acarbose on postprandial blood glucose concentrations in healthy cats fed low and high carbohydrate diets. J Feline Med Surg 2014; 17:848-57. [DOI: 10.1177/1098612x14556559] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Feeding a low carbohydrate diet is recommended for diabetic cats; however, some cats may require diets containing moderate-to-high carbohydrate and may benefit from the use of therapeutic agents to improve glycemic control. The aim of the study was to determine the effect of the α-glucosidase inhibitor acarbose on postprandial plasma glucose concentration when combined with commercially available feline diets high and low in carbohydrate. Methods Twelve healthy, adult, non-obese, neutered cats were enrolled. Plasma glucose concentrations were assessed over 24 h after feeding high and low carbohydrate diets, with and without acarbose, during single and multiple meal tests, in a crossover study. Commercially available feline diets were used, which were high and low in carbohydrate (providing 51% and 7% of metabolizable energy, respectively). Results In cats fed the high carbohydrate diet as a single meal, mean 24 h glucose concentrations were lower when acarbose was administered. Mean glucose concentrations were lower in the first 12 h when acarbose was given once daily, whereas no significant difference was observed in mean results from 12–24 h. Acarbose had little effect in cats eating multiple meals. Compared with consumption of the high carbohydrate diet with acarbose, lower mean 24 h and peak glucose concentrations were achieved by feeding the low carbohydrate diet alone. Conclusions and relevance In healthy cats meal-fed diets of similar composition to the diets used in this study, acarbose has minimal effect when a low carbohydrate diet is fed but reduces postprandial glucose concentrations over 24 h when a high carbohydrate diet is fed. However, mean glucose concentrations over 24 h are still higher when a high carbohydrate diet with acarbose is fed relative to the low carbohydrate diet without acarbose. Future studies in diabetic cats are warranted to confirm these findings.
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Affiliation(s)
- Ranee Singh
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jacquie S Rand
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Marcia Coradini
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - John M Morton
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
- Current address: Jemora Pty Ltd, PO Box 2277, Geelong, VIC, Australia
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Buff PR, Carter RA, Bauer JE, Kersey JH. Natural pet food: a review of natural diets and their impact on canine and feline physiology. J Anim Sci 2014; 92:3781-91. [PMID: 25006071 DOI: 10.2527/jas.2014-7789] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of this review is to clarify the definition of "natural" as it pertains to commercial pet food and to summarize the scientific findings related to natural ingredients in pet foods and natural diets on the impact of pet health and physiology. The term "natural," when used to market commercial pet foods or pet food ingredients in the United States, has been defined by the Association of American Feed Control Officials and requires, at minimum, that the pet food be preserved with natural preservatives. However, pet owners may consider natural as something different than the regulatory definition. The natural pet food trend has focused on the inclusion of whole ingredients, including meats, fruits, and vegetables; avoiding ingredients perceived as heavily processed, including refined grains, fiber sources, and byproducts; and feeding according to ancestral or instinctual nutritional philosophies. Current scientific evidence supporting nutritional benefits of natural pet food products is limited to evaluations of dietary macronutrient profiles, fractionation of ingredients, and the processing of ingredients and final product. Domestic cats select a macronutrient profile (52% of ME from protein) similar to the diet of wild cats. Dogs have evolved much differently in their ability to metabolize carbohydrates and select a diet lower in protein (30% of ME from protein) than the diet of wild wolves. The inclusion of whole food ingredients in natural pet foods as opposed to fractionated ingredients may result in higher nutrient concentrations, including phytonutrients. Additionally, the processing of commercial pet food can impact digestibility, nutrient bioavailability, and safety, which are particularly important considerations with new product formats in the natural pet food category. Future opportunities exist to better understand the effect of natural diets on health and nutrition outcomes and to better integrate sustainable practices in the production of natural pet foods.
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Affiliation(s)
- P R Buff
- The Nutro Company, Franklin, TN 37067
| | | | - J E Bauer
- Colorado State University, Fort Collins 80523-1620
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Peterson ME, Eirmann L. Dietary Management of Feline Endocrine Disease. Vet Clin North Am Small Anim Pract 2014; 44:775-88, vi-vii. [DOI: 10.1016/j.cvsm.2014.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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The Maillard reaction and pet food processing: effects on nutritive value and pet health. Nutr Res Rev 2013; 26:130-48. [PMID: 23916186 DOI: 10.1017/s0954422413000103] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The Maillard reaction, which can occur during heat processing of pet foods or ingredients, is known to reduce the bioavailability of essential amino acids such as lysine due to the formation of early and advanced Maillard reaction products (MRP) that are unavailable for utilisation by the body. Determination of the difference between total and reactive lysine by chemical methods provides an indication of the amount of early MRP present in foods, feeds and ingredients. Previous research reported that the difference between total and reactive lysine in pet foods can be up to 61.8%, and foods for growing dogs may be at risk of supplying less lysine than the animal may require. The endogenous analogues of advanced MRP, advanced glycation endproducts, have been associated with age-related diseases in humans, such as diabetes and impaired renal function. It is unknown to what extent advanced MRP are present in pet foods, and if dietary MRP can be associated with the development of diseases such as diabetes and impaired renal function in pet animals. Avoidance of ingredients with high levels of MRP and processing conditions known to favour the Maillard reaction may be useful strategies to prevent the formation of MRP in manufactured pet food. Future work should further focus on understanding the effects of ingredient choice and processing conditions on the formation of early and advanced MRP, and possible effects on animal health.
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Farrow HA, Rand JS, Morton JM, O'Leary CA, Sunvold GD. Effect of dietary carbohydrate, fat, and protein on postprandial glycemia and energy intake in cats. J Vet Intern Med 2013; 27:1121-35. [PMID: 23869495 DOI: 10.1111/jvim.12139] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 03/13/2013] [Accepted: 05/29/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Reducing carbohydrate intake is recommended in diabetic cats and might also be useful in some healthy cats to decrease diabetes risk. OBJECTIVE To compare postprandial glucose and insulin concentrations and energy intakes between cats fed diets high in protein, fat, or carbohydrate. ANIMALS Twenty-four lean cats with normal glucose tolerance. METHODS In a prospective randomized study, each of 3 matched groups (n = 8) received a different test diet for 5 weeks. Diets were high in either protein (46% of metabolizable energy [ME]), fat (47% ME), or carbohydrate (47% ME). Glucose and insulin were measured during glucose tolerance, ad libitum, and meal-feeding tests. RESULTS During ad libitum feeding, cats fed the high-carbohydrate diet consumed 25% and 18% more carbohydrate than cats fed diets high in fat and protein, respectively, and energy intake was highest when the high-fat and high-protein diets were fed. Regardless of the feeding pattern, cats fed the high-carbohydrate diet had 10-31% higher peak and mean glucose compared with both other diets; peak glucose in some cats reached 10.4 mmol/L (188 mg/dL) in cats fed 47% ME carbohydrate and 9.0 mmol/L (162 mg/dL) in cats fed 23% ME. CONCLUSIONS AND CLINICAL IMPORTANCE High-carbohydrate diets increase postprandial glycemia in healthy cats compared with diets high in fat or protein, although energy intake is lower. Avoidance of high- and moderate-carbohydrate diets can be advantageous in cats at risk of diabetes. Maintenance energy requirements should be fed to prevent weight gain when switching to lower carbohydrate diets.
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Affiliation(s)
- H A Farrow
- School of Veterinary Science, The University of Queensland, Brisbane, Qld, Australia
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