7. When you perform a glucose curve, normal routine must be maintained.
The purpose of a glucose curve is to determine how a particular dose of insulin is performing given a specific diet and schedule.
Thus, routine must be adhered to. Admittedly, the normal routine is difficult to maintain with a patient in the hospital or
even if the dog or cat is being "poked" every two hours at home. However, the standard procedures must be adhered to as much
In the beginning, it is important for a veterinarian or technician to ensure that the insulin is being given correctly. That
means an owner should give the insulin in front of the veterinarian, which may mean a deviation from schedule at that point.
Once administration issues are no longer a concern, it is still desirable to have the insulin given in the hospital so pre-insulin
blood glucose can be measured. However, keeping the schedule usually trumps all.
8. Know the signs of hypoglycemia and what to do.
One of the most dangerous aspects of diabetes is the possibility of causing hypoglycemia. The first signs are often subtle
and include muscle tremors, nervousness, restlessness, and hunger. Then, as the central nervous system becomes "starved" for
glucose, lethargy, weakness, ataxia, bizarre behavior, seizures, and coma can develop. Owners should always have a high-glucose
syrup (e.g. Karo or honey) on hand to give their pets. If signs are mild, feeding a meal can be sufficient. The cat should be taken to
a veterinarian immediately, or the blood glucose should be checked at home if the owner is capable of doing so. First, the
presence of hypoglycemia should be documented, if possible. Second, once hypoglycemia develops in a treated diabetic, it can
take days to resolve, so monitoring, and potentially hospitalization and treatment, are necessary. It is always better to
treat if unsure.
1. Roomp K, Rand JS. Intensive blood glucose control is safe and effective in diabetic cats using home monitoring and treatment
with glargine. J Feline Med Surg 2009;11(8):668-682.
2. Bennett N, Greco DS, Peterson ME. Comparison of a low carbohydrate versus high fiber diet in cats with diabetes mellitus
(abst). J Vet Intern Med 2001;15:297.
3. Frank G, Anderson W, Pazak H, et al. Use of a high-protein diet in the management of feline diabetes mellitus. Vet Ther 2001;2(3):238-246.
4. Mazzaferro EM, Greco DS, Turner AS, et al. Treatment of feline diabetes mellitus using an a-glucosidase inhibitor and
a low-carbohydrate diet. J Feline Med Surg 2003;5(3):183-189.
5. Hall TD, Mahony O, Rozanski EA, et al. Effects of diet on glucose control in cats with diabetes mellitus treated with
twice daily insulin glargine. J Feline Med Surg 2008;11(2):125-130.
6. Greco DS, Broussard JD, Peterson ME. Insulin therapy. Vet Clin North Am Small Anim Pract 1995(3);25:677-689.
7. Feldman EC, Nelson RW, Feldman MS. Intensive 50-week evaluation of glipizide administration in 50 cats with previously
untreated diabetes mellitus. J Am Vet Med Assoc 1997;210(6):772-777.
8. Goossens M, Nelson RW, Feldman EC, et al. Response to insulin treatment and survival in 104 cats with diabetes mellitus
(1985-1995). J Vet Intern Med 1998;12(1):1-6.
9. Singh R, Rand JS, Morton JM. Switching to an ultra-low carbohydrate diet has a similar effect on postprandial blood glucose
concentrations to administering acarbose to healthy cats fed a high carbohydrate diet (abst). J Vet Intern Med 2006;20:726.
10. Fleeman LM, Rand JS. Evaluation of day-to-day variability of serial blood glucose concentration curves in diabetic dogs.
J Am Vet Med Assoc 2003;222(3):317-321.
11. Ristic JME, Herrtage ME, Walti-Lauger SMM, et al. Evaluation of a continuous glucose monitoring system in cats with diabetes
mellitus. J Feline Med Surg 2005;7(3):153-162.
12. Casella M, Wess G, Hassig M, et al. Home monitoring of blood glucose concentration by owners of diabetic dogs. J Small Anim Pract 2003;44(7):298-305.
13. Alt N, Kley S, Haessig M, et al. Day-to-day variability of blood glucose concentration curves generated at home in cats
with diabetes mellitus. J Am Vet Med Assoc 2007;230(7):1011-1017.
14. Reusch CE, Wess G, Casella M. Home monitoring of blood glucose concentration in the management of diabetes mellitus. Compend Contin Educ Pract Vet 2001;23:544-556.
15. Van de Maele I, Rogier N, Daminet S. Retrospective study of owners' perception on home monitoring of blood glucose in
diabetic dogs and cats. Can Vet J 2005;46(8):718-723.
Ellen N. Behrend, VMD, PhD, DACVIM
Joezy Griffin Professor
Department of Clinical Sciences
College of Veterinary Medicine
Auburn University, Auburn, AL 36849