Results of Feline Diabetes "Initial Treatment"
May 13, 2003
An informal survey was taken on the Feline Diabetes Message Board
(FDMB) on May 1, 2003 and May 3,2003 to assess the experience of the
with respect to very first treatment that their vet recommended when
cats were first diagnosed with diabetes. This survey is in no way
or representative of all diabetic cats. The specific questions
1.) Month and year the cat was diagnosed.
2.) Initial type of insulin or name of drug.
3.) Initial dose of insulin or drug.
4.) Once or twice a day?
5.) First diet recommended by vet.
Data were entered into Excel and analyzed with SAS (R) for Windows
Number of observations: 119 cats were represented for
observations (a couple of cats were diagnosed with diabetes twice).
Month and year of diagnosis: The survey was, not
very heavily weighted to the recently diagnosed, with about 26% of the
being diagnosed before mid-2000, 24% between mid-2000 and the end of
30% during 2002, and 19% during 2003 (roughly).
Initial treatment: The vast majority responding -- 86%
said their vets started their cats with insulin. This may be
vets prefer insulin, or it may be because insulin users are more likely
end up on the FDMB. This trend did not change over time (p=0.78,
Type of insulin: 33% of cats were started with N, 19% with L,
with U, and 13% with PZI. The remaining 7% received 70/30,
Iletin II, or Iletin NPH. There were no changes in the relative
of type of insulin over time (p=0.94, chi-square test on common
Frequency of insulin: 71% of cats were started on insulin twice
day, which also did not change over time (p=0.41, chi-square
However, frequency was related to type of insulin; about 50% of
and PZI users were started with once a day dosing, whereas about 85% of
users and 90% of N users were started with twice a day dosing (p=.0006,
Initial Dose: Total daily dose prescribed ranged from 0.5
34 units, with the median at 3.0 units daily, the first quartile at 2.0
daily, and the third quartile at 4.0 units daily. After removing
vets who prescribed massive doses of 70/30 (10 units and 30 units
there was no relationship between total daily dose and type of insulin
ANOVA). However, cats who were prescribed insulin twice a day
to receive more (4.4 units vs 2.15 units, p=.005), or, in other words,
dose at each injection was the same regardless of whether one or two
were prescribed. The total daily dose has not been changing over
Diet: The type of food prescribed has been changing over time
chi-square). Before July 2000, 69% of cats were prescribed
food and none low-carb food; between July 2000 and December 2001,
of cats were prescribed high-carb food and 13% low-carb food; during
31% of cats were prescribed high-carb food and 42% low-carb food;
2003, 30% of cats were prescribed high-carb food and 39% low-carb food.
Relationship between Diet and Dose: Somewhat disturbingly, the
prescribed dose was not lower for cats put on a low-carbohydrate diet
units daily for high-carb vs 2.83 units daily for low-carb, p=0.78),
research, anecdotal evidence, and our own insulin
dose survey indicate that insulin requirements are less for
on a low-carbohydrate diet. Prescribed diet was also not related
prescribed insulin type (p=0.39, renal diet and non-common insulins
Comments: Except for diet, vet practices have not been
much over the past few years. And although vets seem to be more
to recommending low-carbohydrate diets, it appears that they have not
general changed the type and dosage of insulin to match the
consequences of this diet. These conclusions might be seriously
by "selection bias," however, since cats who do not develop problems
be less likely to send their humans to the Internet in search of
Note to readers: This document is copyright
(C) 2003 by Janet M. Peerson. You may freely copy and distribute
document, and you are especially invited to link your web page to it,
you may not charge money for it (not even handling costs), and you may
claim credit for the contents. The original version was
May 13, 2003, and was edited on June 24, 2003.
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