Insulin degludec 100 U/mL for treatment of spontaneous diabetes mellitus in dogs

Background: The advantages of insulin degludec 100 U/mL (IDeg100) in the treatment of diabetes mellitus (DM) include consistent release, predictable glucose-lowering effect, and minimal day-to-day variability. Hypothesis/Objectives: To describe the use of IDeg100 in dogs with DM, level of diabetic control and adverse effects. Animals: Thirty-three client-owned dogs with DM. Methods: A prospective, multi-institutional, uncontrolled study of newly diagnosed or previously insulin-treated, with or without comorbidities and with or without concurrent medications. Clinical signs and continuous glucose monitoring data were monitored and guided insulin dose adjustments. A per-protocol analysis was performed. Results: The final dose of IDeg100 in dogs was 1.3 U/kg (median, range, 0.4-2.2) achieved in 14 days (median, range, 3-32). Seventy-nine percent (26/33) of the dogs had comorbidities with 42% (11/26) having more than 1 comorbidity. Sixty-four percent (21/33) of dogs were receiving concurrent medications with 62% (13/21) receiving more than 1 non-insulin medication. Seventy-six percent (25/33) were scored as having excellent/very good DM control. From baseline to study exit, dogs showed improvements in both ALIVE DM clinical score (from 3 [0-8, 96.49% CI (2-5)] to 1 [0-7, 96.49% CI (1-2)]; P =.0007) and average 3-day interstitial glucose (from 332.8 ± 68.7 mg/dL, 95% CI [308.8-357.2] to 229.0 ± 56.3 mg/dL [CI 209.0 - 248.9]; P <.0001). Conclusions and Clinical Importance: Insulin degludec 100 U/mL is effective for the treatment of dogs with DM. Eighty-four percent (28/33) of dogs responded to once daily dose of IDeg100 with low frequency of clinical hypoglycemia.