EN03 - Frequency of Hypoglycemia When Meal Omission Occurs in Diabetic Dogs Treated with Once‑daily Insulin Degludec

Abstract:

Background: Insulin degludec (IDeg), a basal, peakless insulin, permits q24h dosing in many diabetic dogs and may allow greater flexibility in meal timing. However, the risk of hypoglycemia when a meal is omitted in diabetic dogs remains unstudied.

Objectives: Determine the frequency of hypoglycemia during planned meal omission in well-controlled (ALIVE diabetic clinical score ≤ 2) diabetic dogs treated with q24h IDeg. Animals: Eleven client-owned diabetic dogs.

Methods: Prospective observational study. Four days of continuous glucose monitoring (CGM, Freestyle libre 3) data were collected. After 3 days without intervention, the insulin-associated meal was omitted on day 4. Hypoglycemia was defined as (1) biochemical (≥ 30 min of interstitial glucose [IG] < 60 mg/dL, measured by CGM) or (2) clinical. Data are reported as frequency or mean (±SD), and their 95% Confidence Interval (95% CI).

Results: Prior to meal omission, biochemical hypoglycemia occurred in 6 of 11 dogs (55% [95% CI 28-79%]) for a mean of 0.7h (±SD) per 24h period (95% CI 0.15-1.26). No clinical hypoglycemia was reported. After meal omission, biochemical hypoglycemia was observed in 6 of 11 dogs (55% [95% CI 28-79%]), of which 4 experienced biochemical hypoglycemia prior, for a mean of 3.1h (±SD) per 24h (95% CI 1.2-4.9). Mild clinical hypoglycemia occurred in only 1 dog (9%, 0.5-38%), without prior biochemical hypoglycemia. Conclusion and Clinical Importance: In well controlled diabetic dogs, q24h IDeg administered during fasting is associated with low risk of clinical hypoglycemia. Clinical hypoglycemia when fasting may occur independently of biochemical hypoglycemia when fed.