Glargine Insulin

GLARGINE INSULIN: SOMETHING NEW FOR CATS

Lantus

(original graphic by
marvistavet.com)

Achieving regulation in a diabetic cat can be tricky. In most cats, finding an insulin that lasts long enough is a substantial problem. Glargine is approved only as a human product but its use is rapidly becoming common in cats and is very likely going to be the first choice insulin for a newly diagnosed diabetic cat.

In human diabetes mellitus, the trend has been towards the use of ultra-short acting synthetic insulin (like Humilog®) at meal time and a once a day long-acting peakless insulin (namely glargine insulin) to provide general blood sugar control throughout the day. Glargine insulin is readily available at any drug store and is designed to be long-acting and provide a diabetic person with a "tone" of sugar control that lasts all day. The million dollar question is how well does it work for cats? So far, studies show it works extremely well and in newly diagnosed diabetic cats, it seems to provide such good control - when used in combination with a low carbohydrate diet - that many cats revert to a non-diabetic status in a matter of weeks. In one study, six out of seven cats were in remission after only 4 weeks of glargine therapy. Is it too good to be true?

Before getting too excited, it is important to realize that diabetic remission is about good regulation early in the course of the disease rather than having a magic product. Cats that have been diabetic for some time tend not to experience remission and if your cat is well-regulated on another insulin, it is not worth changing and having to re-regulate your cat.

HERE’S WHAT YOU NEED TO KNOW:

  • Even though glargine is a long-acting insulin, it probably will need to be given twice a day just like other insulins.
     
  • Glargine insulin cannot be diluted. The feline dose of insulin is generally only a few units of insulin and the gradations on an insulin syringe are tiny. With insulins other than glargine, dilution is possible to make measuring easier. The long-activity of glargine depends on the formation of small crystals where it is injected. Diluting glargine interferes with the crystals.
     
  • Glargine is available in a Pen injector that measures one unit increments but it is expensive, expires in 1 month and cannot be refrigerated. The 10 ml bottle of glargine should be refrigerated to insure best activity as they will last at least 6 months when stored this way. Refrigeration is not as important with other insulin types. The 10 ml bottle of glargine will expire in 1 month if it is not kept refrigerated.
     
  • Glargine is available in a 3 ml (300 unit) pen injector that measures one unit increments but it expires in one month, and cannot be refrigerated without ruining the measurement mechanism. The 10 ml (10,000 unit) bottle of glargine should be refrigerated to ensure best activity as it will last at least 6 months when stored this way. Refrigeration is not as important with other insulin types. The 10 ml bottle of glargine will expire in one month if it is not kept refrigerated. The pen can be refrigerated and used as long as the insulin inside it is drawn out by syringe and the pen is considered a 3 ml funny looking storage bottle. The pens may end up being a better economical value than the bottle.
     
  • Because of the strong chance of a cat going into remission (i.e. becoming non-diabetic), it is important for the owner to be well informed on recognizing the signs of hypoglycemia and adhering to the doctor's recommendation on when to have glucoses checked.

The high remission rates reported for diabetic cats
apply to cats newly diagnosed with diabetes.
Other cats who were switched to glargine for better
glucose control after having been diabetic for years
do not tend to revert to non-diabetic status.

Page last updated: 8/29/2014