Once-daily Insulin Glargine 300 U/ml for the Treatment of Canine Diabetes Mellitus

Abstract: Background

In purpose-bred dogs, insulin glargine 300 U/ml (Toujeo®) has a long and peakless action suitable for use as a basal insulin. There are currently no studies on its use in client-owned diabetic dogs.



Objectives

To describe clinical outcomes in a cohort of client-owned dogs treated with Toujeo®.



Animals

Fifty-eight client-owned diabetic dogs.



Methods

Multi-institutional study, including newly diagnosed dogs and dogs previously treated with other insulin formulations. Initial Toujeo® dose was 0.5 U/Kg q24h for newly diagnosed dogs and (median [range]) 0.8 U/Kg (0.2-2.5) q24h for the remainder. Clinical signs and standardized assessment of continuous glucose monitoring data guided dose adjustments and final categorization into level of glycemic control. Data are presented as median (range).



Results

Thirty one dogs had good-excellent glycemic control on q24h (1.9 U/Kg [0.2-5.2]), of which 2 required additional meal-time bolus insulin. Twenty-seven dogs were switched to q12h Toujeo® (total dose = 1.9 U/kg/d [0.6-5.0]). Of these, 23 had good-excellent control (2 with the addition of meal-time bolus insulin) and 4 had poor-moderate control. Only one dog (treated q12h) experienced clinical hypoglycemia. Only 1 dog required < 0.5 U/Kg/daily.



Conclusions

Overall, dogs were well controlled on Toujeo®, with half of them (29/58) maintained on once-daily injections with no need for a meal-time bolus insulin. Clinicians should be aware of the large dose range required to achieve good control and that overall, a higher dose of Toujeo® is required compared to previously described doses for other insulin formulations, suggesting lower potency of this insulin in dogs.