Diabetes mellitus: an update

Diabetes mellitus is characterized by disturbances of carbohydrate, lipid and protein metabolism and glucose intolerance. Several factors are known to contribute to the disease, ie, obesity, immune-mediated insulin resistance, and the diabetogenic hormones glucagon, growth hormone and glucocorticoids. Recently, a number of developments have taken place in the management of human diabetes mellitus which may be applicable to dogs and cats. These include the use of diets high in soluble, non-absorbable carbohydrates which lower post-prandial increases in blood glucose. The more complex causes of instability, ie, insulin-induced hyperglycaemia, rapid metabolism of insulin and insulin resistance can be diagnosed by hospitalizing the patient and measuring blood glucose at four hour intervals for 24 hours. In human medicine, new techniques for controlling diabetes mellitus are pancreatic implants, constant infusion pumps for insulin and the use of the hormone somatostatin which suppresses glucagon secretion, but not all may be applicable to veterinary medicine.