CLINICAL EXPERIENCE AND PROTOCOL OPTIMIZATION OF ONCE-WEEKLY INSULIN ICODECIN FELINE DIABETES MELLITUS: A CASE SERIES FROM CHINA
Wenjing Geng
Meilianzhonghe Animal Referral Center, Beijing, China
Abstract: Managing feline diabetes mellitus (DM) poses significant challenges for owners, impacting their quality of life (QoL) due to rigid twice-daily injection schedules. This report summarises clinical experiences using insulin icodec, a novel ultra-long-actig basal insulin, in cats with long-term DM (duration >1 year) where clinical remission was unlikely. The transition protocol involved a calculated initial weekly dose: 70% of the previous total 7-day glargine dose. Monitoring via continuous glucose monitoring (CGM) revealed a characteristic "front-loaded" glycemic effect. To mitigate hypoglycemia risk during the first 72 hours post-injection, a hybrid diet strategy was implemented: incorporating small amounts of dry kibble for the first 3 days, followed by exclusive wet canned food for the remaining 4 days of the cycle. Results showed that injection intervals typically stabilized at 7. Over the course of several days, varying durations (ranging from 5 to 10 days) were observed based on individual glycemic profiles. CGM data demonstrated effective glycemic control with minimal symptomatic hypoglycemia. Owners reported significantly improved quality of life, enabling travel and social activities previously hindered by treatment requirements.
Relevance and Novel Information: This study provides a practical treatment and dietary management framework for transitioning chronic feline diabetes patients to once-weekly insulin therapy, addressing the critical balance between glycemic control and owner compliance. We introduce a specific dose conversion formula (70% of the 7-day total) and a phase-specific dietary adjustment (kibble versus canned) to manage the unique pharmacokinetic profile of icodec in a clinical setting.
