title: Diabetes mellitus in a population of 180,000 insured dogs: incidence, survival, and breed distribution.
abstract: BACKGROUND
  Canine diabetes mellitus (DM) is a common endocrinopathy with an unclear etiology. For a better understanding of the underlying mechanisms, there is a need for comprehensive epidemiologic studies. Earlier studies have shown that the risk of disease is higher in certain dog breeds.
  
  
  OBJECTIVE
  Incidence, age of onset, survival and sex proportion of DM vary by breed.
  
  
  METHODS
  Data from a cohort of 182,087 insured dogs aged 5-12 years accounting for 652,898 dog-years at risk were studied retrospectively.
  
  
  METHODS
  Incidence rates by sex, breed, and geography were calculated with exact denominators. Age-specific incidence and survival after 1st DM claim were computed with Cox's regression and Kaplan-Meier survival function. Multivariable survival analysis was performed for the outcome diagnosis of DM with age, sex, and geography tested as fixed effects, previous endocrine or pancreatic diseases tested as time-dependent covariates, and breed tested as a random effect.
  
  
  RESULTS
  The mean age at 1st insurance claim for the 860 DM dogs (72% females) was 8.6 years. The incidence of DM was 13 cases per 10,000 dog-years at risk. Australian Terriers, Samoyeds, Swedish Elkhounds, and Swedish Lapphunds were found to have the highest incidence. The proportion of females with DM varied significantly among breeds. Swedish Elkhounds, Beagles, Norwegian Elkhounds, and Border Collies that developed DM were almost exclusively females. The multivariable model showed that breed, previous hyperadrenocorticism, and female sex were risk factors for developing DM. Median survival time was 57 days after 1st claim. Excluding the 223 dogs that died within 1 day, the median survival time was 2 years after 1st claim of DM.
  
  
  CONCLUSIONS
  The significant breed-specific sex and age differences shown in this study indicate that genetic variation could make breeds more or less susceptible to different types of DM.
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden. tove.fall@kv.slu.se
authors.forename: Tove
authors.initials: T
authors.lastname: Fall
authors.forename: Helene Hansson
authors.initials: HH
authors.lastname: Hamlin
authors.forename: Ake
authors.initials: A
authors.lastname: Hedhammar
authors.forename: Olle
authors.initials: O
authors.lastname: Kämpe
authors.forename: Agneta
authors.initials: A
authors.lastname: Egenvall
mesh_terms: D000818:Animals; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000235:genetics / Q000662:veterinary*; D004283:Dog Diseases / Q000453:epidemiology* / Q000235:genetics; D004285:Dogs; D005260:Female; D020022:Genetic Predisposition to Disease; D015994:Incidence; D008136:Longevity; D008297:Male; D013548:Sweden / Q000453:epidemiology