title: Remission of diabetes mellitus in cats cannot be predicted by the arginine stimulation test.
abstract: BACKGROUND
  Cats with diabetes mellitus frequently achieve clinical remission, suggesting residual β-cell function. Responsiveness of β-cells to arginine persists the longest during diabetes progression, making the intravenous arginine stimulation test (IVAST) a useful tool to assess residual insulin and glucagon secretion.
  
  
  OBJECTIVE
  Diabetic cats with and without remission will have different arginine-induced insulin or glucagon response.
  
  
  METHODS
  Seventeen cats with diabetes, 7 healthy cats.
  
  
  METHODS
  Blood samples collected on admission and during subsequent IVAST. Glucose, insulin, and glucagon were measured. Response to IVAST was assessed by calculating the insulin and glucagon area under the curve (AUC) and the AUC glucagon-to-insulin ratio. Diabetic cats were treated with insulin and were followed for 18 weeks. Remission was defined as normoglycemia and disappearance of clinical signs of diabetes for ≥4 weeks, without requiring insulin.
  
  
  RESULTS
  Seven diabetic cats (41%) achieved remission. On admission, blood glucose concentration was significantly lower in cats with remission (median, 389 mg/dL; range, 342-536 mg/dL) than in those without remission (median, 506 mg/dL; range, 266-738 mg/dL). After IVAST, diabetic cats with remission had higher AUC glucagon-to-insulin ratios (median, 61; range, 34-852) than did cats without remission (median, 26; range, 20-498); glucose, insulin, and glucagon AUCs were not different. Diabetic cats had lower insulin AUC than did healthy cats but comparable glucagon AUC.
  
  
  CONCLUSIONS
  Diabetic cats with and without remission have similar arginine-stimulated insulin secretion on admission. Although cats with remission had lower blood glucose concentrations and higher AUC glucagon-to-insulin ratios, large overlap between groups prevents use of these parameters in clinical practice.
authors.affiliation: Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse, Zurich, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Tschuor
authors.forename: E
authors.initials: E
authors.lastname: Zini
authors.forename: S
authors.initials: S
authors.lastname: Schellenberg
authors.forename: M
authors.initials: M
authors.lastname: Wenger
authors.forename: K
authors.initials: K
authors.lastname: Kaufmann
authors.forename: D
authors.initials: D
authors.lastname: Furrer
authors.forename: T A
authors.initials: TA
authors.lastname: Lutz
authors.forename: C E
authors.initials: CE
authors.lastname: Reusch
mesh_terms: D000818:Animals; D001120:Arginine; D001786:Blood Glucose / Q000378:metabolism*; D002371:Cat Diseases / Q000097:blood / Q000175:diagnosis*; D002415:Cats; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D005260:Female; D019270:Fructosamine / Q000097:blood; D005934:Glucagon / Q000097:blood*; D007328:Insulin / Q000097:blood*; D050417:Insulin-Secreting Cells / Q000187:drug effects* / Q000378:metabolism; D008297:Male; D018709:Statistics, Nonparametric
chemical_list: D001786:Blood Glucose; D007328:Insulin; D019270:Fructosamine; D005934:Glucagon; D001120:Arginine