PATHOGENESIS OF FELINE DIABETES MELLITUS [Review]

摘要

Diabetes mellitus may occur as a primary disease process or secondary to destruction of beta cells or insulin resistance caused by another disease. Primary diabetes in humans was subdivided initially based on the clinical characteristics of the disease, such as age of onset, insulin dependence, and susceptibility to ketosis. In most human diabetics, the clinical features correspond well to the underlying pathology. Hence, insulin-dependent diabetes is generally used to describe type 1 diabetes, which is caused by immune-mediated destruction of beta cells.' Noninsulin-dependent diabetes is used to describe type 2 diabetes, associated with islet amyloid deposition.(53) Direct translation of this terminology to feline diabetes has lead to confusion and inaccurate classification. Although there is strong evidence that type 1 and type 2 diabetes both occur in cats, type 2 seems to be more frequent, and in contrast to humans, most cats are insulin dependent. In this article, the terms Spe I and type 2 diabetes are used to imply a specific underlying pathology, and insulin-dependence or non-dependence is used only as a description of the clinical characteristics of the disease. Therefore, insulin-dependent diabetes may occur as a result of either type 1 or type 2 diabetes or secondary diabetes. Impaired glucose tolerance replaces the terms latent and subclinical diabetes,(90) and refers to cats with increased glucose concentration or glucose half-life after a glucose tolerance test, and fasting normoglycemia or mild hyperglycemia.(61, 95) In cats and humans, impaired glucose tolerance is associated with type 2 diabetes, obesity, and stress reactions to disease (Link KRJ, Rand JS, unpublished data, 1994).(22, 91, 95) [References: 147]