Effect of insulin treatment on circulating insulin-like growth factor I and IGF-binding proteins in cats with diabetes mellitus

Emma Strage, Mårten Sundberg, Bodil Ström-Holst, Mikael Andersson Franko, Margareta Ramström, Tove Fall, Moira Lewitt

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Background: Insulin-like growth factor-I (IGF-I) is used to screen for acromegaly in diabetic cats. In humans, most circulating IGF-I forms ternary complexes (TC) with IGF-binding protein (IGFBP-3) and an acid-labile subunit. Compared to humans, the amount of TC in cats is more variable. IGF-I concentrations are reported to increase during insulin treatment, more rapidly in cats achieving remission.

Objectives: To investigate (i) factors associated with circulating IGF-I concentrations, including IGF-binding protein profiles (ii) effect of insulin treatment on IGF-I concentrations and (ii) IGF-I as prognostic marker of DM remission.Animals: 31 privately-owned diabetic cats of which 24 were followed 1 year, and 13 healthy cats.

Methods: In this prospective study, insulin, IGF-I, glucose and fructosamine were measured. IGF-binding forms were determined by chromatography in 14 diabetic and 13 healthy cats. IGF- I, IGF-II, IGFBP-3 and IGFBP-5 was measured by mass spectrometry in 3 cats achieving remission.

Results: IGF-I median (interquartile range) before start of insulin treatment was 300 (160-556) ng/mL. IGF-I was positively associated with TC (p<0.0001) and endogenous insulin (p=0.005) and negatively associated with fructosamine (p<0.0001). IGF-I was 2-fold higher 2-4 weeks after start of insulin treatment compared with baseline (p=0.0001) and predicted future remission (p=0.046). In cats that went into remission, the amount of TC and IGFBP-3 increased, suggesting the increase in IGF-I is dependent on TC formation.

Conclusions: Insulin treatment should be accounted for when interpreting IGF-I in diabetic cats. IGF-I 2-4 weeks after initiation of insulin treatment shows promise as prognostic marker for remission in diabetic cats.
Original languageEnglish
Number of pages12
JournalJournal of Veterinary Internal Medicine
Issue number5
Early online date16 Aug 2018
Publication statusE-pub ahead of print - 16 Aug 2018


  • IGF-II
  • IGFBP-3
  • insulin
  • ternary complex


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