Emerging Technologies in Canine Diabetes Care

Managing canine type 1 diabetes mellitus (T1DM) has traditionally relied on twice-daily insulin injections and periodic blood glucose monitoring. While this approach remains the current standard of care, it is not without challenges. Frequent glucose fluctuations, the risk of hypoglycaemia, and the demands placed on owners have encouraged the development of technologies designed to improve glycaemic control while simplifying long-term management. 

Understanding these emerging technologies can help guide discussions with owners and prepare for future advances that may become part of clinical practice. 

Continuous Glucose Monitoring: A Step Forward in Monitoring 

Continuous glucose monitoring (CGM) systems are already available for use in dogs and provide an alternative to repeated blood sampling. By measuring glucose concentrations in the interstitial fluid, these systems offer continuous information about glucose trends and can assist in optimizing diabetes management^1,2,3. 

Compared with intermittent blood glucose measurements, CGM can reduce the need for repeated needle pricks while allowing veterinarians to evaluate glucose patterns over an extended period. This information may support more informed insulin adjustments and improve the quality of life for both dogs and their owners¹. 

Despite these advantages, CGM should be interpreted with an understanding of its limitations. Interstitial glucose does not immediately reflect changes in blood glucose concentration. A delay of approximately 10 minutes exists between blood glucose changes and interstitial glucose readings, meaning rapid glucose fluctuations may not be detected in real time. Consequently, severe hypoglycaemia may still occur if insulin doses are not adjusted appropriately^1,2. 

Implantable Insulin Pumps: Continuous Drug Delivery 

Another technology under development is the implantable insulin pump. Unlike conventional injections, these devices continuously deliver insulin, reducing dependence on repeated manual administration. 

Experience in dogs has primarily been limited to experimental settings. In one application, an implantable pump delivered insulin intraperitoneally for 28 months while maintaining blood glucose concentrations between 8.3 and 16.7 mmol/L in more than 65% of blood glucose measurements. During this period, no hypoglycaemic coma, infection, or skin irritation was reported, demonstrating that long-term insulin delivery through an implantable device can be both stable and practical under controlled conditions¹. 

Although this approach has not yet been described in privately owned diabetic dogs, it illustrates how continuous insulin delivery could reduce some of the practical challenges associated with lifelong injections. 

The Artificial Pancreas: Bringing Monitoring and Insulin Together 

The artificial pancreas represents an integrated approach to diabetes management by combining three essential components: 

• A continuous glucose monitoring system 

• An implantable insulin pump 

• A control algorithm that automatically regulates insulin delivery based on sequential glucose measurements throughout the day⁴ 

Rather than relying solely on owner-administered insulin injections, this closed-loop system continuously responds to changing glucose concentrations. 

Early canine applications demonstrated that wearable artificial pancreas systems could restore blood glucose control for up to seven days in pancreatectomised dogs¹. Although these early devices gradually lost sensitivity and effectiveness, they established the foundation for future technological development. 

Dogs have since served as valuable translational models in the refinement of artificial pancreas systems intended for human medicine¹. However, recent evaluations of artificial pancreas technology specifically for treating naturally occurring canine diabetes have not been reported. 

Practical Clinical Insights 

Emerging technologies are reshaping how diabetes may eventually be managed in veterinary medicine. Continuous glucose monitoring already provides valuable support for assessing glycaemic trends, while implantable insulin pumps and artificial pancreas systems aim to automate insulin delivery and reduce treatment burden. Each technology offers potential advantages but also presents practical limitations that veterinarians should recognize when interpreting glucose data or discussing future treatment possibilities with owners. As these innovations continue to evolve, familiarity with their capabilities and constraints will position clinicians to adopt new approaches as they become clinically applicable. 

References 

1. Oliveira FC, Voorbij AW, Pereira EC, Alves e Almeida LM, Moraes GR, De Oliveira JT, Gouw BH, Legatti SA, Kooistra HS, Spee B, Meneses AM. Treatment of Canine Type 1 Diabetes Mellitus: The Long Road from Twice Daily Insulin Injection towards Long-Lasting Cell-Based Therapy. Organoids. 2024 Apr 4;3(2):67-82. https://www.mdpi.com/2674-1172/3/2/6 

2. van Beers CA, DeVries JH. Continuous glucose monitoring: impact on hypoglycemia. Journal of Diabetes Science and Technology. 2016 Nov;10(6):1251-8. https://journals.sagepub.com/doi/pdf/10.1177/1932296816653411 

3. Corradini S, Pilosio B, Dondi F, Linari G, Testa S, Brugnoli F, Gianella P, Pietra M, Fracassi F. Accuracy of a flash glucose monitoring system in diabetic dogs. Journal of Veterinary Internal Medicine. 2016 Jul;30(4):983-8. https://academic.oup.com/jvim/article-pdf/30/4/983/66690327/jvim14355.pdf 

4. Kropff J, DeVries JH. Continuous glucose monitoring, future products, and update on worldwide artificial pancreas projects. Diabetes technology & therapeutics. 2016 Feb;18(2_suppl):S2-53. https://journals.sagepub.com/doi/pdf/10.1089/dia.2015.0345