Long‐term management of type 2 diabetes mellitus in callitrichids with oral anti‐hyperglycaemic medication

Abstract

Type 2 diabetes mellitus (T2DM) (also defined as non‐insulin‐dependent diabetes mellitus) is the most common form of spontaneous diabetes in humans and non‐human primates, and has frequently been reported in callitrichids. Oral anti‐hyperglycaemic drugs are the first line of therapy for T2DM along with dietary changes. There are no reports of the successful use of oral anti‐hyperglycaemic medication in callitrichids. Here, we describe the diagnosis of five cases of T2DM in callitrichids at ZSL London Zoo, UK, based on persistent hyperglycaemia, glucosuria and elevated blood‐serum fructosamine. The stabilization and long‐term management of T2DM using oral anti‐hyperglycaemic medication are reported. Treatment with metformin monotherapy was successful in controlling and maintaining normoglycaemia in three individuals for between 4 and 6 years. The addition of glipizide was required to achieve glycaemic control in a fourth animal. A fifth animal was refractory to treatment. Compliance was good and no side effects were seen. Based on these findings, we suggest that anti‐hyperglycaemic drugs, together with appropriate dietary changes, can be effective in the long‐term treatment of T2DM in callitrichids.

Current practices in nutrition management and disease incidence of common marmosets (Callithrix jacchus)

“…Diabetes mellitus was reported by two institutions and incidence may increase as frequency of obesity increases. A limited number of case reports document diagnostic findings and management of type 2 diabetics with metformin 21 …”

“…A limited number of case reports document diagnostic findings and management of type 2 diabetics with metformin. 21 Potential causes for obesity include decreased activity levels in captivity and consumption of food in excess of that needed for energy requirement, influenced by use of highly palatable primary diets, the high digestibility of captive diets, food used as environmental enrichment, high incidence of social housing and difficulty in controlling an individual marmoset's caloric intake while socially housed. Selection for phenotypes with metabolic dysfunction may also contribute.…”

Naturally Occurring Endocrine Disorders in Non-Human Primates: A Comprehensive Review

“…However, strategies to individualize caloric intake and encourage exercise are difficult to implement in socially housed NHP [ 121 ]. Caretakers should be educated on dietary modifications and restrictions [ 30 , 122 ]. The regular primate pallets often contain high levels of carbohydrates, particularly problematic simple sugars.…”

“…Long and short-acting insulin are available to tailor treatment to the individual animals’ needs. The goal of insulin treatment is to reduce hyperglycemia to normal ranges, which will improve quality of life by relieving symptoms and preventing the complications of DM [ 20 , 30 , 122 , 123 , 124 , 125 ]. However, it is challenging to monitor glucose levels and administer daily insulin in NHP.…”

Reproductive one health in primates

“…In the RHSP database, adenomyosis was identified frequently in lemurs, and correlated with advanced endometrial hyperplasia (Moresco & Agnew, unpub. data), this has not been investigated for other taxonomic groups, but single cases are reported in the literature, for example a golden headed lion tamarin ( Leontopithecus chrysomelas ) (Strike & Feltrer, 2017).…”