Treatment of Diabetes Mellitus with Oral Hypoglycemic and Antihyperglycemic Agents in Two Cotton-Top Tamarins (Saguinus oedipus)
Two related cotton-top tamarins (Saguinus oedipus) were diagnosed with diabetes mellitus via persistent glucosuria and elevated glycosylated hemoglobin percentages (GlyHg). Diet changes included removal of all simple sugars from the diet, including fruit, “marmoset jelly,” and sweet corn from a porcupine’s diet (mixed species exhibit). Multiple oral hypoglycemic and anti-hyperglycemic agents were compounded and administered in different combinations including: metformin (50 mg/kg SID), acarbose (2–5 mg/kg BID), glipizide (0.5–4 mg/kg SID–BID), pioglitazone (3–9 mg/kg BID), and glimepiride (1–3 mg/kg BID) (Diamondback Compounding Pharmacy, Scottsdale, AZ). Metformin was not accepted regardless of flavor used for compounding. Animals were target-trained to a clean platform for opportunistic urine collection. Response to treatment was monitored by daily measurement of glucosuria and periodic measurement of GlyHg. The younger animal responded well to a glipizide (1 mg/kg BID) and acarbose (2 mg/kg BID) combination. Pretreatment GlyHg was 8.6% and post-treatment values ranged from 4.6–5.8% (human normal <6.0%). It was eventually weaned off medications and appears to have been a transient non-insulin dependent diabetic. The older animal did not respond to any medication combination over 18 months (pretreatment GlyHg=13%; post-treatment 10.0–11.3%) and as a result was thought to be an insulin-dependent diabetic. This presentation highlights the challenges and solutions of treating diabetes mellitus in small nonhuman primates, including appropriate diet in a mixed species exhibit, training for urine collection, and difficulty in medication administration. It also demonstrates that this disorder can be treated successfully, without insulin injections, if diagnosed early in its progression.