SAN DIEGO – A miracle of marsupial medicine is no more.
An endocrinologist is no longer checking his blood sugar levels on her smartphone a couple times a day, and zookeepers have stopped responding to glucose alerts by preparing tiny doses of insulin. But Quincy, the recipient of a continuous glucose monitor, has provided valuable insight that may benefit a variety of creatures beyond our furry, eucalyptus-eating cousins.
“Through this experience, I am hopeful that we’ll be able to offer better treatment in the future for any animals that are found to have diabetes,” the endocrinologist, Athena Philis-Tsimikas, MD, of Scripps Whittier Diabetes Institute, said in an interview.
And, she added, the experience of working with Quincy “provided an indication of where remote management of diabetes is going for the future, whether this is humans or animals.”
Quincy, a Queensland koala, reportedly died at the San Diego Zoo on Dec. 13 of pneumonia at the age of about 3 years. (Koalas can live into their teens.)
It’s not clear if his death was related to his diabetes. Dr. Philis-Tsimikas said. “Although infection can worsen with poor glucose control, my understanding from the veterinarian was that his diabetes had stabilized and was being successfully treated with a small dose of daily basal insulin,” she said. “He was not having wide fluctuations in glucose control, and the CGM had been removed to make it easier for him to get around his enclosures.”
Nine months before his death, Quincy was diagnosed with type 1 diabetes and transferred from the Los Angeles Zoo for medical reasons. Last June, after veterinarians consulted with Dr. Philis-Tsimikas, Quincy underwent an operation to fit him with a CGM so zookeepers could avoid having to wake him multiple times a day for skin pricks.
Koalas are among many species that can develop the equivalent of human diabetes. Dogs, cats, pigs, apes, horses, and even dolphins can become diabetic.
“The providers and caretakers could all respond with appropriate interventions based on the real-time readings. Improved treatment decisions were made despite not having any verbal communication,” Dr. Philis-Tsimikas said.
“I found it amazing that the CGM device could be placed on such a small body with very little subcutaneous fat,” she said. “It stayed in place and functioned successfully despite movement of the koala around his enclosure.”
In light of his small body and lack of body fat, could Quincy’s experience offer insight into the use of CGM technology in fragile humans such as babies and the elderly? Absolutely, Dr. Philis-Tsimikas said, noting that babies have been diagnosed with diabetes at as young as 9 months.
She said Quincy’s story, which got extensive media attention, provided another benefit. “His story was very relatable to many people with newly diagnosed type 1 diabetes and how difficult it can be to manage the highs and lows,” she said. “Quincy helped show us how this could be addressed with the new technology of a CGM and new types of basal insulin and pens that deliver half units.”
Dr. Philis-Tsimikas reports that her center conducts research with Dexcom and Novo Nordisk.