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Assessment of glucocorticoid and antibiotic exposure as risk factors for diabetes mellitus in selected dog breeds attending UK primary-care clinics

Davison, Lucy; O'Neill, Daniel; Brodbelt, David; Church, David; Heeley, Angela


Lucy Davison

Daniel O'Neill

David Brodbelt

David Church

Angela Heeley


Background: Diabetes mellitus (DM) is an important endocrine disorder in dogs resulting from interactions between both genetic (non-environmental) and environmental factors. This study aimed to explore prior exposure to glucocorticoid or antibiotic treatment as risk factors for developing DM in dogs attending primary-care clinics in the UK.
Methods: A case-control study nested in the cohort of dogs (n= 480,469) aged ≥ 3 years attending clinics participating in VetCompass was used to explore associations between glucocorticoid and antibiotic exposure with the odds of developing DM using multivariable logistic regression. Control dogs were matched to cases by breed, and only breeds with ≥ 10 incident DM cases during 2016-17 were included in the analysis.
Results: A total of 565 cases and 2179 controls were included in the analysis. Dogs with DM had over 4 times the odds of exposure to glucocorticoids within 6 weeks prior to diagnosis (OR: 4.07, 95% CI 2.41-6.89, p<0.001) compared to controls within 6 weeks prior to a randomly selected quasi date of diagnosis. Dogs that had only one unique antibiotic course documented in their available clinical history had a decreased odds of developing DM (odds ratio (OR): 0.65, 95% confidence interval (CI) 0.46-0.91, p=0.012) compared to dogs that had no documented courses of antibiotics. Other factors associated with increased odds for DM included all age categories ≥ 7 years compared to dogs aged 4-<7 years, female entire dogs (OR: 5.50, 95% CI 2.56-11.82, p<0.001) compared to male entire dogs, and insured dogs (OR: 3.64, 95% CI 2.75-4.80, p<0.001) compared to uninsured dogs.
Conclusions: Exposure to glucocorticoids is associated with a substantial increase in the risk of developing DM for the breeds under analysis in this study, and clinicians should be aware of these risks when prescribing glucocorticoids to breeds predisposed to DM. Further work is also required to explore the association of antibiotic therapy and DM to understand if the protective effect of a single course of antibiotics is a true or chance association.


Davison, L., O'Neill, D., Brodbelt, D., Church, D., & Heeley, A. (in press). Assessment of glucocorticoid and antibiotic exposure as risk factors for diabetes mellitus in selected dog breeds attending UK primary-care clinics. Veterinary Record,

Journal Article Type Article
Acceptance Date Feb 22, 2023
Online Publication Date Apr 2, 2023
Deposit Date May 16, 2024
Publicly Available Date May 16, 2024
Print ISSN 0042-4900
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed


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