Use of C-peptide and homeostasis model assessment of insulin resistance to assess insulin resistance in dogs.

HOMA-IR by C-peptide and HOMA-IRCP2 are reliable, non-invasive tools for detecting insulin resistance in diabetic dogs.

This cross-sectional prospective study evaluated the diagnostic utility of C-peptide and homeostasis model assessment (HOMA) indices for detecting insulin resistance (IR) in dogs. Seventy-six dogs from a referral center were classified into four groups: healthy (n=17), pre-diabetes mellitus (PreDM, n=11), insulin-dependent diabetes mellitus (IDDM, n=20), and diabetes mellitus with insulin resistance (DMIR, n=28). Fasting blood samples were analyzed for glucose, C-peptide, and metabolic markers, with HOMA-IR by C-peptide, HOMA-IRCP2, and HOMA2-IR calculated and compared across groups. The DMIR group demonstrated significantly elevated C-peptide and all HOMA indices compared to other groups. ROC curve analysis confirmed diagnostic accuracy for IR detection: HOMA-IR by C-peptide achieved the highest AUC (0.897), followed by HOMA-IRCP2 (0.893), C-peptide alone (0.843), and HOMA2-IR (0.789), all statistically significant (P<0.001). Optimal cutoff values identified were C-peptide ≥0.7 ng/mL and HOMA-IR by C-peptide ≥120 for highest sensitivity (92.9%), while HOMA-IRCP2 ≥1.65 provided the highest specificity (97.9%). These non-invasive biomarkers offer clinically practical alternatives to more complex diagnostic methods such as euglycemic-hyperinsulinemic clamps. Early identification of IR through these indices may enable timely therapeutic intervention, potentially improving glycemic management and overall clinical outcomes in diabetic dogs. The findings support integration of C-peptide-based HOMA indices into routine diabetic monitoring protocols in small animal practice.

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