Management of feline diabetes mellitus

Type 2 diabetes is the most common form of diabetes in cats. Other specific types of diabetes account for up to 10-20% of feline diabetes reported from institutions. These include diseases that lead to loss of beta-cells such as pancreatic neoplasia, and conditions which cause insulin resistance such hyperadreocorticism or acromegaly. At least 75% of cats are insulin dependent, but up to 25% of cats can be controlled with oral hypoglycemic drugs. To date, glipizide is the only oral hypoglycemic drug with well documented efficacy. Good clinical control can be achieved in most cats with NPH, lente, ultralente or PZI insulins. NPH and lente insulin need to be administered twice daily, and in many cats, ultralente or PZI provide better control administered twice daily rather than once daily. Insulin doses should be conservative to avoid clinical hypoglycemia. Feeding does not need to be timed to insulin administration because postprandial hypoglycemia is mild and very prolonged in cats. It is important that clinical signs are used to monitor response to therapy. Fructosamine, glycated hemaglobin and urine glucose are useful adjuncts to monitoring in some cats. Water intake correlates better with mean blood glucose than fructosamine and is less expensive to measure. Diabetic remission occurs in approximately 30% of patients usually within 1-4 months of good glycemic control being established