Peer-reviewed veterinary case report
Non-insulin diabetes drugs for cats - safety and effectiveness
By Romero-Vélez F et al.·2025·Hospital Clínic Veterinari, Spain·View original on Europe PMC →
PetCaseFinder translated the abstract of this peer-reviewed paper into plain English so pet owners can read it. We do not publish original research — every detail traces back to the citation above. How we work →
Original publication title: Efficacy and Safety of Non-Insulin Antidiabetic Drugs in Cats: A Systematic Review.
- Species:
- cat
Plain-English summary
A review of studies on diabetic cats found that while insulin is the standard treatment, some newer oral medications called SGLT2 inhibitors may also be effective. These medications showed promising results in helping control blood sugar levels, but they come with a risk of a serious condition called euglycemic diabetic ketoacidosis (eDKA). Traditional medications like glipizide and metformin had limited success and higher risks of complications. Overall, SGLT2 inhibitors could be a good option for some cats with diabetes, but more research is needed to fully understand their safety and effectiveness.
People also search for: cat diabetes treatment options · SGLT2 inhibitors for cats · diabetic cat medication risks
Abstract
<h4>Background</h4>While insulin is the standard of care for feline diabetes mellitus (FDM), non-insulin antidiabetic drugs (NIADs) are emerging as alternatives. This systematic review aims to synthesize and critically appraise the current evidence for the efficacy and safety of NIADs in cats.<h4>Methods</h4>A systematic review was conducted following PRISMA guidelines. Major databases were searched for studies evaluating NIADs in diabetic cats or at-risk/experimental models. Risk of bias was assessed using RoB 2 and ROBINS-I tools.<h4>Results</h4>Twenty studies were included. In diabetic cats (10 studies), traditional agents (glipizide, metformin, acarbose) showed limited efficacy based on evidence with a high risk of bias. Newer SGLT2 inhibitors (bexagliflozin, velagliflozin) demonstrated high treatment success rates and non-inferiority to insulin but were associated with a significant risk of euglycemic diabetic ketoacidosis (eDKA). In at-risk/experimental models (10 studies), thiazolidinediones consistently improved insulin sensitivity, while glipizide was shown to accelerate islet amyloidosis.<h4>Conclusions</h4>The evidence supports a paradigm shift towards SGLT2 inhibitors as a viable oral monotherapy for select cases of FDM. This alters the clinical risk-benefit discussion from preventing hypoglycemia to mitigating eDKA. Significant evidence gaps remain, particularly the lack of high-quality RCTs and data in cats with common comorbidities.
Find similar cases for your pet
PetCaseFinder finds other peer-reviewed reports of pets with the same symptoms, plus a plain-English summary of what was tried across them.
Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/40941356