Optimising outcomes in feline diabetes: SGLT2 inhibitor use

Abstract

Diabetes is the most common endocrine condition in small animals, with comorbidities including obesity, pancreatitis and hyperadrenocorticism. Dogs most commonly develop ‘type 1’ diabetes due to immune-mediated destruction of β cells. Feline diabetes resembles human type 2 diabetes in approximately 80–90% of cases, with insulin resistance and β-cell dysfunction. However, these classifications may be inappropriate, as diabetes mellitus can arise from various aetiologies. Risk factors include age, male sex, neutering, obesity, inactivity and being an indoor cat. Only Burmese cats show a breed predisposition. Unlike dogs, cats may enter remission, likely because preserved insulin secretion helps prevent ketoacidosis. A novel treatment for feline diabetes, velagliflozin, has been approved. This sodium–glucose cotransporter 2 inhibitor increases urinary glucose excretion and reduces the glucotoxic effect on β cells, promoting a more rapid return to euglycaemia and a reduced risk of adverse effects compared with insulin therapy.