Treating Diabetic Cats

Glucagon-like peptide 1 (GLP-1)—an incretin or gastrointestinal hormone released during food intake—increases insulin secretion from β-cells in the pancreas. This incretin is rapidly degraded by the enzyme dipeptidyl-peptidase-4 (DPP-4). Novel classes of antidiabetic drugs that take advantage of incretin’s glucoregulatory actions have been developed and used successfully in the treatment of human type 2 diabetes. Because feline diabetes most closely mimics human type 2 diabetes, investigation of incretins’ role in cats is warranted. 

This study investigated the safety and efficacy of 2 subcutaneous GLP-1 analogues (exenatide and exenatide extended-release) and 1 oral DPP-4 inhibitor (sitagliptin). All enhanced healthy cats’ insulin secretion. The GLP-1 agonists were capable of more pronounced effects than the DPP-4 inhibitor, which is similar to results seen in humans. Dose escalations showed a proportional insulin secretion increase, and all drugs were associated with mild gastrointestinal side effects that did not appear dose-dependent. Injection site reactions, cystitis, or respiratory signs—potential side effects in humans—were not seen. It is possible these drugs present safe, effective treatment options for diabetic cats.

Commentary

This study presents potential novel treatment options for cats with diabetes. Potential benefits would be decreased dosing frequency compared to the common twice-daily insulin regimen. It is unclear how these drugs would compare to insulin therapy in terms of cost and availability and whether they would result in a higher rate of remission when used with certain prescription diabetes-management diets. Long-term data are necessary to further elucidate the benefits.—Heather Troyer, DVM, DABVP, CVA

This capsule is part of the One Health Initiative.