Diabetes: What's new sugar

Diabetes is the most common endocrine condition in small animals, with comorbidities including obesity, pancreatitis and hyperadrenocorticism (Heeley et al. 2020). Canines most commonly suffer from ‘type 1’ diabetes due to immune mediated (IM) destruction of β cells (O’Kell and Davison, 2023). Feline diabetes resembles human type 2 diabetes in approximately 80-90% of cases, with insulin resistance and β-cell dysfunction (Gostelow and Hazuchanova, 2023; Gottlieb & Rand, 2018; Rand, 2013; Sparkes et al., 2015), however these methods of classification may not be appropriate as diabetes mellitus can be caused by various aetiologies (Gilor et al., 2016). Risk factors include age, male sex, neutering, obesity, inactivity, and being an indoor cat (Panciera et al., 1990; Heeley et al., 2020). Only Burmese cats show a breed predisposition (McCann et al., 2007). Unlike dogs, cats may enter remission (Bjornvad & Jessen, 2015; Niessen et al., 2022), likely due to preserved insulin secretion preventing ketoacidosis (Zini et al., 2009). A novel treatment for feline diabetes, velagliflozin (Senvelgo©) was approved in 2023, a sodium-glucose cotransporter-2 inhibitor (SGLT2) which increases glucose excretion and reduces the associated effect of glucotoxicity on the β cells, promoting quicker return to euglycemia and a lower risk of adverse effects compared to insulin therapy.