How to Treat Diabetes in Cats Without Insulin

Insulin is the treatment of choice in most cases of feline diabetes. However, it may be possible to treat diabetes in cats without insulin. Some diabetic cats will respond to low-carbohydrate diets or oral medications that help control blood sugar. Monitoring of blood sugar levels is an important part of diabetes management and helps veterinarians determine if treatments are effective. Here's what cat parents should know about treating diabetes in cats without insulin.

Diabetes in Cats

When a cat is diagnosed with diabetes mellitus, it means their pancreas is not producing enough insulin to regulate the glucose, or sugar levels, in the bloodstream. The standard treatment for these cats includes insulin injections, diet changes, and blood sugar monitoring.

Though giving injections to a cat can be a scary prospect for many cat owners, most owners find the injections are easier than they thought. However, sometimes pet parents cannot give insulin injections, and the veterinarian may discuss alternatives.

An important consideration in treating a cat with diabetes, especially if the disease is caught early, is that remission is possible if the regulation of blood glucose levels can be controlled effectively. For that reason, aggressive treatment should be started early. Diabetic cats must be diagnosed and managed by a veterinarian, regardless of treatment (including diet) and it's important not to attempt to diagnose or manage diabetes alone.

Dietary Management

A strictly controlled diet can be useful in controlling blood glucose levels in cats with diabetes. Feeding your cat special food by itself may or may not be completely effective, and it is most likely to work for cats who do not have severe diabetes.

The most commonly recommended food for a cat with diabetes is a diet containing high levels of protein and low levels of carbohydrates. These diets can lower blood sugar, but they also promote weight loss, which can improve diabetes.

If you are feeding your cat commercial food, canned cat foods are preferred (as opposed to kibble or dry food).

A high-protein, low-carbohydrate diet can be combined with insulin or oral medications to regulate your cat's blood glucose levels. This may be more effective than using diet or medication alone.

Oral Medications

Oral medications to control blood sugar are worth exploring when a cat will not tolerate daily or twice daily insulin injections, or when a pet parent is physically incapable of giving the insulin injections.

Oral Hypoglycemics

Oral hypoglycemic medications like glipizide and acarbose can help lower blood glucose levels in cats, especially when used in conjunction with a low-carb diet. However, these hypoglycemic medications rarely work to control diabetes in cats.

SGLT2 Inhibitors

Bexacat (tablets) and Senvelgo (oral solution) belong to a newer class of diabetes drugs called SGLT2 inhibitors. These work differently from insulin; they lower a cat’s blood sugar by excreting glucose through the kidneys. SGLT2 inhibitors are best for cats capable of producing some insulin. Your veterinarian can determine whether one of these drugs is appropriate for your cat.

Monitoring Diabetic Cats

Regardless of the treatment type, all diabetic cats should be closely monitored. This involves spot-checking blood glucose levels and periodically performing blood glucose curves that measure blood glucose fluctuations throughout the day.

Your veterinarian can show you how to check your cat's blood sugar levels at home. You'll collect a small blood sample by pricking your cat's ear or paw and measuring glucose with a glucometer. Alternatively, the vet may recommend a continuous glucose monitor, where a sensor is placed under the skin and you use a smartphone to read the glucose measurement.

Close monitoring of diabetic cats enables the vet to make timely adjustments to your cat's treatment plan. Insulin injections typically provide better glycemic control (control of blood sugar levels) than other medications. Insulin injections, particularly when combined with a proper diet of high-protein, low-carbohydrate foods, can convert many cats to a state of remission. This means that insulin injections may be necessary only for a short period, after which your cat may not need them anymore.

In practice, many cats respond better to insulin injections than oral medications or special diets. For this reason, even though alternative treatments may be available if the situation warrants them, insulin is likely to remain the treatment of choice.