ISSN 2398-2950      

Diabetes mellitus


Synonym(s): Sugar diabetes


  • Common endocrine disease of middle-aged cat (approx. 1 in 400).
  • Cause: syndrome characterized by relative or absolute lack of insulin.
  • Signs: polyuria/polydipsia.
  • Diagnosis: glycosuria, persistent hyperglycemia, fructosamine.
  • Treatment: insulin, dietary management.
  • Prognosis: generally good if uncomplicated by concurrent condition.
    Print off the owner factsheets on Diabetes mellitus Diabetes mellitus and Monitoring diabetes in cats Monitoring diabetes in cats to give to your client.



  • Type 1: inadequate secretion of insulin (immune-mediated, destruction of islet cells).
  • Type 2: resistance to insulin activity, eg obesity Obesity leading to relative lack of insulin (most common).
  • Type 3: antagonism to insulin (cortisol, progesterone, growth hormone, catecholamines, glucagon).
  • Inactivation of insulin (immune response).

Predisposing factors


  • Increasing age (may be due to increased presence of diseases causing insulin resistance in older cats).
  • Obesity:
    • Associated with indoor lifestyle.
  • Concurrent disease:
  • Drug therapy:
    • Progestagen therapy, eg megestrol acetate.
    • Glucocorticoids.
    • Cyclosporin may alter glucose homeostasis in humans and dogs (not documented in cats).
  • Genetic susceptibility.


  • Type 1: (insulin dependent - rare) destruction of beta cells (immune-mediated/congenital/neoplastic    →   failure of insulin response to hyperglycemia.
  • Type 2: (non-insulin dependent - most common) peripheral insulin resistance   →   increased insulin production required   →    glucose toxicity and increased amylin secretion    →   fall in insulin levels and islet amyloidosis    →   beta cell degeneration   →    type 1 diabetes.
  • Type 3: (concurrent disease - 5-10%) endocrinopathies or insulin antagonistic drugs   →   increased requirement for insulin   →   initial hyperinsulinemia   →   beta cell degeneration   →   type 1 diabetes.


  • Weeks to months.


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Further Reading


Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Roomp K, Rand J S (2012) Evaluation of detemir in diabetic cats managed with a protocol for intensive glucose control. J Feline Med Surg 14 (8), 566-572 PubMed.
  • Scott-Moncreiff J C (2012) Insulin resistance in cats. Vet Clin N America Small Anim Pract 40 (2), 241-257 PubMed.
  • Marshall R D, Rand J S & Morton J (2009) Treatment of newly diagnosed diabetic cats with glargine insulin imporves glycemia control and results in higher probability of remission than protamine zinc and lente insulins. J Feline Med Surg 11 (8), 683-691 PubMed.
  • Roomp K, Rand J S (2009) Intensive blood glucose control is safe and effective in diabetic cats using home monitoring and treatment with glargine. J Feline Med Surg 11 (8), 668-682 PubMed.
  • Marshall R, Rand J, Morton J (2008) Insulin glargine has a long duration of effect following administration either once daily or twice daily in divided doses in healthy cats. J Feline Med Surg 10 (5), 488-494 PubMed.
  • Marshall R, Rand J, Morton J (2008) Glargine and protamine zinc insulin have a longer duration of action and result in lower mean daily glucose concentrations than lente insulin in healthy cats. J Vet Pharmacol Ther 31 (3), 205-212 PubMed.
  • Bennett N, Greco D S, Peterson M E et al (2006) Comparison of a low carbohydrate-low fiber diet and a moderate carbohydrate-high fiber diet in the management of feline diabetes mellitus. J Feline Med Surg (2), 73-84 PubMed.
  • Reusch C E, Tschour F, Kley S et al (2006) Diabetes mellitus in the cat: a review. Schweiz Arch Tierheilkd 148 (3), 130-138 PubMed.
  • Weaver K E, Rozanski E A, Mahony O M et al (2006) Use of glargine and lente insulins in cats with diabetes mellitus. J Vet Intern Med 20 (2), 234-8 PubMed.
  • Casella M, Hässig M & Reusch C E (2005) Home-monitoring of blood glucose in cats with diabetes mellitus: evaluation over a 4-month period. J Feline Med Surg (3), 163-171 PubMed.
  • Rand J S & Marshall R D (2005) Diabetes mellitus in cats. Vet Clin North Am Small Anim Pract 35 (1), 211-224 PubMed.
  • Ristic J M, Herrtage M E, Walti-Lauger S M et al (2005) Evaluation of a continuous glucose monitoring system in cats with diabetes mellitus. J Feline Med Surg (3), 153-162 PubMed.
  • Van de Maele I, Rogier N & Daminet S (2005) Retrospective study of owners' perception on home monitoriong of blood glucose in diabetic dogs and cats. Can Vet J 46 (8), 718-723 PubMed.
  • Kley S, Casella M & Reusch C E (2004) Evaluation of long-term home monitoring of blood glucose concentrations in cats with diabetes mellitus: 26 cases (1999-2002)JAVMA 225 (2), 261-266 PubMed.
  • Nelson R, Spann D, Elliott D et al (2004) Evaluation of the oral antihyperglycemic drug metformin in normal and diabetic cats. J Vet Intern Med 18 (1), 18-24 PubMed.
  • Rand J S, Fleeman L M, Farrow H A et al (2004) Canine and feline diabetes mellitus: nature or nuture? J Nutr 134 (8 Suppl), 2072S-2080S PubMed.
  • Thiess S, Becskei C, Tomsa K et al (2004) Effects of high carbohydrate and high fat diet on plasma metabolite levels and on i.v. glucose tolerance test in intact and neutered male cats. J Feline Med Surg (4), 207-218 PubMed.
  • Mazzaferro E M, Greco D S, Turner A S et al (2003) Treatment of feline diabetes mellitus using an alpha-glucosidase inhibitor and a low-carbohydrate diet. J Feline Med Surg (3), 183-189 PubMed.
  • Sennello K A, Schulman R L, Prosek R et al (2003) Systolic blood pressure in cats with diabetes mellitus. JAVMA 223 (2), 198-201 PubMed.
  • Wiedmeyer C E, Johnson P J, Cohn L A et al (2003) Evaluation of a continuous glucose monitoring system for use in dogs, cats, and horses. JAVMA 223 (7), 987-992 PubMed.
  • Bennett N (2002) Monitoring techniques for diabetes mellitus in the dog and the cat. Clin Tech Small Anim Pract 17 (2), 65-69 PubMed.
  • Zoran D L (2002) The carnivore connection to nutrition in cats. JAVMA 221 (11), 1559-1567 PubMed.
  • Zerbé C A (2001) What is so special about feline diabetes mellitus? J Feline Med Surg (2), 99-103 PubMed.
  • Behrend E N & Greco D S (2000) Feline diabetes mellitus - evaluation of treatment. Comp Cont Ed Pract Vet 22 (5), 440-453 VetMedResource.
  • Elliott D A, Feldman E C, Koblik P D et al (2000) Prevalence of pituitary tumours among diabetic cats with insulin resistance. JAVMA 216 (11), 1765-1768 PubMed.
  • Hoenig M, Hall G, Ferguson D et al (2000) A feline model of experimentally induced islet amyloidosis. Am J Pathol 157 (6), 2143-2150 PubMed.
  • Hoenig M, Reusch C & Peterson M E (2000) Beta cell and insulin antibodies in treated and untreated diabetic cats. Vet Immunol Immunopathol 77 (1-2), 93-102 PubMed.
  • Nelson R W (2000) Oral medications for treating diabetes mellitus in dogs and cats. JSAP 41 (11), 486-490 PubMed.
  • Nelson R W (2000) Selected topics in the management of diabetes mellitus in cats. Journal Fel Med Surg (2), 101-104 PubMed.
  • Norman E J & Mooney C T (2000) Diagnosis and management of diabetes mellitus in five cats with somatotrophic abnormalities. JFMS (4), 183-190 PubMed.
  • Feldhahn J R, Rand J S, Kinnaird E (1999) The effect of interday variation and a short term stressor on insulin sensitivity in clinically normal cats. J Fel Med Surg 1 (4), 233-240 PubMed.
  • Foldhahn J R & Martin G (1999) Insulin sensitivity in normal and diabetic cats. J Feline Med Surg (2), 107-15 PubMed.
  • Godfrey D R (1999) What is your diagnosis? Non-ketotic hyperosmolar diabetes mellitus. JSAP 40 (9), 409, 450 PubMed.
  • Greco D S (1999) Insulin therapy in cats. JAAHA 35 (4), 269-270 PubMed.
  • Martin G J W, Rand J S (1999) Food intake and blood glucose in normal and diabetic cats fed ad libitum. J Fel Med Surg (4), 241-251 PubMed.
  • Nelson R W, Griffey S M, Feldman E C et al (1999) Transient clinical diabetes mellitus in cats - 10 cases (1989-1991). J Vet Intern Med 13 (1), 28-35 PubMed.
  • Rand J (1999) Current understanding of feline diabetes. Part 1, Pathogenesis. J Feline Med Surg (3), 143-53 PubMed.
  • Feldman E C, Nelson R W & Feldman M S (1997) Intensive 50-week evaluation of glipizide administration in 50 cats with previously untreated diabetes mellitus. JAVMA 210 (6), 772-777 PubMed.
  • Kraus M S, Calvert C A, Jacobs G J et al (1997) Feline diabetes mellitus a retrospective mortality study of 55 cats (1982-1994). JAAHA 33 (2), 107-111 PubMed.
  • Rand J S, Bobbermien L M, Hendrikz J K et al (1997) Over-representation of Burmese cats with diabetes mellitus in Australia. Aust Vet J 75 (6), 402-405 PubMed.
  • Crenshaw K L & Peterson M E (1996) Pre-treatment clinical and laboratory evaluation of cats with diabetes mellitus 104 cases (1992-1994). JAVMA 209 (5), 943-949 PubMed.
  • Crenshaw K L, Peterson M E, Heeb L A et al (1996) Serum fructosamine concentrations as an index of glycemia in cats with diabetes mellitus and stress hyperglycemia. JVIM 10 (6), 360-364 PubMed.
  • Carlson R A (1994) Hyperosmolar nonketotic diabetes mellitus in a cat. Feline Pract 22 (3), 20-24 VetMedResource.
  • Kirk C A, Feldman E C & Nelson R W (1993) Diagnosis of naturally acquired Type I and Type II diabetes mellitus in the cat. Am J Vet Res 54 (3), 463-467 PubMed.
  • Miller A B, Nelson R W, Kirk C A et al (1992) Effect of glipizide on serum insulin and glucose concentrations in healthy cats. Res Vet Sci 52 (2), 177-181 PubMed.

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