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How to Manage Diabetes in Cats – Working to achieve remission!


Diabetes in Cats – An Overview

Cats typically have a form of diabetes resembling Type II in humans in which cellular resistance to insulin results in impaired glucose uptake. This leads to dysfunction of the insulin-producing beta cells in the pancreas and  a progressive reduction in insulin production. There are many potential causes of insulin resistance, with obesity being the most important acquired factor in cats.1 Overweight or obese cats have up to a 4 times greater chance of becoming diabetic than ideal weight cats.2 Other causes of insulin resistance in cats include genetic predisposition, physical inactivity, increasing age, male gender and certain medications.3

Clinical signs of diabetes in cats

Clinical signs of diabetes in cats include increased thirst (polydipsia) and urination (polyuria), weight loss despite increased appetite (polyphagia), lethargy, poor coat condition, developing a plantigrade stance which is related to peripheral neuropathy. If this is left untreated it can eventually result in diabetic ketoacidosis (DKA) which can be a life-threatening complication of uncontrolled diabetes.

cat drinking water

Treatment goals

insuline for cats

The ultimate goal of treating feline diabetes is always diabetic remission. While this won’t always be possible,  the most likely way to achieve remission is to treat early using long-acting insulin therapy twice daily, in conjunction with feeding an appropriate food.3 The highest remission rates have occurred when this regimen is used in newly diagnosed diabetics or those within 6 months of diagnosis.4 This is probably because protracted hyperglycaemia is toxic to pancreatic beta cells, hence controlling high blood glucose levels early in the course of the disease is paramount. As we work towards diabetic remission, selecting the right food will help. For example, in obese patients, successful weight loss can encourage a more normal response to insulin release and potentially lead to diabetic remission.5

Other treatment goals include-:

  • Reducing fluctuations of blood glucose and the rapid rise in blood glucose concentrations that may occur after eating
  • Control of clinical signs such as polydipsia/polyuria and weight loss
  • Avoiding clinical hypoglycaemia which can result in seizures and blindness
  • Preventing ketoacidosis
  • And if overweight, weight loss and maintenance of an ideal weight is critical

Nutritional management of diabetes in cats

The cornerstone of nutritional management of feline diabetics is the use of a low carbohydrate food such as Hill’s Prescription Diet m/d GlucoSupport.  Low carbohydrate foods can help reduce fluctuations in blood glucose and reduce hyperglycaemia and glucose toxicity. In fact Hill’s m/d GlucoSupport has been clinically shown to help stabilise blood glucose concentrations and maintain glycaemic control.6

Prescription Diet m/d, is also clinically proven in cats to reduce body fat while maintaining lean muscle mass.7  And we’ve already touched on the importance of promoting appropriate weight loss in our diabetic patients to help minimise insulin resistance. Feeding the low carbohydrate food should continue even if remission occurs to reduce the risk of requiring insulin therapy again and to maintain an appropriate body weight.

prescription diet m/d
canned prescription diet m/d

Often it is stated that canned cat foods are better than dry kibble for diabetic cats. This is because many readily available over-the-counter canned cat foods have lower carbohydrate levels than dry foods. However, Hill’s m/d GlucoSupport has consistent carbohydrate levels in both the wet and dry forms, aiding compliance for pet parents who wish to offer both forms to their cats.


While meal-feeding twice a day can have some advantages, such as making it easier to monitor intake and appetite. Feeding multiple small meals a day is fine for cats.

Role of the pet owner

Don’t forget the most important factor in managing diabetics – the pet owner! Committed owners make a huge difference. It’s also important to remember that, ultimately, our job is to find the best management regime possible for patient and owner – diabetic remission improves the quality of life for them both. The good news is that Hill’s Prescription Diet m/d GlucoSupport provides twice the fight to help cats reach remission by providing both glucose and weight management. So let’s ensure we’re working together to achieve the best possible quality of life for everyone.


To learn more about diabetes visit Hill’s Learning Centre here to complete two 15 minute interactive modules including disease information and a case study.

human holding her cat in vet

By Dr Delisa Appleton BVSc (Hons) PhD, Professional Consulting Veterinarian, Hill’s Pet Nutrition Australia.

Delisa graduated in Veterinary Science from the University of Queensland with honours in 1987 after which she worked in mixed and small animal veterinary practice for 7 years before commencing work in the nutrition industry.  She then returned to the University of Queensland in 1999 to undertake research into nutritional aspects of obesity and diabetes in cats and was awarded a PhD in nutrition in 2004. 

Delisa is currently employed in the Veterinary Affairs Department of Hill’s Pet Nutrition as a Professional Consulting Veterinarian with more than 27 years’ experience in the field of small animal nutrition.

dr delisa appleton


  1. Appleton DJ, Rand JS, Sunvold GD et al. Insulin sensitivity decreases with obesity, and lean cats with low insulin sensitivity are at greatest risk of glucose intolerance with weight gain. J Feline Med Surg 2001; 3: 211–228.
  2. Scarlett JM, Donoghue S. Associations between body condition and disease in cats. J Am Vet Med Assoc 1998; 212: 1725–1731.
  3. Bloom CA, Rand J. Feline diabetes mellitus: clinical use of long-acting glargine and detemir. J Feline Med Surg 2014;16:205–15.
  4. Roomp K, Rand JS. Management of diabetic cats with long-acting insulin. Vet Clin North Am Small Anim Pract 2013;43:251–66.
  5. Biourge V, Nelson RW, Feldman EC et al. Effect of weight gain and subsequent weight loss on glucose tolerance and insulin response in healthy cats. J Vet Intern Med 1997; 11: 86–91.
  6. Data on file, 2003, Hill’s Pet Nutrition, Inc
  7. Schoenherr WH. Effects of a low-calorie, high-fiber food versus a low carbohydrate, high-protein food on weight loss in obese cats. Unpublished data. Hill’s Science & Technology Center, Topeka, Kansas, 2003.