Goodbye, Needles

In our last piece, you learned how elevated blood sugar is somewhat like a mob of workers milling around in the street, locked out of their jobs and making trouble while they are not gainfully employed. That’s really damaging to the body of a diabetic patient. Humans have access to several different medicines and devices that can help them maintain normal blood sugar levels, but animal diabetics have largely had to rely on a single approach: insulin injections.

For dogs, type I diabetics, there is no alternative to insulin. If we can supply an adequate number of keys, the idle workers will go back to normal function. The object, then, is to match our patient’s food intake (and type) with the insulin dosage and keep that balance intact as long as possible. That sounds pretty simple in theory, but the real world is often much more complicated. A few different insulin preparations are available for dogs. Settling on the correct type and dosage is always a matter of trial and error, so there are many (carefully timed!) vet visits expected for a diabetic dog.

Cats, on the other hand, often have type II diabetes. In this scenario, some fraction of the workers have functional keys to their place of employment. Business could continue on Main Street as long as the crowd outside can be kept under control. Low-carb diets are one way to quiet the mob. This approach helps the incoming nutrients to behave in a more docile fashion, waiting patiently for their turn to enter cells rather than stirring up trouble in the street. Most cats are also prescribed insulin injections, as described above.

A new type of medicine, the SGLT2 inhibitor (names ending in -gliflozin), is now available for feline diabetics, and it looks really promising. In our street scenario, this medication doesn’t function like a key (that’s insulin) and doesn’t repair the broken locks on the body’s cells (human type II diabetics have that, but we can’t do it for cats yet). A gliflozin acts more like patrol officers, calmly escorting excess blood sugar out through the urinary tract before it can cause a lot of damage by loitering in the blood stream. If the patient is using a gliflozin drug, they don’t need any injections, and they only need to take their medicine once a day. The medicine goes in their food, so you don’t need to chase them around the house. They don’t need dosage adjustments and rarely need to visit the clinic. They don’t need to worry about matching an insulin dose precisely with their dietary intake, and they never need to fret about blood sugar dipping too low.

If you’re excited by this idea, it’s probably because you have a diabetic cat, and you’re craving that easy life for yourself and your pet. Unfortunately, it is not safe for insulin users to switch over and start using a gliflozin. This superior new treatment is only accessible to new patients. While that may be disappointing for you and your pet, it promises a much better quality of life for the next generation of feline diabetics and their owners.

Dr. M.S. Regan