Diabetes in Cats - Remission

Remission

In most cases, it is possible to induce remission (a temporary or permanent freedom from insulin-dependence) in type-2 diabetic cats. This appears to be unique to cats. There is growing agreement among experts that a combination of a low-carbohydrate healthy diet, long-lasting insulin, and well-chosen dosage plans can in many cases partially heal a damaged pancreas and allow the cat's blood sugar to be controlled entirely by diet thereafter. (A low carbohydrate diet is usually required for the remainder of the cat's life.)

Remission is a realistic goal for treatment of type-2 diabetic cats (that is, 80–95% of all diabetic cats) who are properly regulated quickly. Chances of success are highest in the first few months after initial diagnosis, due to ongoing damage from glucose toxicity caused by hyperglycemia. This limited time window is a good reason to start with low carbohydrate diet and very slow-acting insulins, the most successful known combination, right away.

An explanation can be pieced together from recent studies in which diabetes in cats is perpetuated, if not always caused, by a combination of glucose toxicity and amyloidosis, such that the insulin-producing islets of the pancreas become clogged with amyloid deposits. Cats may present with type-2 (insulin-resistant) diabetes, at least at first, but hyperglycemia and amyloidosis, left untreated, will damage the pancreas over time and progress to insulin-dependent diabetes.

If blood sugar is well controlled over a period of 2–3 months, glucose toxicity and amyloidosis cease to attack newly generated tissue, and many cats are able to regenerate some of the damaged pancreatic beta cells and slowly resume insulin production.

Note that Glipizide and similar oral diabetic medicines designed for type-2 diabetic humans have been shown to increase amyloid production and amyloidosis, and therefore likely reduce likelihood of remission.