Felis ISSN 2398-2950

Oral hypoglycemic agents

Contributor(s): Dr Linda Fleeman, Sarah Pierard

Introduction

  • Although diabetes can sometimes be controlled by the use of oral hypoglycemic agents, they are not recommended as the first choice of treatment for a diabetic patient, and are never preferred over insulin therapy as the treatment of choice for diabetes.
  • Most agents have not been tested in diabetic cats.
  • The main indication for use is when owners initially refuse insulin treatment. Owners frequently change to insulin treatment when they become more confident about treating their cat's diabetes, or when the oral agent is found ineffective or difficult to administer.
  • There is a risk that by initially using oral hypoglycemic agents, the 'window of opportunity' for diabetic remission may be missed. However, many owners will be open to transition to insulin treatment within a few weeks.
  • Efficacy of agents that stimulate insulin production or increase response to insulin rely on residual insulin production capacity.
  • There is limited information on the use of oral hypoglycemic agents in conjunction with insulin injections in cats.
  • Oral medication is often more difficult to administer regularly than injections to cats.

Sulfonylureas

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Incretins

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Biguanides

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Thiazolidinediones

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Transition metals

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Alpha-glucosidase inhibitors

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed papers
  • Recent references fromPubMed.
  • Singh R, Rand J S, Coradini M, Morton J M (2015)Effects of acarbose on postprandial blood glucose concentrations in healthy cats fed low and high carbohydrate diets. J Feline Med Surg17, 848-857 PubMed.
  • Sparkes A, Cannon M, Church D, Fleeman L et al(2015)ISFM consensus on the practical management of diabetes mellitus in cats. J Feline Med Surg17, 235-250PubMed.
  • Clark M, Thomaseth K, Dirikolu L, Ferguson D C, Hoenig M (2014)Effects of pioglitazone on insulin sensitivity and serum lipids in obese cats. JVIM28, 166-174PubMed.
  • Reusch C E, Padrutt I (2013)New incretin hormonal therapies in humans relevant to diabetic cats. Vet Clin Norht Am Small Anim Pract43, 417-433PubMed.
  • Padrutt I, Zini E, Kaufmann K, Menard J, Lutz T A, Reusch C E (2012)Comparison of the GLP-1 analogues exenatide short-acting, exenatide long-acting and the DPP-4 inhibitor sitagliptin to increase insulin secretion in healthy cats (Abstract). JVIM26, 1520-1521.
  • Gilor C, Graves T K, Gilor S, Ridge T K, Rick M (2011)The GLP-1 mimetic exenatide potentiates insulin secretion in healthy cats. Domest Anim Endocrinol41, 42-49.
  • Mori A, Lee P, Yamashita T et al(2009)Effect of glimepiride and nateglinide on serum insulin and glucose concentration in healthy cats. Vet Res Commun33, 957-970PubMed.
  • Bennett N, Papich M G, Hoenig M, Fettman M J, Lappin M R (2005)Evaluation of transdermal application of glipizide in a pluronic lecithin gel to healthy cats. Am J Vet Res66, 581-588.
  • Nelson R, Spann D, Elliott D, Brondos A & Vulliet R (2004)Evaluation of the oral antihyperglycemic drug metformin in normal and diabetic cats. J Vet Intern Med18(1), 18-24 PubMed.
  • Hoenig M, Ferguson D C (2003)Effect of darglitazone on glucose clearance and lipid metabolism in obese cats. Am J Vet Res64, 1409-1413PubMed.
  • Mazzaferro E M, Greco D S, Turner A S & Fettman M J (2003)Treatment of feline diabetes mellitus using an alpha-glucosidase inhibitor and a low-carbohydrate diet. J Feline Med Surg5(3), 183-189 PubMed.
  • Appleton D J, Rand J S, Sunvold G D, Priest J (2002)Dietary chromium tripicolinate supplementation reduces glucose concentrations and improves glucose tolerance in normall-weight cats. J Feline Med Surg4, 13-25PubMed.
  • Hoenig M, Hall G, Ferguson D et al(2000)A feline model of experimentally induced islet amyloidosis. Am J Pathol157, 2143-2150PubMed.
  • Michels G M, Boudinot F D, Ferguson D C, Hoenig M (2000)Pharmacokinetics of the insulin-sensitizing agent troglitazone in cats. Am J Vet Res61, 775-778.
  • Michels G M, Boudinot F D, Ferguson D C, Hoenig M (1999)Pharmacokinetics of the antihyperglycemic agent metformin in cats. Am J Vet Res60, 738-742PubMed.
  • Cohn L A, Dodam J R, McCaw D l & Tate D J (1999)Effects of chromium supplementation on glucose tolerance in obese and non-obese cats. Am J Vet Res60, 1360-1363.  
  • Feldman E C, Nelson R W & Feldman M S (1997)Intensive 50 week evaluation of glipizide in 50 cats with previously untreated diabetes mellitus. JAVMA210, 772-777.
  • Ford S L (1995)NIDDM in the cat: treatment with the oral hypoglycemic medication, glipizide. Vet Clin North Am Small Anim Pract25, 599-615PubMed.
  • Nelson R W, Feldman E C, Ford S L & Roemer O P (1993)Effect of an orally administered sulfonylurea, glipizide for treatment of diabetes mellitus in cats. JAVMA203, 821-827.


ADDED