Feline Diabetes

Diabetes mellitus happens when your cat's body either doesn't produce enough insulin or doesn't respond to it properly. After your cat eats, the digestive system breaks food down into its components including carbohydrates, which convert into simple sugars like glucose. That glucose gets absorbed into the bloodstream and transported throughout the body. Insulin, produced by beta cells in the pancreas, is what allows glucose to move out of the blood and into cells, where it's converted into usable energy.

When there isn't enough insulin available, or the body doesn't respond to it well, glucose can't get into cells and instead builds up in the bloodstream, a condition called hyperglycemia. This is why a diabetic cat can seem constantly hungry (their cells aren't getting fuel) while also losing weight or appearing malnourished (because that fuel never reaches them).

Damage to the pancreas's beta cells can be temporary or permanent, and can be caused by a virus, infection, trauma, certain medications (like steroids), or long-term strain from excess sugar or carbohydrate intake.

• Type 1 diabetes

  Type 1 diabetes (sometimes called "juvenile" or "insulin-dependent" diabetes) results from the destruction of the pancreas's beta cells. Because this damage isn't reversible, cats with Type 1 diabetes need external insulin for life.

• Type 2 diabetes

  Type 2 diabetes (sometimes called "adult-onset" or "non-insulin-dependent" diabetes) involves insulin resistance combined with a relative insulin shortage. Most feline diabetes cases fall into this Type 2 category.

Diabetes can affect cats of any age, sex, breed, or reproductive status, though older, neutered male cats face somewhat higher risk. Burmese cats, particularly those bred in the UK, Australia, and New Zealand, do show a notably higher rate of diabetes, an effect traced to a genetic founder effect within those specific breeding lines. This risk hasn't been observed in American-bred Burmese cats, which are genetically distinct due to decades of separate breeding. Other key risk factors include:

• Genetics

  Breed and genetic background can influence diabetes risk, including the Burmese founder-effect pattern described above.

• Chronic pancreatitis

  Chronic pancreatitis is a key risk factor for feline diabetes.

• Other metabolic conditions

  Other metabolic conditions, such as hyperthyroidism, Cushing's disease, or acromegaly, can increase risk.

• Physical inactivity

  Physical inactivity contributes to diabetes risk in cats.

• Indoor lifestyle

  A predominantly indoor lifestyle is associated with higher risk.

• Obesity

  Obesity is a major risk factor for diabetes in cats.

• Incidence

  Roughly 0.2% to 1% of cats develop diabetes, and the reported prevalence has been climbing over recent decades.

Your veterinarian will typically start with a urine test to check for glucose, ketones, or signs of a urinary tract infection. If glucose is present, a blood test will confirm both glucose and fructosamine levels. A consistently elevated blood glucose level, whether from insufficient insulin production or the body resisting the insulin it does produce, confirms a diabetes diagnosis.

If your cat shows any of the signs above, it's worth a conversation with your veterinarian.

Because cats can develop either Type 1 or Type 2 diabetes, treatment options are broader than they are for dogs. The goal is always the same: keep glucose levels steady, avoiding sharp spikes and drops, while easing symptoms like excessive thirst and urination. There's currently no cure, but with the right combination of treatment, diet, and home care, diabetic cats can live many healthy years - and some even reach clinical remission.

• Insulin

  Daily insulin injections remain the most common way to manage feline diabetes, especially for cats with Type 1 or long-standing Type 2 disease. Every cat's ideal dose and schedule is different, so your veterinarian will work with you to find the right regimen - this sometimes means a short hospital stay early on to monitor your cat's response. Giving injections can feel intimidating at first, but most owners find it becomes routine surprisingly quickly.

• Oral medication

  For some newly diagnosed, otherwise healthy cats not yet on insulin, oral medication is now an option. Current veterinary guidance has moved away from glipizide, which isn't considered consistently safe or effective in cats. Instead, a newer class of medication called SGLT2 inhibitors (such as bexagliflozin) has become the preferred oral option for eligible cats, lowering blood glucose by helping the body excrete excess sugar through urine rather than requiring insulin at all. This option isn't right for every cat - it's specifically for cats who haven't previously needed insulin, and it requires careful veterinary screening and monitoring, since it does carry a risk of a serious complication called diabetic ketoacidosis in cats who aren't good candidates.

• Clinical remission

  Some cats achieve clinical remission after weeks or months of treatment and no longer need insulin. This isn't the same as being cured - diet and lifestyle management still matter, and insulin may be needed again down the line.

• Monitoring

  Tracking blood glucose is a key part of ongoing management, whether through urine glucose/ketone test strips or a blood glucose meter. Your veterinarian can help you decide what fits your cat and your routine best.

• Diet

  Once glucose levels are stabilized, consistency is key - same food, same amounts, same times each day. Many cats naturally prefer smaller, more frequent meals, and your vet likely won't try to change that. Cats need high levels of good-quality protein, and a high-protein, low-carbohydrate diet is generally considered ideal for diabetic cats. Overall, the diet should be palatable, nutritious, help maintain a healthy weight, and minimize blood glucose swings.

• Checkups

  Regular veterinary visits matter even after your cat's diabetes is stable, since the disease can shift over time, sometimes even after a long period of good control.

When blood sugar isn't well controlled, diabetic cats can develop complications. One well-recognized example is diabetic neuropathy, which may cause a cat to walk flat-footed on the hind legs. Watching for early changes in gait or mobility - and keeping glucose well managed - helps reduce the risk of longer-term problems.

There's ongoing research into new approaches to feline diabetes, and the recent approval of oral SGLT2 inhibitors marks real progress in giving cat owners options beyond daily injections.