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

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Incretins

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Biguanides

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Thiazolidinediones

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Transition metals

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Alpha-glucosidase inhibitors

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Sparkes A H, Cannon M, Church D et al (2015) ISFM consensus on the practical management of diabetes mellitus in cats. J Feline Med Surg 17 (3), 235-250 PubMed.
  • Singh R, Rand J S, Coradini M et al (2015) Effects of acarbose on postprandial blood glucose concentrations in healthy cats fed low and high carbohydrate diets. J Feline Med Surg 17 (10), 848-857 PubMed.
  • Clark M, Thomaseth K, Dirikolu L et al (2014) Effects of pioglitazone on insulin sensitivity and serum lipids in obese cats. JVIM 28, 166-174 PubMed.
  • Reusch C E, Padrutt I (2013) New incretin hormonal therapies in humans relevant to diabetic cats. Vet Clin North Am Small Anim Pract 43 (2), 417-433 PubMed.
  • 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. JVIM 26, 1520-152.
  • Gilor C, Graves T K, Gilor S et al (2011) The GLP-1 mimetic exenatide potentiates insulin secretion in healthy cats. Domest Anim Endocrinol 41 (1), 42-49 PubMed.
  • 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 Commun 33 (8), 957-970 PubMed.
  • Bennett N, Papich M G, Hoenig M et al (2005) Evaluation of transdermal application of glipizide in a pluronic lecithin gel to healthy cats. Am J Vet Res 66 (4), 581-588 PubMed.
  • Nelson R, Spann D, Elliott D et al (2004) Evaluation of the oral antihyperglycemic drug metformin in normal and diabetic cats. J Vet Intern Med 18 (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 Res 64 (11), 1409-1413 PubMed.
  • Mazzaferro E M, Greco D S, Turner A S et al (2003) Treatment of feline diabetes mellitus using an alpha-glucosidase inhibitor and a low-carbohydrate diet. J Feline Med Surg (3), 183-189 PubMed.
  • Appleton D J, Rand J S, Sunvold G D et al (2002) Dietary chromium tripicolinate supplementation reduces glucose concentrations and improves glucose tolerance in normal-weight cats. J Feline Med Surg (1), 13-25 PubMed.
  • Hoenig M, Hall G, Ferguson D et al (2000) A feline model of experimentally induced islet amyloidosis. Am J Pathol 157 (6), 2143-2150 PubMed.
  • Michels G M, Boudinot F D, Ferguson D C et al (2000) Pharmacokinetics of the insulin-sensitizing agent troglitazone in cats. Am J Vet Res 61 (7), 775-778 PubMed.
  • Cohn L A, Dodam J R, McCaw D L et al (1999) Effects of chromium supplementation on glucose tolerance in obese and non-obese cats. Am J Vet Res 60 (11), 1360-1363 PubMed.  
  • Michels G M, Boudinot F D, Ferguson D C et al (1999) Pharmacokinetics of the antihyperglycemic agent metformin in cats. Am J Vet Res 60 (6), 738-742 PubMed.
  • Feldman E C, Nelson R W & Feldman M S (1997) Intensive 50 week evaluation of glipizide in 50 cats with previously untreated diabetes mellitus. JAVMA 210 (6), 772-777 PubMed.
  • Ford S L (1995) NIDDM in the cat: treatment with the oral hypoglycemic medication, glipizide. Vet Clin North Am Small Anim Pract 25 (3), 599-615 PubMed.
  • Nelson R W, Feldman E C, Ford S L et al (1993) Effect of an orally administered sulfonylurea, glipizide for treatment of diabetes mellitus in cats. JAVMA 203 (6), 821-827 PubMed.


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