title: ISFM consensus guidelines on the practical management of diabetes mellitus in cats.
abstract: BACKGROUND
  Diabetes mellitus (DM) is a common endocrinopathy in cats that appears to be increasing in prevalence. The prognosis for affected cats can be good when the disease is well managed, but clinical management presents challenges, both for the veterinary team and for the owner. These ISFM Guidelines have been developed by an independent, international expert panel of clinicians and academics to provide practical advice on the management of routine (uncomplicated) diabetic cats.
  
  
  OBJECTIVE
  Although the diagnosis of diabetes is usually straightforward, optimal management can be challenging. Clinical goals should be to limit or eliminate clinical signs of the disease using a treatment regimen suitable for the owner, and to avoid insulin-induced hypoglycaemia or other complications. Optimising bodyweight, feeding an appropriate diet and using a longer acting insulin preparation (eg, protamine zinc insulin, insulin glargine or insulin detemir) are all factors that are likely to result in improved glycaemic control in the majority of cats. There is also some evidence that improved glycaemic control and reversal of glucose toxicity may promote the chances of diabetic remission. Owner considerations and owner involvement are an important aspect of management. Provided adequate support is given, and owners are able to take an active role in monitoring blood glucose concentrations in the home environment, glycaemic control may be improved. Monitoring of other parameters is also vitally important in assessing the response to insulin. Insulin adjustments should always be made cautiously and not too frequently--unless hypoglycaemia is encountered.
  
  
  METHODS
  The Panel has produced these Guidelines after careful review of the existing literature and of the quality of the published studies. They represent a consensus view on practical management of cats with DM based on available clinical data and experience. However, in many areas, substantial data are lacking and there is a need for better studies in the future to help inform and refine recommendations for the clinical management of this common disease.
authors.affiliation: International Cat Care/ISFM, Tisbury, Wiltshire SP3 6LD, UK andy@icatcare.org.
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Sparkes
authors.affiliation: Oxford Cat Clinic, Oxford OX2 9JU, UK.
authors.forename: Martha
authors.initials: M
authors.lastname: Cannon
authors.affiliation: Professor, Small Animal Medicine and Surgery Group, The Royal Veterinary College, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK.
authors.forename: David
authors.initials: D
authors.lastname: Church
authors.affiliation: Animal Diabetes Australia, Rowville Veterinary Clinic, Rowville, VIC 3178, Australia.
authors.forename: Linda
authors.initials: L
authors.lastname: Fleeman
authors.affiliation: Small Animal Specialist Hospital, North Ryde, NSW 2113, Australia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Harvey
authors.affiliation: Professor, Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana-Champaign, Illinois, USA.
authors.forename: Margarethe
authors.initials: M
authors.lastname: Hoenig
authors.affiliation: Animal Endocrine Clinic, 21 West 100th Street, New York, NY 10025, USA.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Peterson
authors.affiliation: Professor & Director, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland.
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Reusch
authors.affiliation: International Cat Care/ISFM, Tisbury, Wiltshire SP3 6LD, UK.
authors.forename: Samantha
authors.initials: S
authors.lastname: Taylor
authors.affiliation: Micen Vet Centre, 58 Rue Auguste Perret, Parc Technologique, Europarc, 9400 Créteil, France.
authors.forename: Dan
authors.initials: D
authors.lastname: Rosenberg
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000188:drug therapy* / Q000517:prevention & control; D002415:Cats; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000662:veterinary*; D004334:Drug Administration Schedule / Q000662:veterinary; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000069057:Insulin Detemir; D049528:Insulin, Long-Acting / Q000627:therapeutic use; D007390:International Agencies; D012955:Societies, Medical
chemical_list: D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; D000069057:Insulin Detemir