NIDDM (Non-insulin-dependent Diabetes Mellitus?

I read a short paragraph on NIDDM in cats, and it got me wondering about my cat. IMO, he hasn't been responding very well to 1.5 units of Prozinc since starting insulin a couple weeks ago. The vet had me give him 2 units at first, but Teddy really got low numbers after just 2 shots, so I had to do 1 unit after this scare. Now he's up to 1.5, but still as much pee in the litter box as before diagnosis, his behavior has changed (cranky a lot), neuropathy all 4 legs, depressed for sure. He is overweight (17.5 lbs.) which is typical of cats that have NIDDM.

The paragraph I read said, "Approximately 25-50% of cats with diabetes mellitus have NIDDM. ....Some cats can be successfully treated with diet changes and oral hypoglycemic agents such as glipizide. Cats with this type of diabetes tend to be overweight and rarely need insulin to survive." See attached article.

Can somebody explain more about this? TIA

 

Where did you find the article? It is missing some information. There are other causes of diabetes in cats, such as benign pituitary or adrenal tumours too. One in four diabetic cats has acromegaly (as did my girl), which is caused by a benign pituitary tumour.

By the way, without home testing, you have no way of knowing how he is responding to the 1.5 units. Don’t listen to your vet, home testing is very important.

 

Can you link the original source?

The problem with oral agents such as glipizide is that they play havoc with the pancreas. Oral agents act to stimulate the pancreas since the assumption is that there are active beta cells present. This is fine in theory. In reality, by overstimulating the pancreas, you can "burn out" the beta cells and. your kitty is now an insulin dependent diabetic who has no chance for remission.

And Wendy is correct, there are other causes of diabetes. She left out steroid-induced diabetes.

And I agree -- home testing is crucial. You need to be getting tests during both the AM and PM cycles in order to insure that Teddy is safe. It's very likely that Teddy's starting dose was too high.

 

Here is the source: https://www.petcoach.co/article/the-signs-diagnosis-types-of-diabetes-mellitus-in-cats/

 

I freely admit - I'm a research snob. I have no clue what the credentials are of the person who wrote that blog post. The prevalence numbers s/he cited are not consistent with materials from vet journals. If there's a journal article you want, please let me know. I have access to both a medical and veterinary library system and I'm happy to see if I can track an article down.

 

What is true is that a lot of diabetic cats can be diet-controlled on low-carb wet food. When that occurs, you can see it in the numbers. Their glucose numbers drop, and they are able to stay in normal range without any insulin (and giving them insulin pushes them too low). I see in your notes that your vet wants you to stop testing and come in every 4 weeks for them to test. I find that ridiculous, not to mention dangerous. Would the vet recommend that if it was a child? Without testing before every insulin shot, you risk giving insulin when he is lower than expected and causing a hypoglycemic episode which can be deadly, and without any mid-cycle testing, you have no idea what impact the insulin is having.

Just a few excerpts from the AAHA guidelines:
https://www.aaha.org/aaha-guidelines/diabetes-management/treatment/cats/
"Predictors of diabetic remission in cats include achieving excellent glycemic control within 6 mo of diagnosis, using intensive home monitoring, discontinuation of insulin-antagonizing medications, and use of insulin glargine (Lantus) or detemir (Levemir) along with a low-carbohydrate diet."

"Oral hypoglycemic drugs are neither recommended nor considered appropriate for long-term use. Their use is considered temporary and only if combined with dietary modification if the owner refuses insulin therapy or is considering euthanasia for the pet."

https://www.aaha.org/aaha-guidelines/diabetes-management/monitoring/
"Senior cats and dogs of advanced age need to be closely monitored."
"Obtaining BGCs at home is preferred to doing so in the clinic." (BGC = blood glucose curves)

 

Thanks for that link Kel. I will admit I am more familiar with the European names for classifying feline diabetes. Regardless of what caused the diabetes, if a cat has high blood sugar, insulin is the better choice, along with home testing.

Some of the other conditions mentioned in the article, such as hyperthyroidism, acromegaly or pancreatitis can make it harder to regulate the cat. Speaking just to acromegaly, they often have a working pancreas. But there have been very few examples recorded worldwide of diagnosed acros not needing insulin, unless they have had treatment on the pituitary tumour. Home testing is even more key with acros, as the pulsing nature of the pituitary tumour means insulin needs can vary up or down over time.

 

Thanks all for the valuable info. Was just wondering about this for a while. Yes, I'm still testing Teddy at home and won't give in to all the vet's requirements. Just got a good mid day reading for Teddy at 114, and his spirits are up today when yesterday he was such a different cat.