A two-center, randomized controlled trial to determine the effect of 12 weeks of caloric restriction with a novel diet in overweight cats with diabetes mellitus

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Abstract
Background: Obesity is associated with insulin resistance and affects glycemic control in diabetic patients. Hypothesis/Objectives: Assess the impact of 12-week caloric restriction on remission and glycemic control in overweight diabetic cats using a prospective, randomized controlled trial. Animals: Seventy-two overweight (body condition score ≥ 6/9) client-owned insulin-treated diabetic cats, randomized either to caloric restriction (intervention, 32; target approximately 2% weekly weight loss) or body weight maintenance (control, 40). Methods: All cats received a novel therapeutic diabetic diet, suitable for weight reduction, for 12 weeks (%metabolizable energy [protein/fat/nitrogen-free extract]: dry [49.4/24/26.6]; wet [63.2/25.3/11.5]). Physical examination, serum biochemistry, home blood glucose curves (BGC), diabetic clinical score, and quality of life questionnaires were performed on weeks: −1, 4, 8, and 12. Insulin dose was recorded and glycemic variability (SD of BGC) was calculated. Induction of diabetic remission was the primary outcome measure. Data were analyzed using regression and linear mixed models. Results: By week 12, intervention had 2.1 times higher probability of remission (16/32) compared with controls (12/40, P = .04). Weight loss was 7.2% (95% confidence interval [CI], 5.7-8.7) for the intervention versus 2.7% (95% CI, 1.3-4.1, P < .001) for controls. For cats not achieving remission, glycemic variability decreased 45% (95% CI, 26-65) and 7% (95% CI, 16-21) for intervention and control cats, respectively (P = .01), insulin-dose decreased by 36% (95% CI, 2-70) for intervention and increased 28% (95% CI, 3-53, P = .004) for controls. Conclusions and clinical importance: Caloric restriction, using a therapeutic diabetic diet suitable for weight reduction increased the probability of remission and improved glycemic control in overweight diabetic cats.
Funding Information
  • MRC Clinician Scientist Fellowship (MR/R007977/1)
  • MRC Transition Support Award (MR/X023559/1)
  • Beryl Evetts and Robert Luff Animal Welfare Trust

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