what nutritional strategies help with glycemic control in diabetic cats?

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A high-protein, low-carbohydrate diet is the cornerstone of nutritional management for diabetic cats, with protein defined as ≥40% metabolizable energy (ME) and carbohydrates restricted to approximately 12% ME per the 2018 AAHA guidelines, or alternatively >45% protein on a dry-weight basis with <15% carbohydrate per the 2023 AAHA Senior Care Guidelines.15 Remission rates of 15–100% are reported when a high-protein/low-carbohydrate diet is combined with insulin, with the highest remission rates occurring when insulin glargine or insulin detemir is used in cats newly diagnosed or within 6 months of diagnosis.1 Cats achieving diabetic remission display significantly lower glycemic variability than those without remission, suggesting that tight glycemic control through diet and insulin together predicts remission.2 Canned food is preferred over dry food because it provides lower carbohydrate content, easier portion control, lower caloric density, and additional water intake.1 Portioned meals are recommended over free-choice feeding to facilitate monitoring of intake and appetite, though free-choice feeding with a divided daily ration using timed feeders is acceptable when eating habits cannot be changed.1 High-fiber diets are not typically recommended for diabetic cats, in contrast to dogs, for whom diets with increased soluble and insoluble fiber are beneficial for glycemic management.1 For cats, the dietary priority is protein and carbohydrate composition rather than fiber content.111 Weight management is an explicit dietary goal. Target weight loss in obese diabetic cats is 0.5–2% body weight reduction per week, monitored using the same scale at least once or twice monthly with body condition scoring.1 Treating obesity and inactivity is recognized as directly beneficial to managing feline diabetes mellitus.5 Dietary recommendations must be adjusted when concurrent disease is present. Conditions such as chronic kidney disease, pancreatitis, and intestinal disease req