Evolving Paradigms in the Clinical Management of Small Animal Diabetes Toward a Proactive, Technology-Driven Model: A Systematic Review

Background: Diabetes mellitus (DM) is a prevalent and clinically significant endocrinopathy in canine and feline medicine, yet its management is complicated by profound species-specific pathophysiological differences. This review aims to systematically synthesize the current, evidence-based literature on the diagnosis, management, and control of DM in dogs and cats, with a focus on recent therapeutic and technological advancements that are shaping a new, more personalized standard of care. Methods: A comprehensive literature search was conducted across PubMed, Scopus, and Google Scholar for peer-reviewed articles, consensus guidelines, and clinical trial data published between January ۲۰۲۲ and the present. Search terms included "diabetes mellitus," "canine," "feline," "insulin therapy," "SGLT۲ inhibitors," "continuous glucose monitoring," and "diabetic remission." Studies were selected for their relevance to the pathophysiology, diagnosis, and clinical management of spontaneous DM in dogs and cats. Results: The evidence confirms a foundational dichotomy: canine DM is predominantly an irreversible, insulin-deficient state analogous to human Type ۱ DM, whereas feline DM is an insulin-resistant syndrome analogous to human Type ۲ DM, with the potential for diabetic remission. This distinction dictates all aspects of management. Therapeutic cornerstones include species-appropriate insulin therapy and nutritional strategies. The therapeutic landscape for feline DM has been transformed by the approval of oral sodium-glucose cotransporter ۲ (SGLT۲) inhibitors, which offer an effective alternative to insulin for select cases but introduce the novel risk of euglycemic diabetic ketoacidosis (eDKA). Concurrently, the widespread adoption of continuous glucose monitoring (CGM) systems for both species has enabled a shift from reactive, intermittent monitoring to a proactive, dynamic assessment of glycemic control, facilitating safer and more precise therapeutic adjustments. Conclusion: The management of small animal DM is rapidly evolving towards a model of personalized medicine. Success hinges on an integrated approach that combines species-specific medical and nutritional therapy with advanced monitoring technologies. The overarching goal is to optimize glycemic control, prevent complications, and maximize the quality of life for both the patient and the owner, reflecting a holistic and individualized standard of care.

کلیدواژه ها:

Diabetes Mellitus ، Canine ، Feline ، Insulin Therapy ، SGLT۲ Inhibitors