Exenatide Extended-Release for Maintenance of Diabetic Remission in Cats

Abstract: Background – Insulin-treated diabetic cats frequently undergo remission, but this is often temporary. The glucagon-like peptide-1 receptor agonist, exenatide extended-release (exenatide-ER) preserves and improves β-cell function in people with type-2 diabetes mellitus (DM). Objectives – To investigate the effect of exenatide-ER on diabetic remission in cats.Animals – Twenty client-owned cats with recent (4-12 weeks) remission of diabetes (per ALIVE criteria)Methods – In this placebo-controlled, single-blinded study, cats were assigned randomly to receive exenatide-ER (0.13 mg/kg) or saline injection SC, once-monthly for 2 years or until DM relapsed. Cats were fed low-carbohydrate diets (Results – Treatment groups were similar in age, sex, and body weight upon inclusion. Fifteen cats completed the 2-year study, and 5 cats exited it prematurely (placebo: Nf4, exenatide-ER: Nf1). The exenatide-ER group saw a decrease in body weight (-0.360.5 Kg, p=0.04) at study exit. In three cats, DM relapsed (placebo: Nf1, day 212; exenatide-ER: Nf2, days 553 and 558). Excluding cats removed prematurely, the median (range) of total remission time was 745 d (742-805) in the placebo group and 710 d (595-763) in the exenatide-ER group (p=0.08). Hemoglobin A1c did not differ between groups (exenatide-ER 2.5% [1.9-5.1]; placebo 3.4% [1.8-8.1]; p=0.2) at study exit.Conclusions and clinical importance – Exenatide-ER contributed to weight loss but not duration of remission.