What your pet eats—and when—is critical to keeping diabetes in check
Diet plays a critical role in the management of your pet's diabetes. That's because there's an important connection between diabetes mellitus and food.
When your pet eats, there's a sudden increase in available energy, which gets converted into sugar and becomes the primary fuel for the body's cells. Eventually, the amount of sugar in the blood decreases over time until the next meal. It's normal for an animal's blood sugar to rise and fall throughout the day, but the diabetic pet cannot effectively use the sugars entering the blood stream, causing elevated blood glucose levels.
Large fluctuations in blood glucose levels are damaging to your pet's health, longevity, and quality of life—not to mention, they are stressful for you. Drastic drops in blood glucose can be life-threatening. Drastic increases in blood sugar can lead to the return of clinical signs and possibly permanent nerve damage, blindness, and organ failure.
Because feeding plays such an important role in this process, with diabetes it's important to stick to a strict feeding routine and maintain pets on a diet that has a low glycemic index, meaning it promotes a slow, gradual increase in blood sugar instead of sudden, large spikes in blood glucose.
WHY DOES FOOD MATTER?
The normal fasting blood glucose concentration in dogs and cats ranges from 75 to 120 mg/dl. Higher values are seen just following a meal, but, as insulin is released, the values decrease as sugar exits the blood stream and enters the cells of the body. Normally, the release of insulin is responsive to the blood glucose concentration, keeping these values within a safe range.
Your pet needs insulin to utilize sugar, fat, and protein from the diet as energy. In a diabetic pet, either its body isn't producing insulin or isn't able to use it appropriately. Without insulin, the food that was broken down and converted into sugars doesn't get transported into the cells and instead remains in the blood stream. The result is consistently high blood sugar concentrations leading to the development of diabetes.
Because of the inadequate amounts of glucose entering the cells, pets with diabetes may lose weight despite an increased appetite. As glucose concentrations rise, the kidneys can no longer prevent the glucose from spilling into the urine and water travels out with it. This explains the fact that diabetic pets have to urinate often and drink a lot of water to prevent dehydration. If pets don't receive treatment, and blood glucose levels are left abnormally high, serious, life-threatening problems can occur.
The goal of therapy is to limit blood glucose fluctuations and maintain near normal blood glucose levels, as well as to eliminate clinical signs. This is best accomplished with a combination of insulin therapy, diet, and exercise. Insulin injections are given along with, or following, a meal in order to minimize the rise in blood glucose and allow the pet to utilize the energy from food. Most insulin products are given twice daily at regular intervals, which must correspond with mealtime.
Providing foods that release their energy slower also helps to prevent large spikes in blood glucose. Therefore, it's important to not only feed the same amount at the same time every day, but also to provide a consistent diet that will result in an expected increase in blood glucose.
Feeding diets that promote the slow, consistent release of energy and maintaining an ideal body weight are also important. Obesity negatively affects insulin function and your veterinarian will want to initiate a healthy weight loss program if your pet is obese.
Synchronizing meals and insulin injections is critical to eliminating clinical signs and preventing excessive blood glucose fluctuations. People with diabetes often adjust their own insulin doses based on blood glucose testing prior to a meal. However, this is not recommended on pets as they are unable to communicate subtle signs of high or low blood glucose and dangerous situations could occur. In pets, insulin doses should not be adjusted based on a single blood glucose test, and you should consult with your veterinarian before making any changes in the amount of insulin administered. Maintaining a strict diet and feeding schedule is the safest and most reliable method for controlling your pet's diabetes.
WHAT'S AN IDEAL DIET?
Your veterinarian will work with you to determine the best food for your diabetic pet. There's no one diet that's best for all diabetic patients. Here are some guidelines to keep in mind.
First, the diet should be nutritionally complete and balanced, and not contain simple carbohydrates, which are sugars that are rapidly digested and absorbed into the blood stream.
The diet must also be palatable, as missing meals makes insulin therapy and achieving good glycemic control more difficult.
The caloric needs of your pet are the next consideration. The recommendations will be based on the pet's body weight and condition. Any other concurrent disease conditions must also be considered when selecting a pet food.
In general, diets designed for diabetic dogs are higher in soluble fiber in order to slow absorption of sugars, are low in fat, and contain complex carbohydrates, which are slowly digested and absorbed. With carbohydrate and fat restriction, these foods also tend to have higher protein levels. However, there is no evidence to suggest that the protein needs of diabetic dogs are different from those of non-diabetic dogs.
Cats are not as well-adapted to eating carbohydrates and have a higher protein need. They are generally better maintained on high-protein, low-carbohydrate diets. Always consult with your veterinarian before changing the diet of your diabetic pet. He or she can help you avoid any negative consequences.
DON'T FORGET ABOUT THE TREATS
Treats are an important part of you and your pet's relationship, and they often also represent a significant part of their dietary intake. Treats that are high in fat and carbohydrates can cause drastic fluctuations in your pet's blood glucose. So making sure you choose the types of treats carefully—and when you give them—is important. This can make the difference between maintaining and controlling your pet's diabetes long-term or struggling to get a handle on your pet's condition.
Look for treats that are low in fat and do not contain simple carbohydrates. Your veterinarian can give suggestions on what types and when treats are safest to give. Offering table scraps should always be avoided.
Of course, treats should also be given in moderation. Try breaking up larger treats into multiple smaller pieces to make them last longer. And remember, love and attention are the best treats you can give your diabetic pet.
Catherine Reid, DVM, is a practicing veterinarian at the East Side Animal Hospital in New York.