Monthly exenatide injections helped diabetic cats in remission maintain stable HbA1c levels over two years, but did not extend the duration of remission compared to placebo.
HbA1c stable vs +2.3%Exenatide-treated cats maintained stable HbA1c while placebo cats showed a significant increase, despite similar remission durations
What the researchers found
Exenatide extended-release did not significantly affect diabetic remission duration compared to placebo (exenatide: 662 days [28-735] vs placebo: 669 days [121-721], p=0.9). Only 3 of 22 cats relapsed during the 2-year study — 1 on placebo (day 212) and 2 on exenatide (days 553 and 558).
However, exenatide did maintain glycemic control: HbA1c remained stable in the exenatide group (-0.05%) but increased significantly in the placebo group (+2.3%, p=0.03). Both groups lost weight during the study. The low relapse rate overall suggests that active management with low-carbohydrate diets and weight control may itself be important for maintaining remission.
Why it matters
Diabetic remission in cats is common but often temporary, and maintaining remission is a major goal in feline diabetes management. While exenatide didn't extend remission duration in this study, its ability to stabilize HbA1c suggests it may help preserve beta cell function. The overall low relapse rate (only 3 of 22 cats) also highlights the importance of dietary management and weight control, which could inform treatment strategies for both veterinary and human diabetes care.
How the study worked
This was a placebo-controlled, single-blinded, randomized study of 22 client-owned cats with recent diabetic remission. Cats received either exenatide extended-release (0.13 mg/kg) or saline injections subcutaneously once monthly for up to 2 years. All cats were fed low-carbohydrate diets with supervised weight control. Primary outcomes included remission duration, body weight changes, and HbA1c levels, analyzed with paired t-tests and Mann-Whitney tests.
What this study cannot tell us
The small sample size (22 cats) limited statistical power, and 9 cats exited prematurely for various reasons, further reducing the analyzable cohort. The study was single-blinded (not double-blinded). The very low relapse rate in both groups suggests that the dietary and weight management protocol may have been the dominant factor, making it difficult to detect an additional drug effect. Results may not generalize to all diabetic cats.
How to read the evidence
This is a placebo-controlled, randomized, single-blinded veterinary trial — a relatively strong study design. However, the small sample size (22 cats) and high dropout rate limit the statistical power and generalizability of the findings.
When this study was published
Published in 2025, this is very recent research contributing to the growing understanding of GLP-1 receptor agonists in veterinary medicine.
The bigger picture
Feline diabetes closely resembles human type 2 diabetes, making cats a valuable natural disease model. GLP-1 receptor agonists preserve beta cell function in humans, and this study explored whether those benefits translate to cats. While the remission result was negative, the HbA1c finding supports the drug's metabolic effects across species and adds to the growing cross-species research on GLP-1 peptide therapeutics.
Questions still open
- Would a larger study with more cats and a longer follow-up period reveal a remission-extending effect of exenatide?
- Is the HbA1c stabilization from exenatide clinically meaningful for preventing eventual relapse beyond the 2-year window?
- How much of the extended remission in both groups was attributable to the low-carbohydrate diet and weight management protocol?
Common questions
Can cats go into diabetic remission?
Is exenatide approved for use in cats?
Read the original research
Assessment of Exenatide Extended-Release for Maintenance of Diabetic Remission in Cats.
Journal of veterinary internal medicine, 39(2), e70069
Citation
Gilor, Chen; Fleeman, Linda M; Hulsebosch, Sean E; Niessen, Stijn J M; Bjørnvad, Charlotte R; Pires, Jully; Hazuchova, Katarina; Mott, Jocelyn; O'Kell, Allison L; Gostelow, Ruth; Rudinsky, Adam J; Cook, Audrey K. (2025). Assessment of Exenatide Extended-Release for Maintenance of Diabetic Remission in Cats.. Journal of veterinary internal medicine, 39(2), e70069. https://doi.org/10.1111/jvim.70069