There’s no question: Managing diabetes in pets requires a high level of commitment. For starters, they’ll need daily injections of insulin at regular times of the day to help regulate glucose (blood sugar) levels in their body. But it’s better than the alternative: When diabetes is left untreated, poisonous compounds called ketones can make a diabetic pet very sick and may even cause death.

While controlling diabetes is a challenge, it’s not an insurmountable one. By working closely with your veterinary team, you can help your pet thrive. To help make this collaboration as successful as possible, AAHA created the Diabetes Management Guidelines for Dogs and Cats.

Top 8 things you need to know about these guidelines

1. Control is the goal. Diabetes affects pets in a similar way that it affects humans: The body cannot convert glucose into energy due to issues producing or regulating the hormone insulin. Your veterinary team will develop a management plan to keep your pet’s glucose levels in a safe range without getting too low (hypoglycemic).
2. Your team will tailor a care plan based on the severity of the disease. When detected at the earliest stage, lifestyle changes such as diet can help stabilize your pet’s diabetes. Risk factors for diabetes include obesity, diseases (like the hormonal disorder acromegaly in cats and Cushing’s disease in dogs), and medications like steroids. Advanced cases might require treatment for complications, such as cataracts in dogs and weakened hind legs due to nerve damage in cats.
3. Homework is required! Caring for your pet at home is an important part of diabetes management. You will be administering insulin once or twice a day, monitoring blood glucose levels on a regular basis, and handling urine. You’ll also be taking your pet to the veterinary hospital frequently for testing. Your team will provide extensive education about home care, such as storing insulin in the refrigerator and other important tips.
4. Diet therapy is a key component. Your veterinary team will create a plan to optimize body weight with appropriate protein and carbohydrate levels, fat restriction, and calorie control. Obese cats and dogs will need to lose 1%–2% of their weight each week initially to help the insulin work more effectively.
5. In cats, diabetic remission is a reasonable goal. Excellent home care with dietary management, obesity treatment, and monitoring can lead to a cat no longer needing insulin therapy! Unfortunately, remission seldom occurs in dogs.
6. Hypoglycemia can be life threatening. Diabetes is a dynamic disease. Because cats can go into diabetic remission fairly suddenly, home monitoring of blood glucose is key to preventing hypoglycemia (low blood sugar). On the canine side, a dog’s blood sugar can drop to dangerously low levels due to sporadic and strenuous exercise or changes in insulin administration. 
7. Dedication will save your pet’s life. Without proper treatment, your dog or cat will ultimately die. Sadly, some owners even choose to euthanize their pets because of the commitment required to manage diabetes. However, many people find the effort worthwhile and rewarding, as the animal can enjoy a high-quality life as a controlled diabetic.
8. Communication is key. It’s natural to feel overwhelmed when caring for a diabetic pet. Veterinarians and technicians understand this and want to support you as much as possible. Don’t be afraid to reach out for help.

What to ask your veterinarian about diabetes management

• How much time and money will it take for my pet to become a controlled diabetic?
• How often will my pet need to be re-evaluated by you in the hospital?
• I keep an erratic schedule. How will I give my pet insulin injections at consistent times each day?
• How can I safely help my pet lose weight?
• How small is the needle I’ll be using to give my pet insulin injections?
• What do I need to know about preparing and storing insulin?

• I’m diabetic. What are the similarities and differences between my disease and my pet’s?
• How do I monitor my pet’s blood glucose levels? Since I’m monitoring these levels, can I make adjustments in my pet’s insulin dose?

• What are the warning signs that something is off?
• Is it safe to “spot check” glucose levels?
• What kind of treats or table scraps are safe to feed my pet?
• What would be a sensible exercise regimen for my pet?
• Will my pet still enjoy a good quality of life? Will I?