Caloric restriction achieves 50% remission in overweight diabetic cats

At the 2026 Western Veterinary Conference (WVC) in Las Vegas, Nevada, dvm360 sat down with John Flanagan, PhD, to discuss a controlled study. The clinical study was a research collaboration between Royal Canin, and 2 prestigious European veterinary schools, Copenhagen University and the Royal Veterinary College, London. The results of his team’s study, which is soon to be published, showed that caloric restriction implemented with a caregiver-shared weight-reduction plan and flexible wet/dry feeding based on preference produced remission in approximately half of overweight diabetic cats. Flanagan outlines how meal size, meal frequency, and a structured weight-loss program can be used practically in the clinic to improve glycemic control. He also previews follow-up data on sustained remission that will be presented later this year at the 2026 annual American College of Veterinary Internal Medicine (ACVIM) conference.

See part 1 of this interview here: How can a tailored diet support overweight diabetic cats?

Transcript

John Flanagan, PhD: Our hypothesis in the study was that caloric restriction can be very beneficial for diabetic cats. We know from human medicine that people with type 2 diabetes who undergo caloric restriction and weight loss can often go into diabetic remission. This is what we set out to achieve using the Glycoadvanced diet. By putting cats under caloric restriction, we achieved remission rates of 50% in the intervention group. The cats in the intervention group were more than twice as likely to achieve diabetic remission [as] those in the control group, which were also fed the Glycoadvanced diet but fed to maintain excess weight. These results show that diabetic remission is possible in overweight diabetic cats and that it should be a realistic, achievable goal if it is shared with the caregiver.

For practical application, we recommend implementing a weight-reduction program in overweight diabetic cats once clinical signs have stabilized after diagnosis. It can also be applied to cats that have already been diabetic for some time. In our study, we recruited cats that had been diabetic for up to 2 years. Although it is more difficult to induce remission in those cats, it is still possible. Implementing a weight-reduction program does take additional effort, but the possibility of achieving diabetic remission within 12 weeks offsets that difficulty and can [provide] long-term benefit [to] the cat’s quality of life while reducing the caregiver’s burden.

One aspect that might surprise people is that the cats were fed a mixture of wet and dry food based on the cat’s preference. It is commonly recommended that diabetic cats eat a wet diet because it is lower in digestible carbohydrates, which is thought to be beneficial. However, when we analyzed the data, we found that it didn’t matter whether the cats were on a 100% wet, 100% dry, or a [mixed diet]; diet form did not affect remission. This raises questions about the strong recommendation for extremely low-digestible carbohydrate diets. More research is needed, but our internal studies on healthy cats suggest that the closest indicator of postprandial glycemic load is the quantity eaten, not the diet composition. Breaking down meals into multiple small feedings throughout the day can be very beneficial for glycemic control.

When we started the study, insulin was the only drug available for diabetic cats. Since then, SGLT2 [sodium-glucose cotransporter-2] inhibitors have come to market. That raises the question of whether this diet can be used in combination with SGLT2 inhibitors. We hope to have results on that soon. Our next analyses are looking at sustained diabetic remission. We define remission as being without insulin treatment for at least 4 weeks and showing no clinical signs of diabetes. The key question is whether we can sustain remission for an extended period. We have follow-up data for the majority of these cats up to 52 weeks after initiating treatment, and we will be presenting these results at ACVIM in June.