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Velagliflozina, uma Nova Abordagem no Controlo da Diabetes Mellitus em Gatos
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Entre as doenças endócrinas que afetam os gatos, a Diabetes Mellitus tipo 2 (DM2) destaca-se
como a mais prevalente. Caracteriza-se por hiperglicemia persistente resultante de uma combinação
entre resistência periférica à insulina e disfunção progressiva das células β pancreáticas. Esta forma de
diabetes está frequentemente associada a fatores de risco como obesidade, idade avançada,
sedentarismo e predisposição genética. Os sinais clínicos mais comuns incluem poliúria, polidipsia,
polifagia e perda de peso. Quando não controlada, a DM2 pode evoluir para complicações graves como
cetoacidose diabética, neuropatia periférica ou infeções recorrentes, comprometendo
significativamente a qualidade de vida e a sobrevivência do animal. O diagnóstico e o tratamento
precoces são, por isso, essenciais para melhorar o prognóstico e o bem-estar do gato e do seu tutor.
Nos últimos anos, a insulinoterapia tem sido a base do tratamento, embora represente um
desafio significativo para tutores, devido à necessidade de administração injetável diária e de
monitorização rigorosa continua, o que contribui para elevados índices de eutanásia no primeiro ano
pós-diagnóstico.
A velagliflozina, um inibidor seletivo do cotransportador sódio-glicose tipo 2 (iSGLT2),
aprovada recentemente na União Europeia para o tratamento da DM2 felina, surge como uma
abordagem terapêutica inovadora e independente da insulina. Este fármaco, de administração oral
única diária, promove a obtenção da euglicemia através da glicosúria. Esta via terapêutica demonstrou,
em estudos recentes, melhorias significativas no controlo glicémico, nos sinais clínicos e na qualidade
de vida de gatos diabéticos não cetonúricos, com uma taxa de resposta superior a 80%.
Contudo, a terapêutica com velagliflozina não está isenta de riscos. A sua utilização não é uma
escolha adequada para todos os felinos diabéticos exige uma seleção criteriosa dos pacientes e
acompanhamento veterinário contínuo, especialmente nas fases iniciais do tratamento. O seu uso
deve integrar uma abordagem multimodal que inclua maneio nutricional, monitorização laboratorial
e envolvimento ativo dos tutores. Para além do controlo glicémico, destaca-se ainda os seus efeitos
pleiotrópicos com benefícios cardiovasculares, renais e metabólicos, posicionando-se como uma
futura terapêutica promissora noutras áreas da medicina veterinária.
Among the endocrine diseases that affect cats, type 2 Diabetes Mellitus (DM2) stands out as the most prevalent. It is characterized by persistent hyperglycemia resulting from a combination of peripheral insulin resistance and progressive dysfunction of pancreatic β cells. This form of diabetes is often associated with risk factors such as obesity, advanced age, sedentary lifestyle and genetic predisposition. The most common clinical signs include polyuria, polydipsia, polyphagia, and weight loss. When uncontrolled, DM2 can progress to serious complications such as diabetic ketoacidosis, peripheral neuropathy or recurrent infections, significantly compromising the animal's quality of life and survival. Early diagnosis and treatment are therefore essential to improve the prognosis and well being of both the cat and its owner. In recent years, insulin therapy has been the basis of treatment, although it poses a significant challenge for owners due to the need for daily injections and continuous, rigorous monitoring, which contributes to high euthanasia rates in the first year after diagnosis. Velagliflozin, a selective sodium-glucose cotransporter 2 inhibitor (iSGLT2), recently approved in the European Union for the treatment of feline DM2, has emerged as an innovative, insulin-independent therapeutic option. This once-daily oral medication promotes euglycemia through glycosuria. This therapeutic approach has shown significant improvements in glycemic control, clinical signs, and quality of life in non-ketonuric diabetic cats in recent studies, with a response rate of over 80%. However, velagliflozin therapy is not without risks. Its use is not suitable for all diabetic cats and requires careful patient selection and continuous veterinary monitoring, particularly in the early stages of treatment. Its administration should be part of a multimodal approach that includes nutritional management, laboratory monitoring and active involvement of owners. In addition to glycemic control, its pleiotropic effects such as cardiovascular, renal and metabolic benefits are also noteworthy, positioning it as a promising future therapy in other areas of veterinary medicine.
Among the endocrine diseases that affect cats, type 2 Diabetes Mellitus (DM2) stands out as the most prevalent. It is characterized by persistent hyperglycemia resulting from a combination of peripheral insulin resistance and progressive dysfunction of pancreatic β cells. This form of diabetes is often associated with risk factors such as obesity, advanced age, sedentary lifestyle and genetic predisposition. The most common clinical signs include polyuria, polydipsia, polyphagia, and weight loss. When uncontrolled, DM2 can progress to serious complications such as diabetic ketoacidosis, peripheral neuropathy or recurrent infections, significantly compromising the animal's quality of life and survival. Early diagnosis and treatment are therefore essential to improve the prognosis and well being of both the cat and its owner. In recent years, insulin therapy has been the basis of treatment, although it poses a significant challenge for owners due to the need for daily injections and continuous, rigorous monitoring, which contributes to high euthanasia rates in the first year after diagnosis. Velagliflozin, a selective sodium-glucose cotransporter 2 inhibitor (iSGLT2), recently approved in the European Union for the treatment of feline DM2, has emerged as an innovative, insulin-independent therapeutic option. This once-daily oral medication promotes euglycemia through glycosuria. This therapeutic approach has shown significant improvements in glycemic control, clinical signs, and quality of life in non-ketonuric diabetic cats in recent studies, with a response rate of over 80%. However, velagliflozin therapy is not without risks. Its use is not suitable for all diabetic cats and requires careful patient selection and continuous veterinary monitoring, particularly in the early stages of treatment. Its administration should be part of a multimodal approach that includes nutritional management, laboratory monitoring and active involvement of owners. In addition to glycemic control, its pleiotropic effects such as cardiovascular, renal and metabolic benefits are also noteworthy, positioning it as a promising future therapy in other areas of veterinary medicine.
Descrição
Palavras-chave
Diabetes Mellitus Hiperglicemia Inibidores do cotransportador sódio-glicose 2 Velagliflozina Gatos Cats Hyperglycemia Sodium-glucose cotransporter 2 inhibitors Velagliflozin