New Hyperinsulinemia Screening Test Promising (AAEP 2012)

An oral sugar test might provide a more convenient means of screening horses for hyperinsulinemia.
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In a perfect world, veterinarians would be able to detect every horse afflicted with insulin dysregulation before the animal developed the painful and debilitating disease laminitis. Screening for insulin issues is typically cumbersome, because existing tests are time-consuming and involved. A team from the University of Tennessee (UT) led by Nicholas Frank, DVM, PhD, Dipl. ACVIM, who now teaches at Tufts Cummings School of Veterinary Medicine in Massachusetts, tested the feasibility and effectiveness of an oral sugar test that can be administered on the farm.

Frank noted that the idea for this test came from a summer project performed by Amy Schuver, DVM, when she was a student at UT. He presented the study results at the 2012 American Association of Equine Practitioners Convention, held Dec. 1-5 in Anaheim, Calif.

Insulin is a hormone produced in the pancreas that regulates blood glucose levels. When glucose levels rise after feed intake, the pancreas releases more insulin. In the normal animal the insulin is taken up by cell receptors, signaling to the cell to metabolize glucose. However, in horses with insulin dysregulation, high insulin concentrations are detectable after feeding. These horses exhibit excessive insulin responses to starch or sugar intake.

If horses with insulin resistance (IR) consume an increased amount of sugar or starch, the high insulin concentrations they develop increase their risk of developing laminitis, explained Frank, who is a professor of large animal internal medicine and chair of the department of clinical sciences Tufts. He noted that most horses with IR are diagnosed after developing laminitis. The goal of screening for IR, then, said Frank, is to recognize at-risk horses and prevent damage to the hoof. Typical IR testing is cumbersome and involves blood testing for glucose and insulin concentrations, fasting glucose and insulin levels, a combined glucose/insulin test, and/or an intravenous (IV) insulin tolerance test, and these tests aren’t consistent with the natural conditions surrounding IR

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Written by:

Christy Corp-Minamiji, DVM, practices large animal medicine in Northern California, with particular interests in equine wound management and geriatric equine care. She and her husband have three children, and she writes fiction and creative nonfiction in her spare time.

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