Analyze Diet

Topic:Insulin

Insulin is a hormone produced by the pancreas that plays a pivotal role in regulating glucose metabolism in horses. It facilitates the uptake of glucose by cells, thus maintaining blood sugar levels within a normal range. Insulin's function is integral to energy balance and metabolic processes in equines. Disruptions in insulin regulation can lead to metabolic disorders such as Equine Metabolic Syndrome (EMS), characterized by insulin resistance and associated with obesity and laminitis. This page aggregates peer-reviewed research studies and scholarly articles that explore the physiological role, regulatory mechanisms, and clinical implications of insulin in equine health and disease management.
Diagnosis of equine endocrinopathies: The value of measuring blood glucose during an oral glucose test.
Veterinary journal (London, England : 1997)    September 29, 2023   Volume 300-302 106034 doi: 10.1016/j.tvjl.2023.106034
de Laat MA, Sillence MN.Blood glucose concentration is often measured during an oral glucose test (OGT), but is not thought to aid in diagnosing insulin dysregulation (ID) or pituitary pars intermedia dysfunction (PPID). The aim of this retrospective study was to investigate whether the change in blood glucose concentration during an OGT aligned with indicators of equine metabolic syndrome or PPID, including serum insulin and plasma ACTH concentrations, clinical observations, age, sex, breed type and the test dose. The cohort included 149 horses, miniature horses, and ponies that had undergone an in-feed OGT and clin...
Intra-articular triamcinolone acetonide injection results in increases in systemic insulin and glucose concentrations in horses without insulin dysregulation.
Equine veterinary journal    September 13, 2023   doi: 10.1111/evj.14003
Boger BL, Manfredi JM, Loucks AR, Salamey MZ, Kapeller LE, Fricano AG, Winkler A, Yob C, Colbath AC.Corticosteroids are a commonly used, inexpensive intra-articular treatment for osteoarthritis which may increase the risk for laminitis in horses due, in part, to hyperinsulinaemia. Humans with metabolic syndrome experience increases in insulin and glucose concentrations post-injection, but responses in horses are unknown. Objective: To determine the effect of a single intra-articular (IA) dose of triamcinolone acetate (TA) on blood insulin and glucose concentrations. Methods: Before-after study. Methods: Ten horses with normal insulin regulation as assessed by an oral sugar test received 18...
Associations between feeding and glucagon-like peptide-2 in healthy ponies.
Equine veterinary journal    September 13, 2023   doi: 10.1111/evj.14004
Sibthorpe PEM, Fitzgerald DM, Sillence MN, de Laat MA.Gastrointestinal peptides, such as glucagon-like peptide-2 (GLP-2), could play a direct role in the development of equine hyperinsulinaemia. Objective: To describe the secretory pattern of endogenous GLP-2 over 24 h in healthy ponies and determine whether oral administration of a synthetic GLP-2 peptide increases blood glucose or insulin responses to feeding. Methods: A cohort study followed by a randomised, controlled, cross-over study. Methods: In the cohort study, blood samples were collected every 2 h for 24 h in seven healthy ponies and plasma [GLP-2] was measured. In the cross-over...
Sex hormone-binding globulin (SHBG) mitigates ER stress and improves viability and insulin sensitivity in adipose-derived mesenchymal stem cells (ASC) of equine metabolic syndrome (EMS)-affected horses.
Cell communication and signaling : CCS    September 11, 2023   Volume 21, Issue 1 230 doi: 10.1186/s12964-023-01254-6
Bourebaba N, Sikora M, Qasem B, Bourebaba L, Marycz K.Equine metabolic syndrome (EMS), which encompasses insulin resistance, low-grade inflammation and predisposition to laminitis is a critical endocrine disorder among the most prevalent conditions affecting horses from different breeds. According to the most recent research, low human sex hormone-binding globulin (SHBG) serum levels correlate with an increased risk of obesity, insulin resistance and diabetes, and may contribute to overall metabolic dysregulations. This study aimed to test whether exogenous SHBG could protect EMS affected adipose-derived stromal stem cells (EqASC) from apoptosis,...
Development of a Web App to Convert Blood Insulin Concentrations among Various Immunoassays Used in Horses.
Animals : an open access journal from MDPI    August 24, 2023   Volume 13, Issue 17 2704 doi: 10.3390/ani13172704
Delarocque J, Feige K, Carslake HB, Durham AE, Fey K, Warnken T.The measurement of the blood insulin concentration, and comparison to cut-offs, is essential in diagnosing insulin dysregulation, a common equine endocrinopathy. However, different insulin assays provide disparate results. We aimed to ease comparison between assays by compiling original and published data into a web app to convert insulin measurements from one assay to another. Data were available for ADVIA Centaur insulin chemiluminescent immunoassay (CLIA), Beckman Coulter insulin radioimmunoassay (RIA), Immulite 1000 CLIA, Immulite 2000 CLIA, Immulite 2000 XPi CLIA, Mercodia equine insulin ...
Factors associated with insulin responses to oral sugars in a mixed-breed cohort of ponies.
Equine veterinary journal    August 22, 2023   Volume 56, Issue 2 253-263 doi: 10.1111/evj.13983
Knowles EJ, Harris PA, Elliott J, Chang YM, Menzies-Gow NJ.Serum insulin concentration at 60 min (InsulinT60) during an oral sugar test (OST) indicates future laminitis risk and insulin dysregulation (ID). Associations between InsulinT60 and physical and owner-reported variables may help clinicians select individuals for ID testing. Associations between InsulinT60 and other metabolic markers may help elucidate ID pathophysiology. Objective: To describe associations between (A) season, physically-apparent and owner-reported factors and binary InsulinT60 interpretation (initial models) and (B) variables included in the initial models, other metabolic ...
Molecular insights into the lipid-carbohydrates metabolism switch under the endurance effort in Arabian horses.
Equine veterinary journal    August 10, 2023   doi: 10.1111/evj.13984
Myćka G, Ropka-Molik K, Cywińska A, Szmatoła T, Stefaniuk-Szmukier M.Recent studies have shown that in Arabian horse muscle, long-term exercise-induced expression of genes related to fatty acid degradation and the downregulation of genes belonging to the glycolysis/gluconeogenesis and insulin signalling pathways. Long-lasting physical exertion may trigger the metabolism to switch the main energy source from carbohydrates to lipids due to higher caloric content. Objective: To describe the metabolism adaptation at the whole transcriptome of blood to endurance effort in Arabian horses. Methods: In vivo experiment. Methods: Venous blood samples from 10 Arabian hors...
The effect of pre-dosing with metformin on the insulin response to oral sugar in insulin-dysregulated horses.
Equine veterinary journal    August 6, 2023   doi: 10.1111/evj.13979
Colmer SF, Adams AA, Adam E, Miller R, Stefanovski D, Kulp JC, van Eps A.A single dose of metformin administered 1 h prior to oral glucose challenge was previously shown to reduce insulinaemic responses in horses with experimentally-induced insulin dysregulation (ID). Targeted administration could be useful for controlling post-prandial hyperinsulinaemia in horses with naturally-occurring ID.
Evaluation of field-testing protocols to diagnose insulin dysregulation in ponies using a Bayesian approach.
Veterinary journal (London, England : 1997)    August 1, 2023   106019 doi: 10.1016/j.tvjl.2023.106019
Clark BL, Stewart AJ, Kemp KL, Bamford NJ, Bertin FR.Field tests and their association with laminitis have not been evaluated in large cohorts. The objectives of this study were to evaluate the performance of basal insulin (BI), the oral sugar test (OST) and the insulin tolerance test (ITT) to diagnose ID and investigate their association with laminitis. Insulin dysregulation status was determined in 146 ponies using BI (insulin concentration >20 µIU/mL), an OST (insulin concentration >65 µIU/mL at 60 or 90min after oral administration of 0.45mL/kg corn syrup) and an ITT (< 50% reduction in glucose concentration 30min after intravenous adminis...
Equine Metabolic Syndrome: A Complex Disease Influenced by Multifactorial Genetic Factors.
Genes    July 27, 2023   Volume 14, Issue 8 1544 doi: 10.3390/genes14081544
Stefaniuk-Szmukier M, Piórkowska K, Ropka-Molik K.Equine metabolic syndrome (EMS) has become an important issue in modern veterinary medicine and is linked to the common, extremely painful, most-of-the-time performance-terminating hoof laminitis. The growing knowledge in the field of genetic background, inducing environmental factors, diagnosis, treatment and maintenance of affected equines led us to summarise the available information to be used not only for scientific purposes but for fieldwork. In horses, the clinical presentation of EMS includes: obesity or local fat deposition, bilateral lameness or hoof rings attributed to ongoing or pr...
Sex Hormone-Binding Globulin (SHBG) Maintains Proper Equine Adipose-Derived Stromal Cells (ASCs)’ Metabolic Functions and Negatively Regulates their Basal Adipogenic Potential.
Stem cell reviews and reports    July 4, 2023   Volume 19, Issue 7 2251-2273 doi: 10.1007/s12015-023-10580-8
Bourebaba L, Zyzak M, Sikora M, Serwotka-Suszczak A, Mularczyk M, Al Naem M, Marycz K.Sex hormone binding globulin (SHBG) deteriorated expression has been recently strongly correlated to increased level of circulating pro-inflammatory cytokines and insulin resistance, which are typical manifestations of equine metabolic syndrome (EMS). Despite previous reports demonstrated the potential therapeutic application of SHBG for liver-related dysfunctions, whether SHBG might modulate equine adipose-derived stem/stromal cells (EqASCs) metabolic machinery remains unknown. Therefore, we evaluated for the first time the impact of SHBG protein on metabolic changes in ASCs isolated from hea...
Age-Related Differences in Short-Term Transportation Stress Responses of Horses.
Journal of equine veterinary science    July 1, 2023   Volume 128 104879 doi: 10.1016/j.jevs.2023.104879
Jacquay ET, Harris PA, Adams AA.Transportation of horses on short journeys can lead to an increase in stress. There are known age-associated changes in immune and metabolic responses in horses; however, no research exists evaluating how age may influence these responses to transportation stress. Eleven mares within two age groups, aged (n = 5, 22 ± 1 year) or young (n = 6, 2 ± 1 year), were transported 1 hour and 20 minutes. Peripheral blood and saliva were collected before and after transportation at baseline (2 to 3 weeks prior to transportation), 24 hours pre-transport, 1 hour before loading, 15 minutes, 30 minutes,...
Comparison of a modified 2-step insulin response test performed with porcine zinc insulin and an oral glucose test to detect hyperinsulinemic Icelandic horses.
Veterinary journal (London, England : 1997)    June 21, 2023   Volume 298-299 106012 doi: 10.1016/j.tvjl.2023.106012
Frers F, Delarocque J, Huber K, Feige K, Warnken T.Both, oral and intravenous (IV) testing protocols, are recommended and still used to detect insulin dysregulation (ID) in equids. However, IV tests mainly focus on peripheral insulin resistance (IR), while oral tests assess hyperinsulinemia (HI), which are different aspects of ID. The objective of this study was to describe if horses with HI also demonstrate IR and consequently can be detected by a modified 2-step insulin response test (2-step IRT) performed with a veterinary approved porcine zinc insulin (PZI). Twelve Icelandic horses were subjected to an OGT and 2-step IRT in a crossover stu...
Occurrence of equine metabolic syndrome, clinical manifestations, and associated risk factors in Nigeria.
Journal of equine science    June 12, 2023   Volume 34, Issue 2 29-35 doi: 10.1294/jes.34.29
Akinniyi OO, Sackey AKB, Ochube GE, Mshelia PW, Musa FA, Elijah MO, Jolayemi KO.Insulin dysregulation (ID) is central to the pathophysiology of equine metabolic syndrome (EMS), putting the horse at risk of laminitis. There is a paucity of information on the status of EMS in Nigeria. This study aimed to determine the occurrence of EMS, clinical manifestations, and associated risk factors in Nigeria. A cross-sectional study was carried out. Selected horses underwent an insulin 2-step response test to ascertain insulin dysregulation; a physical examination was carried out to diagnose laminitis and obesity. Risk factors were assessed using a questionnaire. The overall prevale...
Equine Endocrine Disease: Challenges With Case Definition for Research.
Journal of equine veterinary science    May 27, 2023   Volume 124 104491 doi: 10.1016/j.jevs.2023.104491
McGowan CM, Ireland JL.Equine endocrine disease is an important area for equine research, requiring an appropriate case definition for inclusion and criteria for exclusion from disease. Defining a case for research may be different from criteria for clinical diagnosis. Further, clinical diagnosis recommendations have been changing regularly, making this area challenging for equine scientists. This review discusses the diagnosis of major equine endocrine diseases, pituitary pars intermedia dysfunction, equine metabolic syndrome and insulin dysregulation, focusing on the most appropriate diagnostic methods for researc...
Evaluation of an HMGA2 variant contribution to height and basal insulin concentrations in ponies.
Journal of veterinary internal medicine    May 6, 2023   Volume 37, Issue 3 1186-1192 doi: 10.1111/jvim.16723
Clark BL, Bamford NJ, Stewart AJ, McCue ME, Rendahl A, Bailey SR, Bertin FR, Norton EM.The HMGA2:c.83G>A variant was identified in Welsh ponies having pleiotropic effects on height and insulin concentration. Objective: Determine whether the HMGA2:c.83G>A variant is associated with decreased height and higher basal insulin concentrations across pony breeds. Methods: Two hundred thirty-six ponies across 6 breeds. Methods: Cross-sectional study. Ponies were genotyped for the HMGA2:c.83G>A variant and phenotyped for height and basal insulin concentrations. Stepwise regression was performed for model analysis using a linear regression model for height and mixed linear model ...
The effects of obesity and insulin dysregulation on mare reproduction, pregnancy, and foal health: a review.
Frontiers in veterinary science    April 20, 2023   Volume 10 1180622 doi: 10.3389/fvets.2023.1180622
Hallman I, Karikoski N, Kareskoski M.Obesity is a growing welfare concern in modern equine populations and predisposes horses to disturbances in energy metabolism such as insulin dysregulation. However, equine metabolic syndrome has only been recognized in recent decades. Functioning energy metabolism is pivotal to normal body homeostasis and affects essentially all organ systems, including reproduction. Previous literature suggests that obesity has an effect not only on the reproductive processes in mares but also on offspring health, predisposing the offspring to later-onset orthopedic and metabolic problems. This review focuse...
Clinical evaluation of the Immulite® 1000 chemiluminescent immunoassay for measurement of equine serum insulin.
Frontiers in veterinary science    March 27, 2023   Volume 10 1018230 doi: 10.3389/fvets.2023.1018230
Go YY, Hazard NW, Balasuriya UBR, Chapman AM, Fitton NS, Kenéz Á, Andrews FM.Accurate quantitative analysis of equine insulin in blood samples is critical for assessing hyperinsulinemia in horses. Although there are various laboratory methods for evaluating equine serum insulin, different immunoassays show significant discrepancies between the determined insulin concentrations and are often not comparable. The aim of this study was to evaluate the Immulite® 1000 chemiluminescent immunoassay (CLIA) to establish independent laboratory and assay-specific cut values to provide an accurate diagnosis of hyperinsulinemia in horses. Thus, the analytical and clinical performan...
Hypertriglyceridemia in equines with refractory hyperinsulinemia treated with SGLT2 inhibitors.
Open veterinary journal    March 20, 2023   Volume 13, Issue 3 365-375 doi: 10.5455/OVJ.2023.v13.i3.14
Kellon EM, Gustafson KM.Sodium-Glucose CoTransporter-2 (SGLT2) inhibitors, the -flozin group of drugs, which block glucose reuptake in the renal proximal tubule, are being increasingly used off-label to treat horses with refractory hyperinsulinemia. After 2 years of use by animals in our group, a horse on canagliflozin was incidentally noted to be hyperlipemic. We have been following a cohort of equines (n = 20) treated with SGLT2 inhibitors due to refractory hyperinsulinemia. The animals are owned by members of the Equine Cushing's and Insulin Resistance Group and treated by their attending veterinarians. The index ...
The PTP1B inhibitor MSI-1436 ameliorates liver insulin sensitivity by modulating autophagy, ER stress and systemic inflammation in Equine metabolic syndrome affected horses.
Frontiers in endocrinology    March 20, 2023   Volume 14 1149610 doi: 10.3389/fendo.2023.1149610
Bourebaba L, Serwotka-Suszczak A, Pielok A, Sikora M, Mularczyk M, Marycz K.Equine metabolic syndrome (EMS) is a multifactorial pathology gathering insulin resistance, low-grade inflammation and past or chronic laminitis. Among the several molecular mechanisms underlying EMS pathogenesis, increased negative insulin signalling regulation mediated by protein tyrosine phosphatase 1 B (PTP1B) has emerged as a critical axis in the development of liver insulin resistance and general metabolic distress associated to increased ER stress, inflammation and disrupted autophagy. Thus, the use of PTP1B selective inhibitors such as MSI-1436 might be considered as a golden therapeut...
A review of cellular and molecular mechanisms in endocrinopathic, sepsis-related and supporting limb equine laminitis.
Equine veterinary journal    March 13, 2023   Volume 55, Issue 3 350-375 doi: 10.1111/evj.13933
Elliott J, Bailey SR.Equine laminitis has both fascinated and frustrated veterinary researchers and clinicians for many years. The recognition that many ponies suffering from pasture-associated laminitis have an insulin-dysregulated phenotype (endocrinopathic laminitis, EL) and that prolonged insulin and glucose infusions can experimentally induce laminar pathology and functional failure are seminal discoveries in this field. Researchers have studied the molecular basis for disease pathogenesis in models of EL, sepsis-related laminitis and supporting limb laminitis and generated much data over the last 15 years....
Equine metabolic syndrome: Role of the enteroinsular axis in the insulin response to oral carbohydrate.
Veterinary journal (London, England : 1997)    February 28, 2023   Volume 294 105967 doi: 10.1016/j.tvjl.2023.105967
de Laat MA, Fitzgerald DM.Equine insulin dysregulation (ID) comprises amplified insulin responses to oral carbohydrates or insulin resistance, or both, which leads to sustained or periodic hyperinsulinaemia. Hyperinsulinaemia is important in horses because of its clear association with laminitis risk, and the gravity of this common sequela justifies the need for a better understanding of insulin and glucose homoeostasis in this species. Post-prandial hyperinsulinaemia is the more commonly identified component of ID and is diagnosed using tests that include an assessment of the gastrointestinal tract (GIT). There are se...
Effect of sirolimus on insulin dynamics in horses.
Journal of veterinary internal medicine    February 25, 2023   Volume 37, Issue 2 703-712 doi: 10.1111/jvim.16650
de Tonnerre DJ, Medina Torres CE, Stefanovski D, Robinson MA, Kemp KL, Bertin FR, van Eps AW.Sirolimus, a mechanistic target of rapamycin inhibitor, suppresses insulin production in other species and has therapeutic potential for hyperinsulinemia in horses. Objective: Determine the pharmacokinetics (PKs) of sirolimus and evaluate its effect on insulin dynamics in healthy and insulin dysregulation (ID) horses. Methods: Eight Standardbred geldings. Methods: A PK study was performed followed by a placebo-controlled, randomized, crossover study. Blood sirolimus concentrations were measured by liquid chromatography-mass-spectrometry. PK indices were estimated by fitting a 2-compartment mod...
Periodontal structures in horses with pituitary pars intermedia dysfunction: A histological evaluation.
Frontiers in veterinary science    January 17, 2023   Volume 10 1114445 doi: 10.3389/fvets.2023.1114445
Zapf AM, Fey K, Büttner K, Gröf M, Staszyk C.Pituitary pars intermedia dysfunction (PPID) and dental disorders are of major concern in horses older than 15 years. Although PPID in geriatric horses and dental disorders in all age groups are well described, a connection between this endocrine disease and pathological changes in equine dental structures has not yet been investigated. In humans, periodontitis is considered to be a complication of systemic diseases like diabetes mellitus type 2, obesity and various conditions leading to an impaired immune response. In PPID, cross links to insulin and immune dysregulations are proven. The aim ...
Association between insulin dysregulation and adrenocorticotropic hormone in aged horses and ponies with no clinical signs of pituitary pars intermedia dysfunction.
Equine veterinary journal    January 15, 2023   doi: 10.1111/evj.13925
Li FI, Spence RJ, de Laat MA, Harris PA, Sonntag J, Menzies-Gow NJ, Durham AE, Bailey SR, Sillence MN.High concentrations of adrenocorticotropic hormone (ACTH) are used as an indicator of pituitary pars intermedia dysfunction (PPID), but other factors that may influence ACTH need to be understood, if diagnostic reference ranges for ACTH are to be used with confidence. Insulin dysregulation (ID) could be one such factor, as insulin affects pituitary hormones in other species. Objective: To test the hypothesis that a relationship exists between high insulin and high ACTH in aged (>15-year-old) animals with no clinical signs of PPID. Methods: A cohort study. Methods: Thirteen horses and eleven p...
Palatability, glycemic, and insulinemic responses to various carbohydrate formulations: Alternatives for the diagnosis of insulin dysregulation in horses?
Journal of veterinary internal medicine    January 10, 2023   Volume 37, Issue 1 282-291 doi: 10.1111/jvim.16614
Warnken T, Schaub C, Delarocque J, Frers F, Feige K, Sonntag J, Reiche DB.Oral glycemic challenge (GC) tests are recommended for diagnosis of insulin dysregulation (ID). Various protocols are used, but all have limitations in terms of palatability, ease of use, variable composition, geographic availability, or some combination of these. Objective: To evaluate newly developed formulations with defined carbohydrate composition for use as oral GCs. Methods: Thirty-four horses and ponies in various metabolic states. Methods: Our objectives were carried out in 2 separate cross-over experiments. First, the palatability and acceptance of various GCs (2 syrups, 1 granulate)...
Carbohydrate pellets to assess insulin dysregulation in horses.
Journal of veterinary internal medicine    December 30, 2022   Volume 37, Issue 1 302-314 doi: 10.1111/jvim.16621
de Laat MA, Warnken T, Delarocque J, Reiche DB, Grob AJ, Feige K, Carslake HB, Durham AE, Sillence MN, Thane KE, Frank N, Brojer J, Lindase S....A glycemic challenge test is used for the diagnosis of insulin dysregulation (ID) in horses and ponies. Different forms of the test exist where the administrative route and dose of glucose vary, which makes interpretation of results challenging. Objective: To evaluate the palatability of, and blood glucose and insulin responses to, carbohydrate pellets fed as an oral glucose test (OGT), and to establish the diagnostic threshold for ID when using the pellets. Methods: University and privately-owned horses and ponies (n = 157) comprised of 31 breeds and both sexes. Methods: Multicenter cohort ...
A one-health approach to identifying and mitigating the impact of endocrine disorders on human and equine athletes.
American journal of veterinary research    December 27, 2022   Volume 84, Issue 2 ajvr.22.11.0194 doi: 10.2460/ajvr.22.11.0194
Manfredi JM, Jacob SI, Boger BL, Norton EM.Endocrinopathies affect multiple species in ever-increasing percentages of their populations, creating an opportunity to apply one-health approaches to determining creative preventative measures and therapies in athletes. Obesity and alterations in insulin and glucose dynamics are medical concerns that play a role in whole-body health and homeostasis in both horses and humans. The role and impact of endocrine disorders on the musculoskeletal, cardiovascular, and reproductive systems are of particular interest to the athlete. Elucidation of both physiologic and pathophysiologic mechanisms invol...
Identifying possible thresholds for nonstructural carbohydrates in the insulin dysregulated horse.
Equine veterinary journal    December 20, 2022   doi: 10.1111/evj.13910
Macon EL, Harris P, Bailey S, Caldwell Barker A, Adams A.Identifying intake levels of nonstructural carbohydrates (NSCs) that limit the postprandial insulinaemic response in the insulin dysregulated (ID) horse may help reduce hyperinsulinaemia-associated laminitis (HAL) risk. Objective: To determine if ID horses have thresholds for pure sources of starch and sugar, above which there is an augmented insulin response. Methods: Randomised crossover experiment. Methods: Fourteen adult horses (6 ID and 8 noninsulin dysregulated, NID; matched for bodyweight) were randomly fed eight dietary treatments. Dietary treatments were formulated using a base of low...
Plasma Amino Acid Concentration in Obese Horses with/without Insulin Dysregulation and Laminitis.
Animals : an open access journal from MDPI    December 18, 2022   Volume 12, Issue 24 3580 doi: 10.3390/ani12243580
Stoeckle SD, Timmermann D, Merle R, Gehlen H.Laminitic horses commonly suffer from an endocrine disease such as equine metabolic syndrome. Hyperinsulinemia is considered a key factor in the pathogenesis of laminitis. Since insulin also affects protein turnover in the body, the resting plasma amino acid concentrations of obese horses that were presented for a combined glucose insulin test (CGIT) were determined. In total, 25 obese horses and two lean horses with recurrent laminitis underwent a CGIT. Of these, five were not insulin dysregulated (obese), 14 were insulin dysregulated (ID), and eight were insulin-dysregulated and laminitic (I...