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.
Essential oil supplementation improves insulin sensitivity and modulates the plasma metabolome of hyperinsulinemic horses.
Frontiers in veterinary science    December 2, 2024   Volume 11 1444581 doi: 10.3389/fvets.2024.1444581
Loos CMM, Zhao S, Li L, Li J, Han W, Vanzant ES, McLeod KR.The objective of this study was to investigate the effect of essential oil (EO) supplementation on insulin sensitivity (IS) and the plasma metabolome in insulin dysregulated (ID) horses. Horses were blocked by degree of IS and assigned randomly to treatment: oral daily bolus (50 mL) of either a plant derived EO supplement or carrier (CON). Mares were housed in dry lots with access to grass hay and supplemented individually twice daily with a concentrate to meet nutrient requirements for mature horses. Before and after 6 wks of treatment, mares underwent a combined glucose-insulin tolerance ...
Nutraceutical Supplement Mitigates Insulin Resistance in Horses with a History of Insulin Dysregulation During a Challenge with a High-Starch Diet.
Animals : an open access journal from MDPI    November 25, 2024   Volume 14, Issue 23 doi: 10.3390/ani14233385
Loos C, Castelein A, Vanzant E, Adam E, McLeod KR.Insulin dysregulation (ID) is associated with an increased risk of laminitis which often necessitates the need for clinical intervention. To test the contention that the prophylactic supplementation of nutraceuticals could mitigate ID in susceptible horses, 16 mature horses with a history of ID were supplemented with either the placebo (n = 8) or nutraceutical (n = 8) once daily. Horses were housed in dry lots with ad libitum access to grass hay and fed a concentrate twice daily to provide 0.5 g starch/kg BW/meal. A combined glucose-insulin tolerance test was performed on all horses before and...
Nutraceutical Supplement Mitigates Insulin Resistance in Horses with a History of Insulin Dysregulation During a Challenge with a High-Starch Diet.
Animals : an open access journal from MDPI    November 25, 2024   Volume 14, Issue 23 doi: 10.3390/ani14233385
Loos C, Castelein A, Vanzant E, Adam E, McLeod KR.Insulin dysregulation (ID) is associated with an increased risk of laminitis which often necessitates the need for clinical intervention. To test the contention that the prophylactic supplementation of nutraceuticals could mitigate ID in susceptible horses, 16 mature horses with a history of ID were supplemented with either the placebo (n = 8) or nutraceutical (n = 8) once daily. Horses were housed in dry lots with ad libitum access to grass hay and fed a concentrate twice daily to provide 0.5 g starch/kg BW/meal. A combined glucose-insulin tolerance test was performed on all horses before and...
Effect of phenylbutazone administration on the enteroinsular axis in horses with insulin dysregulation.
Journal of veterinary internal medicine    November 22, 2024   Volume 39, Issue 1 e17256 doi: 10.1111/jvim.17256
Kemp KL, Skinner JE, Bertin FR.Phenylbutazone is prescribed for laminitis-associated pain and decreases glucose and insulin responses to an oral glucose test (OGT) in horses with insulin dysregulation (ID). Objective: Investigate the effect of phenylbutazone administration on the enteroinsular axis in horses. Methods: Sixteen horses, including 7 with ID. Methods: Randomized cross-over study design, with horses assigned to treatment with phenylbutazone (4.4 mg/kg IV q24h) or placebo (5 mL 0.9% saline). On Day 9 of treatment, an OGT was conducted, followed by a 10-day washout period, administration of the alternative trea...
Short-term clinical and biochemical responses following treatment with dapagliflozin or ertugliflozin in horses with hyperinsulinemia: A retrospective case series.
Domestic animal endocrinology    November 19, 2024   Volume 90 106894 doi: 10.1016/j.domaniend.2024.106894
Sundra T, Knowles E, Rendle D, Kelty E, Lester G, Rossi G.The metabolic and lipid profiles of horses treated with sodium-glucose cotransporter 2 inhibitors are not well understood. This retrospective study evaluated blood parameters in hyperinsulinemic horses treated with either ertugliflozin (0.05 mg/kg) or dapagliflozin (0.02 mg/kg) orally once daily. Blood samples were collected at baseline (day 0) and after 7 and/or 30 days of treatment. Statistical analyses were conducted using Wilcoxon signed-rank, Mann-Whitney and Spearman's rank correlation tests. Thirty-four horses received dapagliflozin and 24 received ertugliflozin. Significant (p<0.05)...
Calcium propionate is an alkalizing agent in exercising Standardbreds.
Journal of equine veterinary science    October 29, 2024   Volume 143 105212 doi: 10.1016/j.jevs.2024.105212
Herbst AC, Puglia AT, Malinowski K, McKeever KH.The objective of this study was to determine if calcium propionate is an alkalizing agent in exercising Standardbreds and if it alters plasma glucose and serum insulin concentrations. This study used a randomized crossover design to test the hypotheses that calcium propionate alters total CO2 (tCO), Ca, pH, strong ion difference (SID), glucose, and insulin in Standardbreds completing a simulated race test (SRT) on a high-speed equine treadmill. Blood was collected from eight horses (mean age ± SD = 16 ± 2.7 years; range = 13 - 21 years) at 10 and 5 min prior to treatment or control administr...
Comparison of a customized glycemic pellets challenge with the oral sugar test to measure glycemic and insulinemic responses in horses.
Journal of veterinary internal medicine    October 28, 2024   Volume 38, Issue 6 3281-3287 doi: 10.1111/jvim.17191
Thane K, Sonntag J, Warnken T, Reiche D, Uricchio C, Frank N.Testing for insulin dysregulation (ID) in horses is commonly performed to guide management and therapeutic strategies. Objective: To evaluate a newly developed glycemic pellets challenge (GPC) and compare results to those obtained using the low-dose oral sugar test (OST). Methods: Twenty-four adult horses with unknown insulin status. Methods: A randomized crossover trial was performed. Horses underwent GPC (0.5 g glycemic carbohydrates/kg body weight) and OST (0.15 mL corn syrup/kg body weight) 7 days apart. Feed was withheld before testing and blood samples were collected at T0, T60, T1...
Effect of short-term dopamine reduction on insulin sensitivity and post-prandial insulin and glucose responses in Standardbred horses.
Domestic animal endocrinology    October 20, 2024   Volume 90 106893 doi: 10.1016/j.domaniend.2024.106893
Galinelli NC, Bamford NJ, Erdody ML, Warnken T, de Laat MA, Sillence MN, Harris PA, Bailey SR.The role of dopamine in the regulation of insulin secretion in horses is poorly understood and requires further investigation. Pituitary pars intermedia dysfunction (PPID) is associated with decreased activity of dopaminergic neurons which normally suppress peptide hormone secretion from the pituitary pars intermedia. A high proportion of horses with PPID also have insulin dysregulation (ID), characterised by post-prandial hyperinsulinaemia and/or tissue insulin resistance, which are risk factors for the development of laminitis. The aim of this study was to investigate the effects of alpha-me...
Erratum for “Effect of phenylbutazone on insulin secretion in horses with insulin dysregulation”.
Journal of veterinary internal medicine    October 7, 2024   Volume 38, Issue 6 3695 doi: 10.1111/jvim.17210
No abstract available
Value of measuring markers of lipid metabolism in horses during an oral glucose test.
Journal of veterinary internal medicine    September 18, 2024   doi: 10.1111/jvim.17199
Zemek CHK, Kemp KL, Bertin FR.Characterizing the lipid response to an oral glucose test (OGT) might improve our understanding of Equine Metabolic Syndrome. Objective: To describe the effects of an OGT on lipid metabolism and determine the value of measuring triglyceride and nonesterified fatty acid (NEFA) concentrations in hyperinsulinemic (HI) and insulin-resistant (IR) horses. Methods: Twenty horses including 7 HI-IR horses, 4 HI-non-IR horses, and 9 non-HI-non-IR horses (control). Methods: Cross-sectional design. Horses underwent an OGT, with blood samples collected at 0, 60, 90, and 120 minutes. Insulin, glucose, tri...
Bayesian Individual Limits for IGF-1 Monitoring in Equine Plasma: Implementation in the Equine Biological Passport.
Drug testing and analysis    September 16, 2024   Volume 17, Issue 7 989-996 doi: 10.1002/dta.3795
Barnabé A, Loup B, Cawley A, Delcourt V, Garcia P, Popot MA, Keledjian J, Bailly-Chouriberry L.Despite the International Federation of Horseracing Authorities (IFHA) regulation associated with heavy sanctions, the abuse of prohibited substances must be identified and deterred throughout horses' athletic careers, such as the administration of recombinant growth hormone (rGH). GH is naturally produced in mammal organisms to stimulate growth. Thus, rGH administration can enhance the performance of horses by expanding some physical abilities. As measuring endogenous GH levels is complex, an indirect strategy is to monitor GH-associated biomarkers in plasma as insulin-like growth factor 1 (I...
Assessing the effects of ex vivo hormonal exposure on oxidative responses in equine leukocytes: A preliminary study.
Veterinary immunology and immunopathology    September 14, 2024   Volume 276 110827 doi: 10.1016/j.vetimm.2024.110827
Vaughn SA, Berghaus LJ, Hart KA.Breed differences exist between horses and ponies in circulating concentrations of several hormones, notably ACTH and insulin. These hormones regulate stress and metabolic responses, but in other species, they also impact leukocyte oxidant responses. The effects of these hormones on equine leukocytes have not been evaluated to date. If equine leukocytes are similarly regulated, breed differences in increased plasma hormone concentrations or altered sensitivity to them at the leukocyte level could result in breed-related differences in oxidant responses or oxidative status. The objective of thi...
The influence of lactation on insulin and glucose metabolism, lipid profile, and cytokines in pregnant mares.
Theriogenology    September 10, 2024   Volume 230 107-114 doi: 10.1016/j.theriogenology.2024.09.003
Affonso FJ, Alonso MA, Bringel B, Douglas R, de Paula Nogueira G, Boakari YL, Fernandes CB.Glucose metabolism adapts to gestation, resulting in progressive physiological insulin resistance and increased insulin secretion to maintain maternal euglycemia and glucose availability for the developing fetus. These changes can impact mare fertility and maternal and neonatal health. This is the first comparison of body condition, regional adiposity, insulin and glucose dynamics, lipid metabolism, and cytokine production between lactating and non-lactating mares before, during pregnancy, and early postpartum. Twelve pregnancies from 9 broodmares, five nonlactating (NL) and seven lactating (L...
The impact of short-term transportation stress on insulin and oral sugar responses in insulin dysregulated and non-insulin dysregulated horses.
Equine veterinary journal    September 4, 2024   doi: 10.1111/evj.14403
Jacquay ET, Harris PA, Adams AA.It is unknown whether short-term transportation affects endocrine responses similarly in horses with and without insulin dysregulation (ID). Objective: To characterise the effect of short-term transportation on stress parameters and insulin responses to an oral sugar test (OST) in horses with and without ID. Methods: Longitudinal cohort study. Methods: Fourteen adult non-pregnant, non-PPID mares of mixed light breeds were grouped as either ID (n = 7) or non-ID (n = 7) based on endocrine testing. Over 2 weeks, horses were transported once, in groups of 3-4 in a horse trailer on a roun...
Studies in vitro of equine intestinal glucagon-like peptide-2 secretion.
Journal of equine veterinary science    August 26, 2024   Volume 142 105179 doi: 10.1016/j.jevs.2024.105179
Sibthorpe PEM, Fitzgerald DM, Sillence MN, de Laat MA.Equine insulin dysregulation (ID) is a significant metabolic problem because the hyperinsulinaemia that develops increases the animal's risk of developing laminitis, a debilitating foot condition. The role of gastrointestinal factors, such as incretin hormones, in the pathogenesis of ID and hyperinsulinaemia in horses is poorly understood, particularly in comparison to other species. Glucagon-like peptide-2 (GLP-2) is an intestinotrophic peptide released from L cells in the gastrointestinal tract and is implicated in metabolic dysfunction in other species. The aim of this study in vitro was to...
The effect of the fat to starch ratio in young horses’ diet on plasma metabolites, muscle endurance and fear responses.
Journal of animal physiology and animal nutrition    August 20, 2024   Volume 109, Issue 1 113-123 doi: 10.1111/jpn.14037
Lashkari S, Beblein C, Christensen JW, Jensen SK.High-starch diets may affect equine hindgut microbiota and increase blood glucose levels, which may cause unwanted physiological changes, but may also elicit behavioural changes such as increased fear reactions. The purpose of the current study was to feed a high starch (300) and low fat (43; HS_LF) or a low starch (60) and high fat (85; LS_HF, g/kg of DM) concentrate within the available commercial range and investigate how muscle endurance and fear reactions of horses respond to different diets. Twenty Danish Warmblood stallions (4 years) were randomly allocated to two treatments: LS_HF (n...
Pharmacokinetics and Alterations in Glucose and Insulin Levels After a Single Dose of Canagliflozin in Healthy Icelandic Horses.
Journal of veterinary pharmacology and therapeutics    August 7, 2024   Volume 48 Suppl 1, Issue Suppl 1 41-49 doi: 10.1111/jvp.13476
Michanek P, Bröjer J, Lilliehöök I, Fjordbakk CT, Löwgren M, Hedeland M, Bergquist J, Ekstrand C.Canagliflozin (CFZ) is a sodium-glucose cotransporter-2 inhibitor that has shown promising results as a drug for the treatment of insulin dysregulation in horses. Even though CFZ is used clinically, no pharmacokinetic data has previously been published. In this study, the pharmacokinetics of CFZ after administration of a single oral dose of 1.8 mg/kg in eight healthy Icelandic horses was examined. Additionally, the effect of treatment on glucose and insulin levels in response to a graded glucose infusion was investigated. Plasma samples for CFZ quantification were taken at 0, 0.33, 0.66, 1, ...
The Effects of Intra-Articular Triamcinolone and Autologous Protein Solution on Metabolic Parameters in Horses.
Animals : an open access journal from MDPI    August 2, 2024   Volume 14, Issue 15 2250 doi: 10.3390/ani14152250
Page AE, Johnson M, Parker JL, Jacob O, Poston R, Adams AA, Adam EN.Intra-articular corticosteroids are a popular treatment choice for joint-associated pain and inflammation in horses despite recent work on the metabolic effects of these drugs. The goal of this project was to compare metabolic effects between intra-articular (IA) triamcinolone acetonide (TA) and an autologous protein solution (APS). Five mixed-breed geldings (4-9 years) were utilized for this project. Three identical and consecutive 28-day treatment blocks were used, with metacarpophalangeal IA treatments consisting of equal volumes of saline, a commercially available APS, or 9 mg of TA. Regul...
Prevalence of insulin dysregulation in the non-obese stock-type horse and relationship with morphometric neck measurements.
Journal of equine veterinary science    July 26, 2024   Volume 141 105151 doi: 10.1016/j.jevs.2024.105151
Heaton CP, Cavinder CA, McClure EN, Smith T, Smith WB, Liburt N, Krotky A, Harris P.Insulin dysregulation (ID), core to equine metabolic syndrome, may present without obesity. Testing for ID risk is commonly based on breed and obese phenotype but might be valuable for non-obese stock-type horses. This study aimed to determine the prevalence of ID in non-obese stock-type horses and evaluate if morphometric neck measurements (MNM) correlate with ID. Sixty-two, non-obese (BCS 5, range 2.5-6/9) stock-type horses were assessed for MNM: neck circumference at 25%, 50% (NC50), and 75% (NC75) length, and crest height. An oral sugar test (OST; 0.15 mL/kg BW corn syrup) was performed wi...
Sodium-glucose transport protein 2 inhibitor use in the management of insulin dysregulation in ponies and horses.
Journal of veterinary pharmacology and therapeutics    July 10, 2024   Volume 48 Suppl 1, Issue Suppl 1 31-40 doi: 10.1111/jvp.13470
Menzies-Gow NJ, Knowles EJ.Laminitis is a common and painful condition of the equine foot and approximately 90% of cases are associated with insulin dysregulation (ID) that is a central feature of the common endocrine disorder equine metabolic syndrome (EMS) and occurs in a subset of animals with pituitary pars intermedia dysfunction. Additional features of EMS include obesity, altered circulating concentrations of adipokines (particularly adiponectin and leptin) and hypertriglyceridaemia. Obesity, ID, hypoadiponectinaemia, hyperleptinaemia and an altered plasma lipid profile are also features of human metabolic syndrom...
The detection of ACTH and insulin in equine plasma by solid-phase extraction and micro-flow LC/MSMS.
Drug testing and analysis    July 8, 2024   Volume 17, Issue 5 589-600 doi: 10.1002/dta.3762
Steel R, Timms M, Bamford N, Spence R, Sillence M.Previous liquid chromatography/mass spectrometry (LC/MS) methods for the detection of insulin and other similar peptide hormones in equine plasma relied on the use of antibody affinity extraction. As a result, these methods were not suitable for routine high-throughput analysis. A solid-phase extraction (SPE) method incorporating size exclusion as well as reversed-phase interactions allows the selective extraction of peptide hormones such as adrenocorticotropic hormone (ACTH), insulin and their synthetic analogues from equine plasma with approximately 80% extraction efficiencies. This extracti...
Evaluating insulindysregulation in horses: A two-step insulin-tolerance test using porcine zinc insulin.
Veterinary journal (London, England : 1997)    June 21, 2024   Volume 306 106172 doi: 10.1016/j.tvjl.2024.106172
Grob AJ, Delarocque J, Feige K, Warnken T.In insulin dysregulation, hyperinsulinemia (HI) can be accompanied by peripheral insulin resistance (IR) in horses, which can be diagnosed with an insulin-tolerance test (ITT). The administration of 0.1 IU/kg body weight of recombinant regular human insulin (RHI) should elicit a 50 % reduction of the initial blood glucose concentration at 30 min after insulin administration in insulin sensitive horses. Compared to RHI, porcine zinc insulin (PZI) is veterinary-approved and therefore easier accessible for many practitioners. The aim of this study was to compare the insulin and glucose dynami...
Adiposity in mares induces insulin dysregulation and mitochondrial dysfunction which can be mitigated by nutritional intervention.
Scientific reports    June 18, 2024   Volume 14, Issue 1 13992 doi: 10.1038/s41598-024-64628-x
Fresa K, Catandi GD, Whitcomb L, Gonzalez-Castro RA, Chicco AJ, Carnevale EM.Obesity is a complex disease associated with augmented risk of metabolic disorder development and cellular dysfunction in various species. The goal of the present study was to investigate the impacts of obesity on the metabolic health of old mares as well as test the ability of diet supplementation with either a complex blend of nutrients designed to improve equine metabolism and gastrointestinal health or L-carnitine alone to mitigate negative effects of obesity. Mares (n = 19, 17.9 ± 3.7 years) were placed into one of three group: normal-weight (NW, n = 6), obese (OB, n = 7...
Diagnosis of equine endocrine disease special issue.
Veterinary journal (London, England : 1997)    June 14, 2024   Volume 306 106177 doi: 10.1016/j.tvjl.2024.106177
McGowan C, Ireland J, Carslake H.No abstract available
Sex hormone binding globulin (SHBG) modulates mitochondrial dynamics in PPARγ-depleted equine adipose derived stromal cells.
Journal of molecular medicine (Berlin, Germany)    June 14, 2024   Volume 102, Issue 8 1015-1036 doi: 10.1007/s00109-024-02459-z
Marycz K, Wiatrak B, Irwin-Houston JM, Marcinkowska K, Mularczyk M, Bourebaba L.Peroxisome proliferator-activated receptor gamma (PPARγ) is a transcription factor that promotes adipogenesis, lipid uptake and storage, insulin sensitivity, and glucose metabolism. Hence, defects in PPARγ have been associated to the development of metabolic disorders. Sex hormone-binding globulin (SHBG) is a glycoprotein primarily produced in the liver that regulates the bioavailability of sex hormones. Alike PPARγ, low SHBG levels have been correlated with insulin resistance and associated endocrine abnormalities. Therefore, this study aimed to verify whether SHBG may restore depleted PPA...
Obesity and gestation in Criollo mares: endocrine and metabolic profiles.
Domestic animal endocrinology    May 28, 2024   Volume 89 106857 doi: 10.1016/j.domaniend.2024.106857
Pardié M, Kalpokas I, Freccero F, Castagnetti C, Meikle A.The aim of this study was to determine the effect of body condition score (BCS) on metabolic and endocrine parameters in pregnant Criollo mares (n=41), which were categorized according to their BCS as obese (7 to 9 BCS, n=26) or normal (5 to 7, n=15). Blood samples were taken during gestation in 3 periods: between 3.5 and 5 months (I), 8 and 9 months (II) and in the last month of gestation (III). The data was analyzed in the statistical model by mixed procedures, including BCS, gestational period and their interaction as fixed effects. BCS was only different in period I, as normal mares increa...
Effects of different winter paddock management of Thoroughbred weanlings and yearlings in the cold region of Japan on physiological function, endocrine function and growth.
The Journal of veterinary medical science    May 23, 2024   doi: 10.1292/jvms.24-0083
Ishimaru M, Tsuchiya T, Endo Y, Matsui A, Ohmura H, Murase H, Korosue K, Sato F, Taya K.Effects of different winter paddock management of Thoroughbred weanlings and yearlings in Hokkaido, Japan, which is extremely cold in winter, on physiological function, endocrine function and growth were investigated. They were divided into two groups; those kept outdoors for 22 hr in the paddock (22hr group) and those kept outdoors for 7 hr in daytime with walking exercise for 1 hr using the horse-walker (7hr +W group), and the changes in daily distance travelled, body temperature (BT), heart rate (HR), HR variability (HRV), endocrine function and growth parameters were compared between the t...
Systemic absorption of triamcinolone acetonide is increased from intrasynovial versus extrasynovial sites and induces hyperglycemia, hyperinsulinemia, and suppression of the hypothalamic-pituitary-adrenal axis.
Frontiers in veterinary science    May 15, 2024   Volume 11 1388470 doi: 10.3389/fvets.2024.1388470
Hallowell KL, Dembek K, Horne CR, Knych HK, Messenger KM, Schnabel LV.Steroid-associated laminitis remains a major concern with use of corticosteroids in horses. Individual case factors such as joint pathology, pre-existing endocrinopathies, or corticosteroid type, dose, and timing influencing steroid-induced laminitis risk have not been investigated. This study aimed to determine if systemic absorption of triamcinolone acetonide (TA) varies between intrasynovial (antebrachiocarpal) and extrasynovial (sacroiliac) injection sites, and to determine the effects of TA absorption on glucose, insulin, cortisol, and adrenocorticotropic hormone (ACTH). Twenty adult hors...
Effect of pregnancy on isolation efficiency and in vitro proliferation of equine peripheral-blood derived mesenchymal stromal cells.
Theriogenology    May 14, 2024   Volume 224 107-118 doi: 10.1016/j.theriogenology.2024.05.015
Mattei DN, Harman RM, Van de Walle GR, Smith R, Grivel JC, Abdelalim EM, Vinardell T.Mesenchymal stromal cells (MSCs) have regenerative and immunomodulatory potential and may be used to treat injured tissues. Pregnancy has been associated with increased MSCs in the peripheral circulation in multiple species, but to date, there are no reports on this matter in horses. This study aimed to evaluate the effect of pregnancy on isolation efficiency and proliferation capacity of equine MSCs derived from the peripheral blood (PB) of mares. Venous blood samples were collected at the 11th month of gestation and 1 month after delivery from clinically healthy Arabian mares that presented ...
Arthrospira platensis enriched with Cr(III), Mg(II), and Mn(II) ions improves insulin sensitivity and reduces systemic inflammation in equine metabolic affected horses.
Frontiers in endocrinology    April 16, 2024   Volume 15 1382844 doi: 10.3389/fendo.2024.1382844
Tomal A, Szłapka-Kosarzewska J, Mironiuk M, Michalak I, Marycz K.Equine metabolic syndrome (EMS) is a critical endocrine condition in horses, characterized by hyperinsulinemia, hyperlipidemia, and insulin resistance, posing a significant threat to their health. This study investigates the efficacy of supplementing EMS-affected horses with Arthrospira platensis enriched with Cr(III), Mg(II), and Mn(II) ions using biosorption process in improving insulin sensitivity and glucose tolerance, reducing inflammation, and mitigating obesity-related fat accumulation. Our results demonstrate that Arthrospira supplementation reduces baseline insulin and glucose levels,...