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Equine veterinary journal2013; 46(1); 103-112; doi: 10.1111/evj.12169

Insulin dysregulation.

Abstract: Abnormalities of insulin metabolism include hyperinsulinaemia and insulin resistance, and these problems are collectively referred to as insulin dysregulation in this review. Insulin dysregulation is a key component of equine metabolic syndrome: a collection of endocrine and metabolic abnormalities associated with the development of laminitis in horses, ponies and donkeys. Insulin dysregulation can also accompany prematurity and systemic illness in foals. Causes of insulin resistance are discussed, including pathological conditions of obesity, systemic inflammation and pituitary pars intermedia dysfunction, as well as the physiological responses to stress and pregnancy. Most of the discussion of insulin dysregulation to date has focused on insulin resistance, but there is increasing interest in hyperinsulinaemia itself and insulin responses to feeding. An oral sugar test or in-feed oral glucose tolerance test can be performed to assess insulin responses to dietary carbohydrates, and these tests are now recommended for use in clinical practice. Incretin hormones are likely to play an important role in postprandial hyperinsulinaemia and are the subject of current research. Insulin resistance exacerbates hyperinsulinaemia, and insulin sensitivity can be measured by performing a combined glucose-insulin test or i.v. insulin tolerance test. In both of these tests, exogenous insulin is administered and the rate of glucose uptake into tissues measured. Diagnosis and management of hyperinsulinaemia is recommended to reduce the risk of laminitis. The term insulin dysregulation is introduced here to refer collectively to excessive insulin responses to sugars, fasting hyperinsulinaemia and insulin resistance, which are all components of equine metabolic syndrome.
© 2013 EVJ Ltd.
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Publication Date: 2013-11-18 PubMed ID: 24033478DOI: 10.1111/evj.12169Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article explores the phenomenon of insulin dysregulation, its causes, and implications, primarily focusing on its role as a significant factor in equine metabolic syndrome which leads to laminitis in horses, ponies and donkeys. It touches upon diagnostic measures and discusses possible mitigation strategies for the condition.

Insulin Dysregulation: Definition and Implications

  • Insulin dysregulation refers to metabolic irregularities typified by boosted insulin levels, medically termed hyperinsulinaemia, and insulin resistance. They contribute significantly towards equine metabolic syndrome, a cluster of endocrine and metabolic irregularities leading to laminitis in equine animals.
  • Laminitis is a painful and potentially crippling disease affecting horses, ponies, and donkeys, causing the tissues connecting the hoof wall to the pedal bone to inflame.
  • In addition, insulin dysregulation may also occur in foals due to prematurity or systemic illness.

Causes of Insulin Resistance

  • The paper discusses various causes of insulin resistance, including obesity-related pathology, systemic inflammation, and pituitary pars intermedia dysfunction, effectively an endocrine disorder in horses resulting in the abnormal growth of pituitary gland tissue.
  • It also outlines physiological responses causing insulin dysregulation, such as stress and pregnancy.

Diagnosis and Measurement of Insulin Dysregulation

  • Though most research so far has focused on insulin resistance, growing interest is shown in hyperinsulinaemia itself and how insulin responds to feeding.
  • To assess insulin responses to dietary carbohydrates, either an oral sugar test or in-feed oral glucose tolerance test can be administered. These tests are now recommended for use in routine clinical practice.
  • Incretin hormones, which are released from the gut after meals and stimulate insulin secretion, are also identified as likely contributors to postprandial hyperinsulinaemia and are currently being researched.
  • Insulin resistance can further increase hyperinsulinaemia. Insulin sensitivity, a measure of insulin resistance, can be gauged by a combined glucose-insulin test or intravenous insulin tolerance test, where insulin is externally administered and glucose uptake rate into tissues can be measured.

Management of Hyperinsulinaemia

  • Hyperinsulinaemia’s diagnosis and management are advised to decrease laminitis risk.
  • The term ‘insulin dysregulation’ is thus an umbrella term, denoting excessive insulin reactions to sugars, fasting hyperinsulinaemia and insulin resistance – all equine metabolic syndrome components.

Cite This Article

APA
Frank N, Tadros EM. (2013). Insulin dysregulation. Equine Vet J, 46(1), 103-112. https://doi.org/10.1111/evj.12169

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 46
Issue: 1
Pages: 103-112

Researcher Affiliations

Frank, N
  • Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, Massachusetts, USA; Division of Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Leicestershire, UK.
Tadros, E M

    MeSH Terms

    • Animals
    • Horse Diseases / metabolism
    • Horses
    • Hyperinsulinism / veterinary
    • Insulin / metabolism
    • Insulin Resistance / physiology

    Citations

    This article has been cited 65 times.
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