BackgroundAn oral sugar test (OST) using Karo® Light Corn Syrup has been developed in the USA as a field test for the assessment of insulin dysregulation in horses but the syrup is not available in Scandinavian grocery stores. The aim of the study was to compare the results of a modified OST between horses with equine metabolic syndrome (EMS) and healthy horses using a Scandinavian commercially available glucose syrup (Dansukker glykossirap). In addition, the effect of breed and the repeatability of the test were evaluated. In the present study, clinically healthy horses (7 Shetland ponies, 8 Icelandic horses, 8 Standardbred horses) and 20 horses of various breeds with EMS underwent the modified OST test. The Icelandic horses and Shetland ponies underwent the OST twice. Insulin and glucose data from the OST were used to calculate peak insulin concentration (PeakINS), time to peak insulin concentration (T-peakINS), area under the curve for insulin (AUCINS) and glucose (AUCGLU) as well as whole body insulin sensitivity index (ISICOMP).ResultsCompared to the healthy group, the EMS group had 6–7 times higher geometric mean for PeakINS and AUCINS and 8 times lower geometric mean for ISICOMP. The EMS group had a delayed T-peakINS compared to the healthy group. There was no effect of breed in the group of healthy horses on PeakINS, T-peakINS, AUCINS, AUCGLU and ISICOMP. Coefficient of variation for repeated tests was 19.8, 19.0 and 17.6 % for PeakINS, AUCINS and ISICOMP respectively.ConclusionsThe results of the present study demonstrate that the modified OST appears to be a practical and useful diagnostic tool for assessment of insulin dysregulation in the horse. However, to make it possible to establish the most appropriate sampling interval and to evaluate the accuracy of the modified OST, further studies in horses with a variable degree of insulin resistance are needed, where results from the modified OST are compared with quantitative measurements for IS.

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Background: The increasing number of horses diagnosed with insulin resistance (IR) and the suggested link between IR and laminitis has highlighted the need to accurately diagnose IR in clinical practice.Hypothesis/Objectives: The aim of the study was to evaluate the repeatability of the combined glucose-insulin tolerance test (CGIT) as well as to determine the effect of 2 different breeds and the effect of a stressor on the test results.Animals: Clinically normal horses, 9 Standardbred horses and 9 Icelandic horses. Methods: Prospective clinical nonrandomized trial. The CGIT was performed on all horses on 2 occasions 3 weeks apart. An additional CGIT was performed on four of the Standardbred and four of the Icelandic horses after transportation to a new environment (stressor) the day before testing.Results: Calculated parameters for the glucose curve of the CGIT had low repeatability, whereas the parameters for the insulin curve had high repeatability. There was an effect of breed (Standarbred versus Icelandic horse) as well as stress on the glucose dynamics, but not on the insulin dynamics of the CGIT.Conclusion and Clinical Importance: Repeatability of the glucose dynamics of the CGIT is low. In addition, there appears to be breed differences in the glucose dynamics. It is therefore suggested that diagnosis of IR should not be made solely based on results from the glucose curve of the CGIT.

BackgroundA hyperbolic relationship between β‐cell response and insulin sensitivity (IS) has been described in several species including rodents, dogs, and humans. This relationship has not been elucidated in the horse.Hypothesis/ObjectivesTo determine whether the hyperbolic relationship between β‐cell response and IS exists in horses by using indices of β‐cell response from the oral sugar test (OST) and IS measurements from the euglycemic hyperinsulinemic clamp (EHC). A second aim was to compare how well IS estimates from the OST and EHC correlate.AnimalsForty‐nine horses with different degrees of insulin regulation (normal‐to‐severe insulin dysregulation).MethodsCross‐sectional study. Horses were examined with an OST and an EHC.ResultsDecreased IS was associated with increased β‐cell response in the horses. Nine of 12 comparisons between indices of β‐cell response and IS measures fulfilled the criteria for a hyperbolic relationship. Indices of IS calculated from the OST correlated highly with the insulin‐dependent glucose disposal rate (M) and the insulin‐dependent glucose disposal rate per unit of insulin (M/I) determined from the EHC (r = 0.81–0.87).Conclusions and Clinical ImportanceA hyperbolic relationship between β‐cell response and IS exists in horses, which suggest that horses with insulin dysregulation respond not only with postprandial hyperinsulinemia but are also insulin resistant. The OST is primarily a test for β‐cell response rather than a test for IS, but calculated indices of IS from the OST may be useful to estimate IS in horses, especially when the horse is insulin resistant.

Findings indicated that dietary composition played a more important role than did short-term weight gain on alterations in insulin sensitivity of horses.