Relationship Between β‐cell Response and Insulin Sensitivity in Horses based on the Oral Sugar Test and the Euglycemic Hyperinsulinemic Clamp

Lindåse, Sanna; Nostell, Katarina; Söder, Josefin; Bröjer, Johan

doi:10.1111/jvim.14799

Cited by 14 publications

(19 citation statements)

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“…This was consistent for the entire cohort, and for the subset of animals diagnosed with PPID. However, plasma ACTH concentration (pg/mL) was only significantly different (P = .01) between autumn (26 [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]) and spring (15 [10][11][12][13][14][15][16][17][18][19][20][21]) in horses without PPID ( Figure 3B). In autumn, the ACTH concentration was found to be higher (P = .005) in ponies (93 pg/mL) than horses 30.9 [22.8-37.6] pg/mL).…”

Section: Adrenocorticotrophic Hormonementioning

confidence: 99%

“…Hyperinsulinemia can be transient and occur in response to carbohydrate consumption, or it can be persistent, as indicated by basal (resting) hyperinsulinemia, which might result from, or induce, tissue resistance to insulin . Resting hyperinsulinemia, insulin resistance, and abnormal insulin responses to oral carbohydrate can all occur in an insulin‐dysregulated horse or pony (alone or in combination), and any uncontrolled hyperinsulinemia increases an individual's risk of laminitis …”

Section: Introductionmentioning

confidence: 99%

“…15,16 Resting hyperinsulinemia, insulin resistance, and abnormal insulin responses to oral carbohydrate can all occur in an insulin-dysregulated horse or pony (alone or in combination), and any uncontrolled hyperinsulinemia increases an individual's risk of laminitis. 9,17 Given the number of potential underlying causative factors, or combinations thereof, it is important to gain an increased understanding of the complex interplay among these contributing factors in endocrinopathic laminitis. These data would then aid in the understanding, diagnosis, and management of what is currently a challenging condition for practitioners to treat and prevent.…”

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confidence: 99%

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Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis

Laat

Sillence

Reiche

2019

Veterinary Internal Medicne

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Background Equine endocrinopathic laminitis is common and can be associated with an underlying endocrinopathy, such as equine metabolic syndrome (EMS), pituitary pars intermedia dysfunction (PPID), pasture consumption, or any combination of these factors. Objectives The aim of the study was to improve the risk assessment capabilities of clinicians, and to inform management strategies, for acute endocrinopathic laminitis by prospectively examining the phenotypic, hormonal, and clinical characteristics of the disease in a large cohort. Animals Privately owned horses and ponies (n = 301) of any age, sex, or breed diagnosed with laminitis by a veterinarian. A history of laminitis was acceptable. Methods This was a prospective cohort study. Veterinarians provided information on each case via an online questionnaire after informed consent from the animal's owner, and all data were de‐identified before analysis. Serum insulin and plasma adrenocorticotrophic hormone concentrations were measured in each case. Results Most cases were recruited in spring (109/301; 36.2%). Concurrent EMS and PPID resulted in higher basal insulin concentrations (49 [21.5‐141]; P < .02) than if an animal had a single underlying cause for their laminitis. The insulin concentration was negatively correlated (r 2 = −0.38; P < .001) with the animal's height, being higher in ponies (33[10‐14]; P < .001) than horses (9.5 [3‐25.7]) and was positively correlated (r 2 = 0.12; P = .05) with their grade (severity) of laminitis. Conclusions and Clinical Importance Horses and ponies with concurrent endocrinopathies have more marked hyperinsulinemia. Higher basal insulin concentrations were associated with more severe lameness.

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Section: Adrenocorticotrophic Hormonementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis

Laat

Sillence

Reiche

2019

Veterinary Internal Medicne

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“…The OGTT can also be used to assess the b-cell response in both humans and horses [5,7]. The different types of oral glucose tolerance tests in horses (OGTT and oral sugar test; OST) have shown low repeatability for indices of b-cell response [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Repeatability of the hyperglycaemic clamp for assessment of β‐cell response and insulin sensitivity in horses

Lindåse

Johansson

Månsby

et al. 2019

Equine Veterinary Journal

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Summary Background The hyperglycaemic clamp has been used for measurement of insulin sensitivity (IS) but not for measurement of β‐cell response in the horse. However, the repeatability of this test has not been reported for horses. Objectives To determine the repeatability and reliability of measures for IS and β‐cell response to glucose using the hyperglycaemic clamp in horses. Study design Repeated measures, longitudinal study. Methods Six healthy Standardbred mares underwent a 120‐min hyperglycaemic clamp on two occasions with a 10‐day washout period. Indices of repeatability and reliability were calculated from measures of IS and β‐cell response to glucose derived from each hyperglycaemic clamp. Results Measures of β‐cell response to glucose, including area under the insulin response curve in the time interval 0–120 min and during steady state (60–120 min), as well as the mean insulin concentration during steady state had coefficient of variations (CV) of 9.5, 10.5 and 9.3 respectively and intraclass correlation coefficients (ICC) of 0.93, 0.93 and 0.95 respectively. The measure of glucose disposal (M) had lower CV (12.4) and ICC (0.71) compared to measure of IS (M/I‐index; CV of 17.4 and ICC of 0.89). Main limitations The study was conducted in a small number of horses. Conclusions The hyperglycaemic clamp is a diagnostic method for assessing β‐cell response to intravenous glucose with high repeatability and reliability. Insulin sensitivity can be determined with the same test but the repeatability for these measurements is lower compared to the measurements for β‐cell response.

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“…Monitoring glucose homeostasis both in people and horses is increasingly important in terms of management of critical patients (systemic inflammatory response syndrome, sepsis, hyperlipaemia), patients receiving parenteral nutrition and patients investigated for diabetes or insulin dysregulation (ID) 1–9. Conventional methods of monitoring blood glucose including point-of-care glucometers (POCs) and enzymatic ultraviolet tests are routinely used in diagnostic settings.…”

Section: Introductionmentioning

confidence: 99%

Comparison of a continuous indwelling glucometer with a point‐of‐care device in healthy adult horses

et al. 2020

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BackgroundBlood glucose is tightly regulated in horses; however, since hypoglycaemia and hyperglycaemia are associated with poor prognosis, close monitoring is warranted. This study aimed at evaluating a continuous indwelling glucometer (CIG) by comparing performance with a point-of-care glucometer (POC).MethodsTen horses were equipped with CIG and an intravenous catheter. Interstitial glucose concentrations were determined by CIG every 5 min at rest, during insulin-induced hypoglycaemia and dextrose-induced hyperglycaemia, and compared with blood glucose determined by POC. Glucose concentrations were compared by two-way repeated measures analysis of variance and weighted kappa with Bland-Altman plots to determine agreement between assays.ResultsHorses tolerated CIG well; however, five devices had to be replaced. There were no statistically significant differences between assays at rest or during hyperglycaemia; however, during hypoglycaemia, glucose concentrations determined by CIG were significantly higher (P=0.01). The mean bias (95% limits of agreement) between assays ranged from −0.03 (−2.46 to 2.52) mmol/l (hyperglycaemia) to 0.97 (−1.23 to 3.16) mmol/l (hypoglycaemia). Assay agreement was ‘good’ with observed agreements of 87.04% (κ=0.67).Conclusions of the studyCIG has acceptable accuracy in horses as compared with POC but overestimates glucose concentrations during hypoglycaemia and requires frequent replacement, limiting its clinical application.

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Relationship Between β‐cell Response and Insulin Sensitivity in Horses based on the Oral Sugar Test and the Euglycemic Hyperinsulinemic Clamp

Cited by 14 publications

References 61 publications

Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis

Phenotypic, hormonal, and clinical characteristics of equine endocrinopathic laminitis

Repeatability of the hyperglycaemic clamp for assessment of β‐cell response and insulin sensitivity in horses

Comparison of a continuous indwelling glucometer with a point‐of‐care device in healthy adult horses

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