The sodium-glucose co-transporter 2 inhibitor velagliflozin reduces hyperinsulinemia and prevents laminitis in insulin-dysregulated ponies.
Authors: Meier, Reiche, de Laat, Pollitt, Walsh, Sillence
Journal: PloS one
Summary
# Editorial Summary: Velagliflozin for Insulin Dysregulation in Ponies With no licensed veterinary treatments currently available for insulin dysregulation and laminitis prevention, this 2019 study investigated velagliflozin—a sodium-glucose co-transporter 2 inhibitor that lowers blood glucose by increasing urinary glucose excretion—as a potential therapeutic option. Researchers screened 75 ponies using oral glucose tolerance testing and selected 49 with the highest insulin responses; 12 received velagliflozin (0.3 mg/kg once daily) whilst 37 controls received no treatment, with all animals fed a high non-structural carbohydrate challenge diet (12 g NSC/kg bodyweight daily) for up to 18 days to induce insulin dysregulation. The treated group demonstrated a 22% reduction in peak glucose concentrations (9.4 versus 12.1 mM) and a substantially lower 45% reduction in peak insulin levels (149 versus 272 μIU/mL) compared to controls measured over 4 hours post-feeding. Crucially, whilst 38% of untreated ponies developed Obel grade 1–2 laminitis, zero cases occurred in the velagliflozin group, with the drug proving well-tolerated and free from hypoglycaemic episodes or adverse effects. For equine professionals managing insulin-dysregulated animals, these findings suggest velagliflozin warrants further investigation as a pharmaceutical tool for blunting the hyperinsulinaemic response to dietary challenges, though larger-scale trials are needed before clinical recommendations can be established.
Read the full abstract on PubMed
Practical Takeaways
- •Velagliflozin offers a promising pharmacological option for preventing laminitis in insulin-dysregulated horses and ponies by significantly reducing hyperinsulinemia
- •This treatment could be particularly valuable for high-risk animals during spring/summer when pasture NSC content is elevated, or for those on concentrate-based diets
- •Safe medication profile with no observed adverse effects means it could be incorporated into laminitis prevention protocols alongside dietary management and exercise
Key Findings
- •Velagliflozin reduced maximum glucose concentration by 22% (9.4 vs 12.1 mM, P=0.014) in insulin-dysregulated ponies
- •Maximum insulin concentrations were 45% lower in treated animals (149 vs 272 µIU/mL, P=0.017)
- •Laminitis developed in 38% of controls (14/37) but 0% of velagliflozin-treated ponies (P=0.011)
- •Velagliflozin was well-tolerated with no hypoglycemia or clinical adverse effects observed