The diagnosis of equine insulin dysregulation.
Authors: Bertin F R, de Laat M A
Journal: Equine veterinary journal
Summary
# Editorial Summary: The diagnosis of equine insulin dysregulation Insulin dysregulation sits at the heart of equine metabolic syndrome and represents a critical risk factor for laminitis, yet early identification of susceptible horses remains challenging in clinical practice. Bertin and de Laat's 2017 review examines the full spectrum of diagnostic approaches currently available, moving beyond the conventional focus on tissue insulin resistance to highlight the emerging importance of the enteroinsular axis—the gut's role in regulating insulin secretion and the hyperinsulinaemia commonly observed in affected horses. The authors detail both the strengths and limitations of available tests, emphasising that diagnosis should incorporate assessment of both tissue-level insulin sensitivity and enteroinsular function to maximise detection of at-risk individuals. Critically, they identify numerous confounding variables—including breed, diet, fasting status and season—that can significantly alter test results, necessitating careful contextual interpretation rather than reliance on reference ranges alone. For practitioners seeking to prevent laminitis through early intervention, this review underscores the need for a multifaceted diagnostic approach tailored to individual circumstances, rather than any single test performed in isolation.
Read the full abstract on PubMed
Practical Takeaways
- •Diagnosis of insulin dysregulation should investigate both tissue insulin resistance and enteroinsular axis function rather than relying on single tests
- •Account for breed, diet, fasting status, and seasonal variations when interpreting insulin dysregulation test results to avoid false negatives in at-risk horses
- •Focus on identifying horses with insulin dysregulation early to enable preventive laminitis management, as established laminitis remains difficult to treat effectively
Key Findings
- •Insulin dysregulation encompasses both tissue insulin resistance and dysfunction of the enteroinsular axis in horses
- •The equine enteroinsular axis plays a major role in insulin secretion and hyperinsulinaemia development
- •Multiple factors including breed, diet, fasting state, and season significantly influence diagnostic test results and must be considered during interpretation
- •Early detection of insulin dysregulation is critical for laminitis prophylaxis as treatment options for established laminitis remain inadequate