Practical management of insulin dysregulation and hyperinsulinaemia-associated laminitis
Authors: Sundra Tania, Rossi Gabriele, Rendle David, Lester Guy
Summary
# Editorial Summary: Managing Insulin Dysregulation and Hyperinsulinaemia-Associated Laminitis Hyperinsulinaemia represents a major contributor to laminitis in horses with equine metabolic syndrome, yet many practitioners lack clarity on diagnosis and intervention protocols. This review synthesises current evidence on identifying insulin dysregulation through various diagnostic approaches and outlines both established and emerging management strategies to prevent the progression to clinical laminitis. The authors examine practical diagnostics—likely including resting insulin concentrations, dynamic testing protocols, and assessment of insulin sensitivity markers—alongside conventional interventions such as dietary modification, exercise and weight management, whilst also considering newer therapeutic options that have become available to the profession. Rather than treating laminitis reactively once hyperinsulinaemia has caused lamellar damage, early identification and aggressive management of underlying insulin dysregulation offers the potential to halt disease progression and significantly improve clinical outcomes. For farriers, veterinarians, physiotherapists and nutritionists working with at-risk populations—particularly middle-aged and older horses with regional adiposity—this review provides the framework for coordinated, evidence-based management that prioritises metabolic stability before lameness develops.
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Practical Takeaways
- •Screening for insulin dysregulation should be a priority in horses at risk of metabolic syndrome to prevent laminitis development
- •Practitioners now have access to improved diagnostic tools and management options beyond traditional approaches for hyperinsulinemic horses
- •Early intervention in insulin dysregulation cases can significantly reduce laminitis morbidity and mortality in your practice
Key Findings
- •Hyperinsulinemia is a significant cause of morbidity and mortality in horses with equine metabolic syndrome
- •Early diagnosis and management of insulin dysregulation are critical to prevent hyperinsulinemia-associated laminitis
- •Multiple diagnostic approaches and management strategies are available for clinical application in primary care settings