Assessment of Insulin and Glucose Dynamics by Using an Oral Sugar Test in Horses

Schuver, Amy; Frank, Nicholas; Chameroy, Kelly A.; Elliott, Sarah B.

doi:10.1016/j.jevs.2013.09.006

Cited by 106 publications

(130 citation statements)

References 19 publications

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“…These findings indicate poor repeatability and are consistent with the high CV (45% for AUC Insulin ) reported previously [2].…”

Section: Accepted Articlesupporting

confidence: 91%

“…Baseline blood samples were taken (T 0 ) and corn syrup c (0.15 ml/kg) was administered orally using a dosing syringe [2]. Further blood samples were collected at 30, 60, 75, 90 and 120 (T 30 -120 ) minutes after oral dosing.…”

Section: Oral Sugar Testsmentioning

confidence: 99%

“…An oral sugar test (OST) is recommended for the identification of insulin dysregulation (ID) in horses at risk of laminitis [1,2]. Clinicians are advised to perform the OST in the morning after an overnight fast and to interpret insulin concentrations in one [1,3] or two [4] blood samples taken 60-90 minutes after administering oral corn sugar.…”

Section: Introductionmentioning

confidence: 99%

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Use of the oral sugar test in ponies when performed with or without prior fasting

Knowles

Harris²,

Elliott

et al. 2016

Equine Veterinary Journal

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Summary Background It is recommended that the oral sugar test (OST) for insulin dysregulation (ID) be performed after an overnight fast, but fasting is impractical in ponies kept solely at pasture. There are few data on OST repeatability and reliability in ponies. Objectives To report 1) whether OST results obtained in the morning after an overnight fast or without fasting in the afternoon (FASTING/FED) can be used interchangeably, 2) time of highest insulin concentration Tmax[insulin], repeatability and reliability of insulin response to the OST when FASTING or FED and 3) dichotomous agreement (ID/normal) within a small sample when FASTING or FED. Study design Method comparison study. Methods Oral sugar tests were performed on four occasions in 10 adult native British ponies, twice FASTING and twice FED. Insulin concentrations were measured by radioimmunoassay at 0–120 min (T0,30,60,75,90,120). Differences between FASTING and FED results were assessed using mixed effects models. Indices of repeatability and reliability were calculated; dichotomous agreement was reported using kappa statistics. Results Serum [insulin] was significantly (P≤0.05) higher at T60–T90 with prior fasting (estimated differences [95% confidence intervals]): T60: 23.5 μiu/ml (8.7–38.4 μiu/ml), T75: 27.1 μiu/ml (12.3–41.8 μiu/ml), T90: 15.1 (0.36–29.9 μiu/ml). Most frequently, Tmax[ins] occurred at T30. At any single time point, within‐subject coefficients of variation were: FASTING: 40% and FED: 31%. The 95% limits for repeatability were FASTING: 29–340%, FED: 41–240%. Test reliabilities were FASTING: 0.70 and FED: 0.67. For dichotomous interpretation similar results (kappa = 0.7) were obtained using cut‐offs of [Insulin] >60 μiu/ml at T60 or T90 for FASTING and [Insulin] >51 μiu/ml at T30 or T60 for FED samples. Main limitations Oral sugar tests were performed on a small number of animals on one pasture during one season (spring). Conclusions Clinicians should beware of interpreting changes in absolute OST results owing to poor repeatability. When stabling is unavailable, OSTs of ponies at pasture may yield similar dichotomous results without prior fasting.

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“…These findings indicate poor repeatability and are consistent with the high CV (45% for AUC Insulin ) reported previously [2].…”

Section: Accepted Articlesupporting

confidence: 91%

Section: Oral Sugar Testsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of the oral sugar test in ponies when performed with or without prior fasting

Knowles

Harris²,

Elliott

et al. 2016

Equine Veterinary Journal

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“…Hierbei erhalten die Pferde 1g/kg Glukose als 10%ige Lösung über die Nasenschlundsonde (Pratt-Phillips et al 2015). Alternativ kann der Test auch mit der oralen Gabe von Maissirup durchgeführt werden (Schuver et al 2014). Für einen Zeitraum von vier Stunden werden zunächst alle 15 und später alle 30 Minuten Blutproben zur Glukosebestimmung gewonnen.…”

Section: Materials Und Methodenunclassified

“…Die Werte dieses Tests werden jedoch von der Magenentleerung und der Glukoseabsorption beeinflusst (Kronfeld et al 2005). So berichten einige Autoren von einer guten Korrelation des OGTT mit intravenösen Glukosetests, andere Autoren beschreiben jedoch starke Schwankungen der Insulinantwort (Pratt-Phillips et al 2015;Schuver et al 2014).…”

Section: Materials Und Methodenunclassified

Oral supplementation of magnesium aspartate hydrochloride in horses with Equine Metabolic Syndrome

Winter¹,

Liertz²,

Merle³

et al. 2016

PHK

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Diabetes mellitus type 2 is a worldwide problem in human medicine as is the equine equivalent "Equine Metabolic Syndrome" (EMS). In humans, an inverse relationship between serum magnesium content and the incidence of diabetes mellitus type II has been shown. Humans with peripheral insulin resistance often show cellular magnesium deficits and multiple studies have demonstrated the beneficial effect of dietary magnesium supplementation on insulin sensitivity. One study has evaluated the effects of magnesium supplementation on insulin sensitivity in laminitic horses and could not find differences. In this previous study, a different magnesium formulation (magnesium oxide) and dosage had been used. The purpose of this study was to evaluate the effects of an oral supplementation with magnesium aspartate hydrochloride in horses with Equine Metabolic Syndrome. The study was performed on five horses (four mares and one gelding) of different breeds, aged seven to 26 years with Equine Metabolic Syndrome based on the results of a CGIT (Combined Glucose Insulin Tolerance Test). In these horses body weight, Body Condition Score (BCS) and Cresty Neck Score (CNS) were assessed. The following blood parameters were measured in the serum: magnesium (Mg 2+ ), ACTH, fructosamine, reciprocal inverse square of insulin (RISQI) and modified insulin to glucose ratio (MIRG). Gamma-glutamyltransferase (GGT) and triglyzerides (TG) were measured in EDTA blood samples. All horses were supplemented with 30 mg/kg BW magnesium as magnesium aspartate hydrochloride for a time period of three month. Afterwards all blood parameters and the CGIT were repeated. A Wilcoxon signed rank test was used for non-normally distributed data. Statistical significance was set at 95 %. All horses had increased BCS and CNS ). The magnesium content in the serum, ACTH, GGT, TG and MIRG before supplementation were within the reference ranges in all horses. The fructosamine content was increased in horses one, four and five. RISQI was decreased in horse five. During the magnesium supplementation, no adverse effects were observed. There were no significant changes in body weight, BCS and CNS. There were also no significant changes regarding serum magnesium concentration, ACTH, RISQI and MIRG or GGT and TG. There was a tendency for decreased fructosamine concentration, which was also not statistically significant. In three of five horses the CGIT after magnesium supplementation was negative. These horses reached their glucose baseline levels after at least 45 minutes, while insulin (baseline and after 45 minutes) was within the reference ranges. The remaining two horses did not show significant differences compared to the beginning of the trial. It is concluded that the supplementation of magnesium aspartate hydrochloride in horses with Equine Metabolic Syndrome can have positive effects on the insulin sensitivity. Further examinations with more horses are necessary.

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Laboratory Testing for Endocrine and Metabolic Disorders

Frank

2017

Interpretation of Equine Laboratory Diagnostics

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Assessment of Insulin and Glucose Dynamics by Using an Oral Sugar Test in Horses

Cited by 106 publications

References 19 publications

Use of the oral sugar test in ponies when performed with or without prior fasting

Use of the oral sugar test in ponies when performed with or without prior fasting

Oral supplementation of magnesium aspartate hydrochloride in horses with Equine Metabolic Syndrome

Laboratory Testing for Endocrine and Metabolic Disorders

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