The repeatability of an oral glucose test in ponies

Laat, Melody A. de; Sillence, Martin N.

doi:10.1111/evj.12579

Cited by 41 publications

(64 citation statements)

References 20 publications

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“…A limitation of our study was the absence of dynamic testing to more fully assess the endocrine status of each horse during the episode of SIRS. Although EMS and PPID are well‐described, dynamic tests such as the oral glucose test, the 2‐step insulin response test and the thyrotropin‐releasing hormone stimulation test would have been required before or after the period of illness to completely eliminate subclinical EMS or PPID . Because our study involved spontaneous disease in client‐owned animals in which survivors were discharged after recovery, it was impossible to perform dynamic testing before or after the onset of SIRS.…”

Section: Discussionmentioning

confidence: 99%

Insulin dysregulation in horses with systemic inflammatory response syndrome

Bertin

Ruffin-Taylor

Stewart

2018

Veterinary Internal Medicne

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BackgroundSystemic inflammation is a cause of insulin dysregulation in many species, but the insulin and glucose dynamics in adult horses diagnosed with systemic inflammatory response syndrome (SIRS) are poorly documented.Hypothesis/ObjectivesIn SIRS in horses, insulin and glucose dynamics will be altered and associated with survival.AnimalsAdult horses diagnosed with SIRS admitted to a referral hospital.MethodsProspective study enrolling horses diagnosed with SIRS in which serum insulin and glucose concentrations were measured. Horses were grouped by outcome (survival, hyperinsulinemia, and hyperglycemia) and compared with P < .05 considered significant.ResultsFifty‐eight horses were included in the study and 36 (62%) survived. At admission, 21 horses (36%) were hyperinsulinemic and 44 horses (88%) were hyperglycemic, with survivors having significantly higher serum insulin and a significantly lower serum glucose concentration. Horses diagnosed with hyperinsulinemia at any time during hospitalization were 4 times more likely to survive whereas horses that were hyperglycemic at any time during hospitalization were 5 times less likely to survive. Serum glucose concentration and presence of hyperglycemia both were associated with severity of disease. Insulin/glucose ratio, reflecting insulin secretion, was significantly higher in survivors whereas glucose/insulin ratio, reflecting peripheral tissue insulin resistance, was significantly lower in nonsurvivors. Only in survivors was there a significant correlation between serum insulin and glucose concentrations.Conclusions and Clinical ImportanceHyperinsulinemia and hyperglycemia are common features of SIRS in horses, but those presenting with relative hypoinsulinemia and corresponding hyperglycemia suggestive of endocrine pancreatic dysfunction have a worse prognosis.

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Section: Discussionmentioning

confidence: 99%

Insulin dysregulation in horses with systemic inflammatory response syndrome

Bertin

Ruffin-Taylor

Stewart

2018

Veterinary Internal Medicne

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“…When repeatability of oral glucose tests has been examined, the in‐feed OGT was found to have reasonable repeatability, with median (range) coefficient of variation (CV) values of 23% (16–44%), 19% (31–43%), and 45% (23–75%) detected at 90, 120, and 180 minutes, respectively, for 8 healthy ponies undergoing 3 consecutive tests . Repeatability of the OST also has been assessed in healthy ponies, with results compared between tests performed twice, under fed or fasted conditions .…”

mentioning

confidence: 99%

Repeatability of Oral Sugar Test Results, Glucagon‐Like Peptide‐1 Measurements, and Serum High‐Molecular‐Weight Adiponectin Concentrations in Horses

Frank

Walsh²

2017

Veterinary Internal Medicne

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BackgroundRepeatability of the oral sugar test (OST) has not been evaluated.ObjectivesWe hypothesized that OST glucose, insulin, active (aGLP‐1) and total (tGLP‐1) glucagon‐like peptide 1, and high‐molecular‐weight (HMW) adiponectin results would be repeatable.AnimalsFifty‐three horses from a Tennessee research facility (n = 23) and private practice in Missouri (n = 30), including animals with medical histories of equine metabolic syndrome.MethodsTwo OSTs were performed 7–14 days apart and plasma glucose and insulin concentrations were measured at 0, 60, and 75 minutes; a positive result was defined as detection of an insulin concentration >45 μU/mL at 60 or 75 minutes. Plasma aGLP‐1 and serum tGLP‐1 concentrations at 75 minutes and serum HMW adiponectin concentrations at 0 minute were measured in the Missouri group. Bland‐Altman analyses were performed.ResultsNo adverse events were reported. Bland‐Altman analysis indicated mean ± SD bias of 1.5 ± 14.8 μU/mL (95% confidence interval [CI], −27.6 to 30.5 μU/mL) and 1.2 ± 16.1 μU/mL (95% CI, −30.4 to 32.8 μU/mL) for insulin concentrations at 60 and 75 minutes, respectively. There was 91 and 83% agreement in test interpretation between test days for OST insulin results for all horses in the Tennessee and Missouri groups, respectively.Conclusions and Clinical ImportanceRepeatability of the OST was acceptable when values obtained from Bland‐Altman analyses were evaluated, and there was good agreement in binary (negative/positive) test interpretation for insulin concentrations. However, wide 95% CIs were detected for insulin concentrations.

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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]. This low repeatability is likely a result of Insulin AUC 0-120 , area under the plasma insulin vs. time curve at 0-120 min; Insulin AUC 60-120 , area under the plasma insulin vs. time curve at steady state; Insulin 60-120 , mean plasma insulin concentration 60-120 min; DIns/DGlu, incremental increase in plasma insulin divided by incremental increase in plasma glucose; M 60-120 , mean disposal rate of glucose during steady state; M/I 60-120 , mean disposal rate of glucose per unit of insulin during steady state; CV, coefficient of variation; ICC, intraclass correlation coefficient; CR, coefficient of repeatability.…”

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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The repeatability of an oral glucose test in ponies

Cited by 41 publications

References 20 publications

Insulin dysregulation in horses with systemic inflammatory response syndrome

Insulin dysregulation in horses with systemic inflammatory response syndrome

Repeatability of Oral Sugar Test Results, Glucagon‐Like Peptide‐1 Measurements, and Serum High‐Molecular‐Weight Adiponectin Concentrations in Horses

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

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