In­sulin-Re­sis­tance Q&A

Here’s what you need to know about in­sulin re­sis­tance and re­lated metabolic is­sues.

Horse & Rider - - Your Horse Your Life -

Your horse is over­weight and you’re wor­ried about those metabolic is­sues you’ve been hear­ing about, es­pe­cially in­sulin re­sis­tance. What should you know? Here, we share the lat­est from H&R’s con­sult­ing vet­eri­nar­ian, Dr. Barb Crabbe. She gives you the ba­sics, plus tells you what to watch for and ask your vet about.

What is in­sulin re­sis­tance?

In­sulin is a hor­mone re­leased by the pan­creas to help reg­u­late blood glu­cose (sugar). When your horse is in­sulin­re­sis­tant, his tis­sues don’t re­spond ad­e­quately to cir­cu­lat­ing in­sulin when it’s re­leased, caus­ing his blood glu­cose to be un­con­trolled.

There are two types of in­sulin re­sis­tance—com­pen­sated and un­com­pen­sated. In com­pen­sated IR (the more com­mon one in horses) the pan­creas re­sponds to tis­sue re­sis­tance to in­sulin by pro­duc­ing more, even while the in­sulin al­ready cir­cu­lat­ing isn’t be­ing cleared by the body. This causes el­e­vated in­sulin lev­els.

Un­com­pen­sated in­sulin re­sis­tance oc­curs when the pan­creas be­comes ex­hausted, no longer pro­duc­ing enough in­sulin to con­trol glu­cose. Com­pa­ra­ble to type-2 di­a­betes in hu­mans, it’s rare in horses.

Are IR and EMS the same?

No. In­sulin re­sis­tance is just one part of equine metabolic syn­drome (or EMS), de­fined as a horse with obe­sity, in­sulin re­sis­tance, and ei­ther lamini­tis or high lamini­tis risk. You could think of EMS in three steps: obe­sity (risk fac­tor), in­sulin re­sis­tance (the patho­phys­i­ol­ogy), and lamini­tis (the po­ten­tial re­sult). lin level is mean­ing­ful, but if the num­bers are nor­mal, it doesn’t nec­es­sar­ily rule out IR. A more re­cently de­vel­oped oral sugar tol­er­ance test is more ac­cu­rate for mak­ing a di­ag­no­sis. (Your vet would mea­sure your horse’s in­sulin, give him sugar, wait a while, then mea­sure his in­sulin again.)

What can I do to help my in­sulin-re­sis­tant horse?

Feed low-carb hay. Ide­ally, have your hay an­a­lyzed, with the goal of stay­ing below 10-per­cent NSC—that is, non-struc­tural car­bo­hy­drates, also known as starch and sugar. (For a list of test­ing fa­cil­i­ties, go to for­agetest­ing.org and click on cer­ti­fied labs.) If you can’t get hay that low in NSC, soak­ing your horse’s hay for 60 min­utes in cold wa­ter can re­duce its carb con­tent by as much as 30 per­cent. Feed no grain, only low-starch con­cen­trates if needed. If your horse lives out in pas­ture, a graz­ing muz­zle works well to pre­vent overeat­ing. Ex­er­cise is help­ful on two lev­els: It aids with weight loss and main­te­nance, but also can also im­prove in­sulin sen­si­tiv­ity all by it­self. There are also new prod­ucts on the mar­ket de­signed to help mod­er­ate in­sulin lev­els; check with your vet­eri­nar­ian about these.

Un­lim­ited graz­ing can lead to obe­sity, the

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