Tufts University, Cummings School of Veterinary Medicine, North Grafton, Massachusetts, USA.
Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany.
J Vet Intern Med. 2024 Nov-Dec;38(6):3281-3287. doi: 10.1111/jvim.17191. Epub 2024 Oct 28.
Testing for insulin dysregulation (ID) in horses is commonly performed to guide management and therapeutic strategies.
To evaluate a newly developed glycemic pellets challenge (GPC) and compare results to those obtained using the low-dose oral sugar test (OST).
Twenty-four adult horses with unknown insulin status.
A randomized crossover trial was performed. Horses underwent GPC (0.5 g glycemic carbohydrates/kg body weight) and OST (0.15 mL corn syrup/kg body weight) 7 days apart. Feed was withheld before testing and blood samples were collected at T0, T60, T120, and T180 minutes for GPC and at T0, T60, and T90 minutes for OST. Blood glucose concentration was measured using a point-of-care glucometer and insulin by radioimmunoassay. Comparisons were made using nonparametric tests, linear regression, and Bland-Altman agreement analysis.
Eighteen horses consumed >85% of the GPC pellets within 10 minutes and had acceptable OST results. Maximum glucose (P = .02) and insulin (P = .007) concentrations were significantly higher for GPC compared with OST. Time to maximum insulin concentration (Tmax[ins]) varied within and between tests and neither Tmax[ins] (P = .28) nor maximum insulin concentration (P = .46) was correlated with the time horses took to consume pellets.
The GPC is well tolerated and may offer another diagnostic testing modality for ID. Blood glucose and insulin concentrations increase during GPC and reach higher concentrations than observed with low-dose OST. The Tmax[ins] varied for GPC and OST, emphasizing the importance of identifying the optimal time range for the collection of samples to capture diagnostically relevant changes in insulin concentration.
检测马的胰岛素失调（ID）通常用于指导管理和治疗策略。
评估新开发的血糖丸挑战（GPC），并将结果与低剂量口服糖测试（OST）进行比较。
24 匹具有未知胰岛素状态的成年马。
进行了一项随机交叉试验。马匹接受 GPC（0.5 g 血糖碳水化合物/kg 体重）和 OST（0.15 mL 玉米糖浆/kg 体重），间隔 7 天。测试前禁食，在 GPC 时采集 T0、T60、T120 和 T180 分钟的血样，在 OST 时采集 T0、T60 和 T90 分钟的血样。使用即时血糖仪测量血糖浓度，使用放射免疫法测量胰岛素。使用非参数检验、线性回归和 Bland-Altman 一致性分析进行比较。
18 匹马在 10 分钟内消耗了 >85%的 GPC 丸，并且 OST 结果可接受。与 OST 相比，GPC 的最大血糖（P=0.02）和胰岛素（P=0.007）浓度显著更高。胰岛素最大浓度（Tmax[ins]）在测试内和测试间变化，并且 Tmax[ins]（P=0.28）和最大胰岛素浓度（P=0.46）均与马匹消耗丸的时间无关。
GPC 耐受良好，可能为 ID 提供另一种诊断测试方法。GPC 期间血糖和胰岛素浓度升高，达到比低剂量 OST 观察到的更高浓度。GPC 和 OST 的 Tmax[ins]变化，强调确定最佳样本采集时间范围以捕获胰岛素浓度的诊断相关变化的重要性。
