Evaluating insulindysregulation in horses: A two-step insulin-tolerance test using porcine zinc insulin
In insulin dysregulation, hyperinsulinemia (HI) can be accompanied by peripheral insulin resistance (IR) in horses, which can be diagnosed with an insulin-tolerance test (ITT). The administration of 0.1 IU/kg body weight of recombinant regular human insulin (RHI) should elicit a 50 % reduction of th...
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description | In insulin dysregulation, hyperinsulinemia (HI) can be accompanied by peripheral insulin resistance (IR) in horses, which can be diagnosed with an insulin-tolerance test (ITT). The administration of 0.1 IU/kg body weight of recombinant regular human insulin (RHI) should elicit a 50 % reduction of the initial blood glucose concentration at 30 min after insulin administration in insulin sensitive horses. Compared to RHI, porcine zinc insulin (PZI) is veterinary-approved and therefore easier accessible for many practitioners. The aim of this study was to compare the insulin and glucose dynamics during a standard ITT with RHI to an ITT performed with PZI. Twelve Icelandic horses were subjected to an ITT with RHI (ITT-RHI) and with PZI (ITT-PZI) at same dosages in a randomised crossover design. The insulin and glucose dynamics that resulted from these tests were compared, and the consistency of classification into insulin-sensitive and IR categories was evaluated. No complications were observed with the use of either RHI or PZI in ITT. A good correlation of the test results was observed (r = 0.88; P < 0.001). The blood glucose concentrations and the percentage reduction in glucose concentration did not differ significantly between the two tests (P = 0.053), but four out of twelve horses were classified as IR in the ITT-RHI whereas with the ITT-PZI seven out of twelve horses were classified as IR with the 50 % glucose reduction from baseline. Based on the Youden index, when using the ITT-PZI, an adjusted cut-off value for blood glucose reduction of 40 % at 30 min resulted in better test performance. With consideration for the seemingly weaker effect of PZI and the adjusted cut-off value, PZI can be an appropriate substitute to RHI in an ITT.
•Zinc insulin (PZI) could be used in an insulin-response test (IRT) in horses.•PZI used intravenously seemed less effective compared to regular insulin.•A 40 % blood glucose reduction was indicative of insulin resistance in IRT with PZI. |
doi_str_mv | 10.1016/j.tvjl.2024.106172 |
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•Zinc insulin (PZI) could be used in an insulin-response test (IRT) in horses.•PZI used intravenously seemed less effective compared to regular insulin.•A 40 % blood glucose reduction was indicative of insulin resistance in IRT with PZI.</description><identifier>ISSN: 1090-0233</identifier><identifier>ISSN: 1532-2971</identifier><identifier>EISSN: 1532-2971</identifier><identifier>DOI: 10.1016/j.tvjl.2024.106172</identifier><identifier>PMID: 38909714</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>blood glucose ; body weight ; cross-over studies ; EMS ; glucose ; humans ; hyperinsulinemia ; insulin ; Insulin dysregulation ; Insulin resistance ; Insulin-tolerance test ; Porcine-zinc-insulin ; swine ; zinc</subject><ispartof>The veterinary journal (1997), 2024-08, Vol.306, p.106172, Article 106172</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c384t-f43f5c91a2e5125e5de559567c3b23258708816d5ded4d7021f33da0ff66cc873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1090023324001114$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38909714$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grob, A.J.</creatorcontrib><creatorcontrib>Delarocque, J.</creatorcontrib><creatorcontrib>Feige, K.</creatorcontrib><creatorcontrib>Warnken, T.</creatorcontrib><title>Evaluating insulindysregulation in horses: A two-step insulin-tolerance test using porcine zinc insulin</title><title>The veterinary journal (1997)</title><addtitle>Vet J</addtitle><description>In insulin dysregulation, hyperinsulinemia (HI) can be accompanied by peripheral insulin resistance (IR) in horses, which can be diagnosed with an insulin-tolerance test (ITT). The administration of 0.1 IU/kg body weight of recombinant regular human insulin (RHI) should elicit a 50 % reduction of the initial blood glucose concentration at 30 min after insulin administration in insulin sensitive horses. Compared to RHI, porcine zinc insulin (PZI) is veterinary-approved and therefore easier accessible for many practitioners. The aim of this study was to compare the insulin and glucose dynamics during a standard ITT with RHI to an ITT performed with PZI. Twelve Icelandic horses were subjected to an ITT with RHI (ITT-RHI) and with PZI (ITT-PZI) at same dosages in a randomised crossover design. The insulin and glucose dynamics that resulted from these tests were compared, and the consistency of classification into insulin-sensitive and IR categories was evaluated. No complications were observed with the use of either RHI or PZI in ITT. A good correlation of the test results was observed (r = 0.88; P < 0.001). The blood glucose concentrations and the percentage reduction in glucose concentration did not differ significantly between the two tests (P = 0.053), but four out of twelve horses were classified as IR in the ITT-RHI whereas with the ITT-PZI seven out of twelve horses were classified as IR with the 50 % glucose reduction from baseline. Based on the Youden index, when using the ITT-PZI, an adjusted cut-off value for blood glucose reduction of 40 % at 30 min resulted in better test performance. With consideration for the seemingly weaker effect of PZI and the adjusted cut-off value, PZI can be an appropriate substitute to RHI in an ITT.
•Zinc insulin (PZI) could be used in an insulin-response test (IRT) in horses.•PZI used intravenously seemed less effective compared to regular insulin.•A 40 % blood glucose reduction was indicative of insulin resistance in IRT with PZI.</description><subject>blood glucose</subject><subject>body weight</subject><subject>cross-over studies</subject><subject>EMS</subject><subject>glucose</subject><subject>humans</subject><subject>hyperinsulinemia</subject><subject>insulin</subject><subject>Insulin dysregulation</subject><subject>Insulin resistance</subject><subject>Insulin-tolerance test</subject><subject>Porcine-zinc-insulin</subject><subject>swine</subject><subject>zinc</subject><issn>1090-0233</issn><issn>1532-2971</issn><issn>1532-2971</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkUtPwzAQhC0EoqXwBzigHLmk-BHHCeJSVeUhVeICZyu1N8VVGhfbKSq_HkdtOcJpV6NvR6sZhK4JHhNM8rvVOGxXzZhimkUhJ4KeoCHhjKa0FOQ07rjEKaaMDdCF9yuMcZll9BwNWFHiiGRDtJxtq6argmmXiWl915hW77yDZddE0bZRTD6s8-Dvk0kSvmzqA2yOaBpsA65qFSQBfEg63_tsrFOmheTbtOpIXqKzumo8XB3mCL0_zt6mz-n89ellOpmnihVZSOuM1VyVpKLACeXANXBe8lwotqCM8kLgoiC5jrrOtMCU1IzpCtd1nitVCDZCt3vfjbOfXfxJro1X0DRVC7bzksV8BBMlx_-jWJD4RMmLiNI9qpz1MZ1abpxZV24nCZZ9F3Il-y5k34XcdxGPbg7-3WIN-vfkGH4EHvYAxEC2Bpz0ykAMUxsHKkhtzV_-P5LAm8k</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Grob, A.J.</creator><creator>Delarocque, J.</creator><creator>Feige, K.</creator><creator>Warnken, T.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7S9</scope><scope>L.6</scope></search><sort><creationdate>20240801</creationdate><title>Evaluating insulindysregulation in horses: A two-step insulin-tolerance test using porcine zinc insulin</title><author>Grob, A.J. ; Delarocque, J. ; Feige, K. ; Warnken, T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-f43f5c91a2e5125e5de559567c3b23258708816d5ded4d7021f33da0ff66cc873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>blood glucose</topic><topic>body weight</topic><topic>cross-over studies</topic><topic>EMS</topic><topic>glucose</topic><topic>humans</topic><topic>hyperinsulinemia</topic><topic>insulin</topic><topic>Insulin dysregulation</topic><topic>Insulin resistance</topic><topic>Insulin-tolerance test</topic><topic>Porcine-zinc-insulin</topic><topic>swine</topic><topic>zinc</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grob, A.J.</creatorcontrib><creatorcontrib>Delarocque, J.</creatorcontrib><creatorcontrib>Feige, K.</creatorcontrib><creatorcontrib>Warnken, T.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>AGRICOLA</collection><collection>AGRICOLA - Academic</collection><jtitle>The veterinary journal (1997)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grob, A.J.</au><au>Delarocque, J.</au><au>Feige, K.</au><au>Warnken, T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluating insulindysregulation in horses: A two-step insulin-tolerance test using porcine zinc insulin</atitle><jtitle>The veterinary journal (1997)</jtitle><addtitle>Vet J</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>306</volume><spage>106172</spage><pages>106172-</pages><artnum>106172</artnum><issn>1090-0233</issn><issn>1532-2971</issn><eissn>1532-2971</eissn><abstract>In insulin dysregulation, hyperinsulinemia (HI) can be accompanied by peripheral insulin resistance (IR) in horses, which can be diagnosed with an insulin-tolerance test (ITT). The administration of 0.1 IU/kg body weight of recombinant regular human insulin (RHI) should elicit a 50 % reduction of the initial blood glucose concentration at 30 min after insulin administration in insulin sensitive horses. Compared to RHI, porcine zinc insulin (PZI) is veterinary-approved and therefore easier accessible for many practitioners. The aim of this study was to compare the insulin and glucose dynamics during a standard ITT with RHI to an ITT performed with PZI. Twelve Icelandic horses were subjected to an ITT with RHI (ITT-RHI) and with PZI (ITT-PZI) at same dosages in a randomised crossover design. The insulin and glucose dynamics that resulted from these tests were compared, and the consistency of classification into insulin-sensitive and IR categories was evaluated. No complications were observed with the use of either RHI or PZI in ITT. A good correlation of the test results was observed (r = 0.88; P < 0.001). The blood glucose concentrations and the percentage reduction in glucose concentration did not differ significantly between the two tests (P = 0.053), but four out of twelve horses were classified as IR in the ITT-RHI whereas with the ITT-PZI seven out of twelve horses were classified as IR with the 50 % glucose reduction from baseline. Based on the Youden index, when using the ITT-PZI, an adjusted cut-off value for blood glucose reduction of 40 % at 30 min resulted in better test performance. With consideration for the seemingly weaker effect of PZI and the adjusted cut-off value, PZI can be an appropriate substitute to RHI in an ITT.
•Zinc insulin (PZI) could be used in an insulin-response test (IRT) in horses.•PZI used intravenously seemed less effective compared to regular insulin.•A 40 % blood glucose reduction was indicative of insulin resistance in IRT with PZI.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>38909714</pmid><doi>10.1016/j.tvjl.2024.106172</doi><oa>free_for_read</oa></addata></record> |
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subjects | blood glucose body weight cross-over studies EMS glucose humans hyperinsulinemia insulin Insulin dysregulation Insulin resistance Insulin-tolerance test Porcine-zinc-insulin swine zinc |
title | Evaluating insulindysregulation in horses: A two-step insulin-tolerance test using porcine zinc insulin |
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