Briefings: July / Aug. 2024

Researchers Study SFLT2i for Limiting Insulin Response

To prevent diet-induced laminitis, sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown some success in limiting insulin response after eating.


Australian researchers found that SGLT2i has some success in limiting insulin response in horses.

A 2022 Australian study — summarized by EquiManagement and originally published in Equine Veterinary Education — examined the use of ertugliflozin, an SGLT2i, to manage horses with laminitis and hyperinsulinemia. How hyperinsulinemia induces laminitis is unclear, though other studies have suggested that insulin may stimulate insulin-like growth factor-1 receptors within the lamellae, which promotes growth that leads to weakening and ultimately lamellar failure.

The study included 51 horses, the majority being pony breeds, including Welsh, Shetland and miniature ponies. All horses were unshod and regularly seen by a farrier.

“A dozen horses were also diagnosed with PPID and treated with pergolide. Of the 51 horses in the study, 33 also received phenylbutazone at the time ertugliflozin treatment began,” EquiManagement reports.

SGLT2i recently was developed for treating human diabetes but may also reduce equine insulin through urinary glucose excretion, according to the study. In a 2018-2019 study where ponies were fed diets high in nonstructural carbohydrates, a different SGLT2i reduced hyperinsulinemia and prevented the development of laminitis. Another 2018 study showed that an SGLT2i decreased the insulin response to an oral sugar test in horses when used with octreotide.

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