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Insulin dysregulation is a key component of equine metabolic syndrome: a collection of endocrine and metabolic abnormalities associated with the development of laminitis in horses, ponies and donkeys. Insulin dysregulation can also accompany prematurity and systemic illness in foals. Causes of insulin resistance are discussed, including pathological conditions of obesity, systemic inflammation and pituitary\n                    <jats:italic>pars intermedia<\/jats:italic>\n                    dysfunction, as well as the physiological responses to stress and pregnancy. Most of the discussion of insulin dysregulation to date has focused on insulin resistance, but there is increasing interest in hyperinsulinaemia itself and insulin responses to feeding. An oral sugar test or in\u2010feed oral glucose tolerance test can be performed to assess insulin responses to dietary carbohydrates, and these tests are now recommended for use in clinical practice. Incretin hormones are likely to play an important role in postprandial hyperinsulinaemia and are the subject of current research. Insulin resistance exacerbates hyperinsulinaemia, and insulin sensitivity can be measured by performing a combined glucose\u2010insulin test or i.v. insulin tolerance test. In both of these tests, exogenous insulin is administered and the rate of glucose uptake into tissues measured. Diagnosis and management of hyperinsulinaemia is recommended to reduce the risk of laminitis. The term\n                    <jats:italic>insulin dysregulation<\/jats:italic>\n                    is introduced here to refer collectively to excessive insulin responses to sugars, fasting hyperinsulinaemia and insulin resistance, which are all components of equine metabolic syndrome.\n                  <\/jats:p>","DOI":"10.1111\/evj.12169","type":"journal-article","created":{"date-parts":[[2013,8,28]],"date-time":"2013-08-28T07:22:44Z","timestamp":1377674564000},"page":"103-112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":200,"title":["Insulin dysregulation"],"prefix":"10.1111","volume":"46","author":[{"given":"N.","family":"Frank","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Tufts Cummings School of Veterinary Medicine  North Grafton Massachusetts USA"},{"name":"Division of Veterinary Medicine School of Veterinary Medicine and Science University of Nottingham  Sutton Bonington Leicestershire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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