{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:54:30Z","timestamp":1787316870557,"version":"build-2736575974"},"reference-count":41,"publisher":"American Veterinary Medical Association (AVMA)","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize the effects of pioglitazone (2 mg\/kg, PO, either q 24 h [PIO-SID] or q 12 h [PIO-BID]) in equids with severe hyperinsulinemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>17 client-owned equids with severe resting hyperinsulinemia (&gt; 100 \u00b5IU\/mL) were assigned to PIO-SID or PIO-BID in a prospective cohort study with rolling enrollment over an 11-month study period (December 13, 2022, to November 17, 2023). Basal insulin, total and high-molecular-weight adiponectin concentrations, and plasma pioglitazone concentrations were measured over 70 days. Oral sugar tests (OSTs) were performed on days 0 and 28. Results were analyzed via a mixed-effects linear regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean (95% CI) resting insulin concentrations decreased from day 0 (PIO-SID, 191.2 \u00b5IU\/mL [10.1 to 372.1 \u00b5IU\/mL]; PIO-BID, 113.0 \u00b5IU\/mL [46.9 to 179.2 \u00b5IU\/mL]) to day 70 (PIO-SID, 183.4 \u00b5IU\/mL [\u201344.6 to 411.4 \u00b5IU\/mL]; PIO-BID, 66.7 \u00b5IU\/mL [28.8 to 104.5 \u00b5IU\/mL]) equivocally in both treatment groups; however OST insulin did not change in either. The high-molecular-weight adiponectin increased in PIO-BID between day 0 (3.5 \u00b5g\/mL [\u20130.3 to 7.2 \u00b5g\/mL]) and day 70 (15.0 \u00b5g\/mL [6.9 to 23.0 \u00b5g\/mL]), but not in PIO-SID (day 0 = 0.7 \u00b5g\/mL [0.2 to 1.3 \u00b5g\/mL]; day 70 = 4.0 \u00b5g\/mL [\u20133.0 to 11.1 \u00b5g\/mL]). Plasma pioglitazone concentrations on day 70 were 291.8 ng\/mL (\u201340.1 to 623.7 ng\/mL [PIO SID]) and 739.7 (453.0 to 1,026.3 ng\/mL [PIO-BID]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pioglitazone did not affect OST insulin and failed to normalize resting insulin. With PO administration every 12 hours, plasma concentrations exceeded the reported human therapeutic threshold (617 ng\/mL), and adiponectin significantly increased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Although not effective as a sole treatment for severe hyperinsulinemia, pioglitazone increases adiponectin, a potentially beneficial effect that warrants further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/javma.25.04.0269","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:43:14Z","timestamp":1753893794000},"page":"1-11","source":"Crossref","is-referenced-by-count":2,"title":["Pioglitazone does not adequately control hyperinsulinemia but does increase serum adiponectin concentrations in equids with severe insulin dysregulation"],"prefix":"10.2460","volume":"263","author":[{"given":"Caitrin R.","family":"Lowndes","sequence":"first","affiliation":[{"name":"Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley G.","family":"Boyle","sequence":"additional","affiliation":[{"name":"Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeaneen","family":"Kulp","sequence":"additional","affiliation":[{"name":"Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darko","family":"Stefanovski","sequence":"additional","affiliation":[{"name":"Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7930-4589","authenticated-orcid":true,"given":"Jennifer L.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences & Pathobiology, VA-MD College of Veterinary Medicine, Blacksburg, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"van Eps","sequence":"additional","affiliation":[{"name":"Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"3","key":"ref1","series-title":"Domest Anim Endocrinol","first-page":"111","article-title":"The prevalence of endocrinopathic laminitis among horses presented for laminitis at a first-opinion\/referral equine hospital","volume":"41","author":"Karikoski NP","year":"2011","unstructured":"Karikoski NP, Horn I, McGowan TW, McGowan CM. The prevalence of endocrinopathic laminitis among horses presented for laminitis at a first-opinion\/referral equine hospital. Domest Anim Endocrinol. 2011;41(3):111-117."},{"issue":"1","key":"ref2","series-title":"Am J Vet Res","first-page":"76","article-title":"Effects of long-term oral administration of levothyroxine sodium on glucose dynamics in healthy adult horses","volume":"69","author":"Frank N","year":"2008","unstructured":"Frank N, Elliott SB, Boston RC. Effects of long-term oral administration of levothyroxine sodium on glucose dynamics in healthy adult horses. Am J Vet Res. 2008;69(1):76-81."},{"issue":"6","key":"ref3","series-title":"Am J Vet Res","first-page":"1032","article-title":"Effects of oral administration of levothyroxine sodium on concentrations of plasma lipids, concentration and composition of very-low-density lipoproteins, and glucose dynamics in healthy adult mares","volume":"66","author":"Frank N","year":"2005","unstructured":"Frank N, Sommardahl CS, Eiler H, Webb LL, Denhart JW, Boston RC. Effects of oral administration of levothyroxine sodium on concentrations of plasma lipids, concentration and composition of very-low-density lipoproteins, and glucose dynamics in healthy adult mares. Am J Vet Res. 2005;66(6):1032-1038."},{"issue":"1","key":"ref4","series-title":"Am J Vet Res","first-page":"60","article-title":"Effects of pretreatment with dexamethasone or levothyroxine sodium on endotoxin-induced alterations in glucose and insulin dynamics in horses","volume":"71","author":"T\u00f3th F","year":"2010","unstructured":"T\u00f3th F, Frank N, Geor RJ, Boston RC. Effects of pretreatment with dexamethasone or levothyroxine sodium on endotoxin-induced alterations in glucose and insulin dynamics in horses. Am J Vet Res. 2010;71(1):60-68."},{"issue":"2","key":"ref5","series-title":"Equine Vet J","first-page":"318","article-title":"The effect of pre-dosing with metformin on the insulin response to oral sugar in insulin-dysregulated horses","volume":"56","author":"Colmer SF","year":"2024","unstructured":"Colmer SF, Adams AA, Adam E,  The effect of pre-dosing with metformin on the insulin response to oral sugar in insulin-dysregulated horses. Equine Vet J. 2024;56(2):318-325."},{"issue":"5","key":"ref6","series-title":"Equine Vet J","first-page":"493","article-title":"The effect of metformin on measurements of insulin sensitivity and \u03b2 cell response in 18 horses and ponies with insulin resistance","volume":"40","author":"Durham AE","year":"2008","unstructured":"Durham AE, Rendle DI, Newton JE. The effect of metformin on measurements of insulin sensitivity and \u03b2 cell response in 18 horses and ponies with insulin resistance. Equine Vet J. 2008;40(5):493-500."},{"issue":"6","key":"ref7","series-title":"Equine Vet J","first-page":"751","article-title":"Effects of metformin hydrochloride on blood glucose and insulin responses to oral dextrose in horses","volume":"45","author":"Rendle DI","year":"2013","unstructured":"Rendle DI, Rutledge F, Hughes KJ, Heller J, Durham AE. Effects of metformin hydrochloride on blood glucose and insulin responses to oral dextrose in horses. Equine Vet J. 2013;45(6):751-754."},{"issue":"1","key":"ref8","series-title":"Vet J","first-page":"79","article-title":"The effect of oral metformin on insulin sensitivity in insulin-resistant ponies","volume":"191","author":"Tinworth KD","year":"2012","unstructured":"Tinworth KD, Boston RC, Harris PA, Sillence MN, Raidal SL, Noble GK. The effect of oral metformin on insulin sensitivity in insulin-resistant ponies. Vet J. 2012;191(1):79-84."},{"key":"ref9","series-title":"J Equine Vet Sci","first-page":"102930","article-title":"Investigation of the effects of a dietary supplement on insulin and adipokine concentrations in equine metabolic syndrome\/insulin dysregulation","volume":"88","author":"Manfredi JM","year":"2020","unstructured":"Manfredi JM, Stapley ED, Nadeau JA, Nash D. Investigation of the effects of a dietary supplement on insulin and adipokine concentrations in equine metabolic syndrome\/insulin dysregulation. J Equine Vet Sci. 2020;88:102930. doi:10.1016\/j.jevs.2020.102930"},{"issue":"6","key":"ref10","series-title":"J Vet Intern Med","first-page":"2520","article-title":"Short-term effects of canagliflozin on glucose and insulin responses in insulin dysregulated horses: a randomized, placebo-controlled, double-blind, study","volume":"37","author":"Lind\u00e5se S","year":"2023","unstructured":"Lind\u00e5se S, Nostell K, Forslund A, Bergsten P, Br\u00f6jer J. Short-term effects of canagliflozin on glucose and insulin responses in insulin dysregulated horses: a randomized, placebo-controlled, double-blind, study. J Vet Intern Med. 2023;37(6):2520-2528."},{"issue":"9","key":"ref11","series-title":"PLoS One","first-page":"e0203655","article-title":"The sodium-glucose co-transporter 2 inhibitor velagliflozin reduces hyperinsulinemia and prevents laminitis in insulin-dysregulated ponies","volume":"13","author":"Meier A","year":"2018","unstructured":"Meier A, Reiche D, de Laat M, Pollitt C, Walsh D, Sillence M. The sodium-glucose co-transporter 2 inhibitor velagliflozin reduces hyperinsulinemia and prevents laminitis in insulin-dysregulated ponies. PLoS One. 2018;13(9):e0203655. doi:10.1371\/journal.pone.0203655"},{"key":"ref12","series-title":"Equine Vet Educ","first-page":"311","article-title":"Preliminary observations on the use of ertugliflozin in the management of hyperinsulinaemia and laminitis in 51 horses: a case series","volume":"35","author":"Sundra T","year":"2023","unstructured":"Sundra T, Kelty E, Rendle D. Preliminary observations on the use of ertugliflozin in the management of hyperinsulinaemia and laminitis in 51 horses: a case series. Equine Vet Educ. 2023;35:311-320. doi:10.1111\/eve.13738"},{"issue":"6","key":"ref13","series-title":"Equine Vet Educ","first-page":"317","article-title":"Oral sugar test responses to ertugliflozin in ten horses with insulin dysregulation","volume":"36","author":"Sundra T","year":"2024","unstructured":"Sundra T, Rossi G, Kelty E,  Oral sugar test responses to ertugliflozin in ten horses with insulin dysregulation. Equine Vet Educ. 2024;36(6):317-324. doi:10.1111\/eve.13924"},{"issue":"11","key":"ref14","series-title":"N Engl J Med","first-page":"1106","article-title":"Thiazolidinediones","volume":"351","author":"Yki-J\u00e4rvinen H","year":"2004","unstructured":"Yki-J\u00e4rvinen H. Thiazolidinediones. N Engl J Med. 2004;351(11):1106-1118. doi:10.1056\/NEJMra041001"},{"issue":"2","key":"ref15","series-title":"Drugs","first-page":"333","article-title":"Pioglitazone","volume":"60","author":"Gillies PS","year":"2000","unstructured":"Gillies PS, Dunn CJ. Pioglitazone. Drugs. 2000;60(2):333-345. doi:10.2165\/00003495-200060020-00009"},{"key":"ref16","series-title":"J Equine Vet Sci","first-page":"102797","article-title":"Pharmacodynamic effects of pioglitazone on high molecular weight adiponectin concentrations and insulin response after oral sugar in equids","volume":"82","author":"Legere RM","year":"2019","unstructured":"Legere RM, Taylor DR, Davis JL,  Pharmacodynamic effects of pioglitazone on high molecular weight adiponectin concentrations and insulin response after oral sugar in equids. J Equine Vet Sci. 2019;82:102797. doi:10.1016\/j.jevs.2019.102797"},{"issue":"3","key":"ref17","series-title":"Diabetes Obes Metab","first-page":"264","article-title":"Adiponectin\u2014a key adipokine in the metabolic syndrome","volume":"8","author":"Whitehead JP","year":"2006","unstructured":"Whitehead JP, Richards AA, Hickman IJ, Macdonald GA, Prins JB. Adiponectin\u2014a key adipokine in the metabolic syndrome. Diabetes Obes Metab. 2006;8(3):264-280."},{"issue":"7","key":"ref18","series-title":"J Clin Invest","first-page":"1784","article-title":"Adiponectin and adiponectin receptors in insulin resistance, diabetes, and the metabolic syndrome","volume":"116","author":"Kadowaki T","year":"2006","unstructured":"Kadowaki T, Yamauchi T, Kubota N, Hara K, Ueki K, Tobe K. Adiponectin and adiponectin receptors in insulin resistance, diabetes, and the metabolic syndrome. J Clin Invest. 2006;116(7):1784-1792."},{"issue":"2","key":"ref19","series-title":"Cent Asian J Glob Health","first-page":"55","article-title":"Total and high-molecular-weight adiponectin levels in relation to insulin resistance among overweight\/obese adults","volume":"2","author":"Acharya SD","year":"2013","unstructured":"Acharya SD, Evans RW, Brooks MM, Linkov F, Burke LE. Total and high-molecular-weight adiponectin levels in relation to insulin resistance among overweight\/obese adults. Cent Asian J Glob Health. 2013;2(2):55. doi:10.5195\/cajgh.2013.55"},{"issue":"12","key":"ref20","series-title":"Diabetologia","first-page":"2675","article-title":"Adiponectin treatment improves insulin resistance in mice by regulating the expression of the mitochondrial-derived peptide MOTS-c and its response to exercise via APPL1-SIRT1-PGC-1\u03b1","volume":"63","author":"Guo Q","year":"2020","unstructured":"Guo Q, Chang B, Yu QL, Xu ST, Yi XJ, Cao SC. Adiponectin treatment improves insulin resistance in mice by regulating the expression of the mitochondrial-derived peptide MOTS-c and its response to exercise via APPL1-SIRT1-PGC-1\u03b1. Diabetologia. 2020;63(12):2675-2688."},{"issue":"5","key":"ref21","series-title":"J Biol Chem","first-page":"2654","article-title":"Mice lacking adiponectin show decreased hepatic insulin sensitivity and reduced responsiveness to peroxisome proliferator-activated receptor \u03b3 agonists","volume":"281","author":"Nawrocki AR","year":"2006","unstructured":"Nawrocki AR, Rajala MW, Tomas E,  Mice lacking adiponectin show decreased hepatic insulin sensitivity and reduced responsiveness to peroxisome proliferator-activated receptor \u03b3 agonists. J Biol Chem. 2006;281(5):2654-2660."},{"issue":"3","key":"ref22","series-title":"J Vet Intern Med","first-page":"1215","article-title":"Metabolic perturbations in Welsh Ponies with insulin dysregulation, obesity, and laminitis","volume":"32","author":"Jacob SI","year":"2018","unstructured":"Jacob SI, Murray KJ, Rendahl AK, Geor RJ, Schultz NE, McCue ME. Metabolic perturbations in Welsh Ponies with insulin dysregulation, obesity, and laminitis. J Vet Intern Med. 2018;32(3):1215-1233."},{"issue":"2","key":"ref23","series-title":"Equine Vet J","first-page":"253","article-title":"Factors associated with insulin responses to oral sugars in a mixed-breed cohort of ponies","volume":"56","author":"Knowles EJ","year":"2024","unstructured":"Knowles EJ, Harris PA, Elliott J, Chang YM, Menzies-Gow NJ. Factors associated with insulin responses to oral sugars in a mixed-breed cohort of ponies. Equine Vet J. 2024;56(2):253-263."},{"issue":"5","key":"ref24","series-title":"Equine Vet J","first-page":"905","article-title":"Variation in insulin response to oral sugar test in a cohort of horses throughout the year and evaluation of risk factors for insulin dysregulation","volume":"54","author":"Karikoski NP","year":"2022","unstructured":"Karikoski NP, Box JR, Mykk\u00e4nen AK, Kotiranta VV, Raekallio MR. Variation in insulin response to oral sugar test in a cohort of horses throughout the year and evaluation of risk factors for insulin dysregulation. Equine Vet J. 2022;54(5):905-913."},{"issue":"2","key":"ref25","series-title":"J Vet Intern Med","first-page":"335","article-title":"ECEIM consensus statement on equine metabolic syndrome","volume":"33","author":"Durham AE","year":"2019","unstructured":"Durham AE, Frank N, McGowan CM,  ECEIM consensus statement on equine metabolic syndrome. J Vet Intern Med. 2019;33(2):335-349."},{"issue":"suppl 1","key":"ref26","series-title":"J Clin Endocrinol Metab","first-page":"S64","article-title":"Adipocytokines and the metabolic complications of obesity","volume":"93","author":"Rasouli N","year":"2008","unstructured":"Rasouli N, Kern PA. Adipocytokines and the metabolic complications of obesity. J Clin Endocrinol Metab. 2008;93(suppl 1):S64-S73."},{"issue":"3","key":"ref27","series-title":"J Vet Pharmacol Ther","first-page":"252","article-title":"Pharmacokinetics of pioglitazone after multiple oral dose administration in horses","volume":"34","author":"Wearn JMG","year":"2011","unstructured":"Wearn JMG, Crisman MV, Davis JL,  Pharmacokinetics of pioglitazone after multiple oral dose administration in horses. J Vet Pharmacol Ther. 2011;34(3):252-258."},{"issue":"4","key":"ref28","series-title":"Drug Metab Dispos","first-page":"625","article-title":"Disposition and metabolism of the hypoglycemic agent pioglitazone in rats","volume":"22","author":"Krieter PA","year":"1994","unstructured":"Krieter PA, Colletti AE, Doss GA, Miller RR. Disposition and metabolism of the hypoglycemic agent pioglitazone in rats. Drug Metab Dispos. 1994;22(4):625-630."},{"issue":"4","key":"ref29","series-title":"J Equine Vet Sci","first-page":"465","article-title":"Assessment of insulin and glucose dynamics by using an oral sugar test in horses","volume":"34","author":"Schuver A","year":"2014","unstructured":"Schuver A, Frank N, Chameroy KA, Elliott SB. Assessment of insulin and glucose dynamics by using an oral sugar test in horses. J Equine Vet Sci. 2014;34(4):465-470. doi:10.1016\/j.jevs.2013.09.006"},{"issue":"4","key":"ref30","series-title":"Equine Vet J","first-page":"371","article-title":"Relationship between condition score, physical measurements and body fat percentage in mares","volume":"15","author":"Henneke DR","year":"1983","unstructured":"Henneke DR, Potter GD, Kreider JL, Yeates BF. Relationship between condition score, physical measurements and body fat percentage in mares. Equine Vet J. 1983;15(4):371-372."},{"key":"ref31","article-title":"Veterinarian\u2019s Guide to Equestrian Competition Official Duties","author":"American Association of Equine Practitioners Performance Horse Committee","year":"2020","unstructured":"American Association of Equine Practitioners Performance Horse Committee. Veterinarian\u2019s Guide to Equestrian Competition Official Duties. American Association of Equine Practitioners; 2020."},{"key":"ref32","series-title":"PeerJ","first-page":"e7084","article-title":"A \u201cmodified Obel\u201d method for the severity scoring of (endocrinopathic) equine laminitis","volume":"7","author":"Meier A","year":"2019","unstructured":"Meier A, de Laat M, Pollitt C,  A \u201cmodified Obel\u201d method for the severity scoring of (endocrinopathic) equine laminitis. PeerJ. 2019;7:e7084. doi:10.7717\/peerj.7084"},{"key":"ref33","article-title":"Studies on the Histopathology of Acute Laminitis","author":"Obel NJ","year":"1948","unstructured":"Obel NJ. Studies on the Histopathology of Acute Laminitis. Uppsala, Almqvist and Wiksell; 1948."},{"issue":"2","key":"ref34","series-title":"J Vet Intern Med","first-page":"568","article-title":"Evaluation of a chemiluminescent immunoassay for measurement of equine insulin","volume":"31","author":"Carslake HB","year":"2017","unstructured":"Carslake HB, Pinchbeck GL, McGowan CM. Evaluation of a chemiluminescent immunoassay for measurement of equine insulin. J Vet Intern Med. 2017;31(2):568-574."},{"issue":"1","key":"ref35","series-title":"Equine Vet J","first-page":"33","article-title":"Validity and application of immunoturbidimetric and enzyme-linked immunosorbent assays for the measurement of adiponectin concentration in ponies","volume":"51","author":"Menzies-Gow NJ","year":"2019","unstructured":"Menzies-Gow NJ, Knowles EJ, Rogers I, Rendle DI. Validity and application of immunoturbidimetric and enzyme-linked immunosorbent assays for the measurement of adiponectin concentration in ponies. Equine Vet J. 2019;51(1):33-37."},{"issue":"1","key":"ref36","series-title":"Equine Vet J","first-page":"12","article-title":"Predictors of laminitis development in a cohort of nonlaminitic ponies","volume":"55","author":"Knowles EJ","year":"2023","unstructured":"Knowles EJ, Elliott J, Harris PA, Chang YM, Menzies-Gow NJ. Predictors of laminitis development in a cohort of nonlaminitic ponies. Equine Vet J. 2023;55(1):12-23."},{"issue":"2","key":"ref37","series-title":"Diabetes Obes Metab","first-page":"574","article-title":"Benefits of combining SGLT2 inhibitors and pioglitazone on risk of MASH in type 2 diabetes\u2014a real-world study","volume":"27","author":"Lee CH","year":"2025","unstructured":"Lee CH, Lui DTW, Mak LY,  Benefits of combining SGLT2 inhibitors and pioglitazone on risk of MASH in type 2 diabetes\u2014a real-world study. Diabetes Obes Metab. 2025;27(2):574-582."},{"issue":"1","key":"ref38","series-title":"Endocrinol Diabetes Metab","first-page":"e00050","article-title":"Sodium-glucose cotransporter 2 inhibitor plus pioglitazone vs pioglitazone alone in patients with diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials","volume":"2","author":"Liao HW","year":"2018","unstructured":"Liao HW, Wu YL, Sue YM, Lee M, Ovbiagele B. Sodium-glucose cotransporter 2 inhibitor plus pioglitazone vs pioglitazone alone in patients with diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Endocrinol Diabetes Metab. 2018;2(1):e00050. doi:10.1002\/edm2.50"},{"key":"ref39","series-title":"Front Endocrinol (Lausanne)","first-page":"15:1420485","article-title":"Synergistically improved cardiovascular outcomes in type 2 diabetes mellitus patients with combined treatment of SGLT-2 inhibitors and pioglitazone","author":"Li Y-R","year":"2024","unstructured":"Li Y-R, Wang C-C, Liu C-H,  Synergistically improved cardiovascular outcomes in type 2 diabetes mellitus patients with combined treatment of SGLT-2 inhibitors and pioglitazone. Front Endocrinol (Lausanne). 2024:15:1420485. doi:10.3389\/fendo.2024.1420485"},{"issue":"5","key":"ref40","series-title":"J Vet Pharmacol Ther","first-page":"379","article-title":"Mucosal permeability of water-soluble drugs in the equine jejunum: a preliminary investigation","volume":"29","author":"Davis JL","year":"2006","unstructured":"Davis JL, Little D, Blikslager AT, Papich MG. Mucosal permeability of water-soluble drugs in the equine jejunum: a preliminary investigation. J Vet Pharmacol Ther. 2006;29(5):379-385."},{"issue":"2","key":"ref41","series-title":"J Vet Intern Med","first-page":"356","article-title":"Effects of the insulin-sensitizing drug pioglitazone and lipopolysaccharide administration on insulin sensitivity in horses","volume":"25","author":"Suagee JK","year":"2011","unstructured":"Suagee JK, Corl BA, Wearn JG,  Effects of the insulin-sensitizing drug pioglitazone and lipopolysaccharide administration on insulin sensitivity in horses. J Vet Intern Med. 2011;25(2):356-364."}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/263\/10\/javma.25.04.0269.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/263\/10\/javma.25.04.0269.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/263\/10\/javma.25.04.0269.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T03:11:19Z","timestamp":1758337879000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/263\/10\/javma.25.04.0269.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":41,"journal-issue":{"issue":"10"},"URL":"https:\/\/doi.org\/10.2460\/javma.25.04.0269","relation":{},"ISSN":["0003-1488"],"issn-type":[{"value":"0003-1488","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,1]]}}}