New Medication for Insulin Dysregulation in Horses Explored

Without any FDA-approved medications specifically indicated for insulin dysregulation—a component of equine metabolic syndrome—veterinarians borrowed metformin from human medicine to help affected horses. In some cases, human patients require an additional medication to help control blood sugar levels, with sitagliptin being one drug combined with metformin. Will it work in horses like it does in humans?

To explore this potential treatment option for horses with insulin dysregulation, veterinary researchers recruited healthy horses and administered both metformin and sitagliptin orally. Both medications were well tolerated, and no adverse events were reported. Results of this study suggest that metformin plus sitagliptin could be safe to use in the treatment of insulin dysfunction, though more research is needed to ascertain effectiveness and tolerance in horses with metabolic disease.

“Other ways of managing insulin dysregulation and metabolic syndrome in horses rely on appropriate weight management and exercise,” reminded Kathleen Crandell, Ph.D., a Kentucky Equine Research nutritionist. “Owner compliance with these strategies, however, has proven challenging for professionals trying to keep client horses healthy. Be sure to follow your veterinarian’s instructions precisely for weight loss and management of chronic laminitis.”

Management suggestions may include limiting certain types of feeds and treats, offering forage with a lower nonstructural carbohydrate content, and supplementing with products designed to support hoof health.

For easy keepers on all-forage diets, choose a vitamin and mineral supplement to round out the diet.

For more information on feeding horses with insulin dysregulation, consult with a Kentucky Equine Research nutrition advisor.

*Cárceles-Rodríguez, C.M., E. Fernández-Varón, T. Martín-Gimenez, et al. 2019. Pharmacokinetics of metformin in combination with sitagliptin in adult horses after enteral administration. Journal of Equine Veterinary Science. 72:84-88.