title: Type 2 diabetes mellitus with pancreatic beta cell dysfunction in 3 horses confirmed with minimal model analysis.
abstract: BACKGROUND
  Type 2 diabetes mellitus (T2DM) is diagnosed rarely in equine practice although it may be under-recognised. A greater awareness of the condition and therapeutic considerations would be to the benefit of such cases presenting in practice. More investigation into the pharmacological management of these cases is needed.
  
  
  OBJECTIVE
  Three cases of diabetes mellitus were investigated using a specific test for insulin sensitivity and pancreatic beta cell function in order to define accurately and characterise the existence of T2DM in all 3 subjects.
  
  
  METHODS
  The insulin-modified frequently sampled i.v. glucose tolerance test was performed in each case and the data so obtained were subject to minimal model analysis of insulin-glucose dynamics. Cases were then monitored following treatment using a combination of dietary modification, metformin, glibenclamide and pergolide.
  
  
  RESULTS
  Marked insulin resistance was identified in each case and, furthermore, severe pancreatic beta cell dysfunction was present therefore classifying each case as end stage T2DM. Treatment was nevertheless associated with restoration of normoglycaemia in all cases.
  
  
  CONCLUSIONS
  T2DM in horses may be more common than generally considered.In some cases individuals may respond to therapy aimed at restoring insulin sensitivity and pancreatic function. Drugs used in other species for the treatment of T2DM have not yet been adequately tested in horses.
  
  
  CONCLUSIONS
  T2DM should be considered as an important differential diagnosis in mature to elderly horses and ponies suffering from weight loss, polydipsia and polyuria. Clinicians should be encouraged to offer treatment and management advice when such cases are encountered.
authors.affiliation: The Liphook Equine Hospital, Forest Mere, Liphook, Hampshire GU30 7JG, UK.
authors.forename: A E
authors.initials: AE
authors.lastname: Durham
authors.forename: K J
authors.initials: KJ
authors.lastname: Hughes
authors.forename: H J
authors.initials: HJ
authors.lastname: Cottle
authors.forename: D I
authors.initials: DI
authors.lastname: Rendle
authors.forename: R C
authors.initials: RC
authors.lastname: Boston
mesh_terms: D000821:Animal Feed; D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000628:therapy / Q000662:veterinary*; D004032:Diet / Q000662:veterinary; D004035:Diet Therapy; D005260:Female; D005951:Glucose Tolerance Test / Q000662:veterinary*; D005905:Glyburide / Q000627:therapeutic use; D006734:Horse Diseases / Q000175:diagnosis*; D006736:Horses; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D050417:Insulin-Secreting Cells / Q000378:metabolism*; D008297:Male; D008687:Metformin / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin; D005905:Glyburide