We recommend: CoolStance Copra PowerStance CoolFibre

Low NSC feed for insulin resistant horses

Insulin resistance in horses is similar to Type II diabetes in humans, and describes the condition where the cells in the muscles and liver lose sensitivity to insulin, and are unable to continue to take up glucose. Insulin resistance is directly related to the high intake of sugar and starch (Non Structural Carbohydrates, NSC).

The Stance Equine Feeding System outlines several feeds suitable for insulin resistant horses. These include

• CoolFibre contains a low NSC (7%), high level of digestible fibre, and MCT for gut health
• CoolStance contains <12% NSC, which reduces the amount of fermentable sugars that can cause an increase in blood glucose and insulin.

• CoolStance and PowerStance contain MCT in the coconut oil, which are thought to control excessive growth of intestinal organisms causing Dysbiosis. Dysbiosis is thought to increase glucose absorption, increase cortisol levels, and hence increase insulin resistance.

Depending on the cause of the resistance to insulin there are many ways in which it can be managed and avoided. For obese horses a feeding and exercise program should be adopted for weight loss. Avoid feeds that elevate blood glucose levels , ie feeds with NSC levels >12%.

Look for any of the feeds with a low NSC (<12%), which can include some hays, beet pulp. These feeds have low NSC, howver they are also low energy. CoolStance is the one of the only feeds that provides both low NSC, and a high level of digestible energy. Coolstance also contains MCT, which are thought to have antimicrobial and antiviral effects, that could control dysbiosis.

PowerStance is powdered coconut oil, which is rich in MCT for promoting gut health

CoolFibre provides very low, non NSC energy, and quality fibre for insulin resistant, Cushings and EMS horses. CoolFibre absorbs water to assist with intestinal function and metabolism in metabolically stressed horses.

What is Insulin Resistance?

Insulin is a hormone produced by the pancreas to control blood glucose levels. When feed containing non-structural carbohydrates (NSC) - like simple sugars or starches - are eaten, they are digested and absorbed into the blood as glucose. Insulin is then released to signal to the muscle and liver cells to absorb the glucose, and to promote glycogen formation. Once glucose is absorbed and the glucose concentration in the blood drops back to normal levels, the insulin is broken down and insulin levels also return to normal.

Resistance to insulin can then be defined as where the body's cells become less sensitive to the effects of insulin on glucose uptake. The cells become more resistant to the effects of insulin on glucose uptake, and so higher levels of insulin are required to maintain normal blood glucose levels after a high-sugar or high-starch (high NSC ) meal.

Some causes of Insulin Resistance are;

• Diet - high NSC diets increase the amount of soluble carbohydrates for absorption and hence circulating glucose
• High NSC diets are correlated with dysbiosis, and hence increased concentrations of circulating blood glucose.
• Obesity - easy keepers are usually insulin resistantand develop fat deposits on the head, neck and base of their tail.
• Breed - ponies and cobs are more prone to this insulin resistance
• Age - older horses more prone to insulin resistance usually in conjunction with Cushings disease. There is a strong correlation between insulin resistance and Laminitis

Insulin is a hormone produced by the pancreas to control blood glucose levels. When feed containing NSC - like simple sugars or starches - are eaten, they are digested and absorbed into the blood as glucose. Insulin is then released to signal to the muscle and liver cells to absorb the glucose, and to promote glycogen formation. Once glucose is absorbed and the glucose concentration in the blood drops back to normal levels, the insulin is broken down and insulin levels also return to normal. This is termed insulin sensitivity, ie the cells are sensitive to insulin.

Insulin resistance is where the body's cells become less sensitive to the effects of insulin on glucose uptake (1), and the cells become more resistant to the effects of insulin on glucose uptake, and so higher levels of insulin are required to maintain normal blood glucose levels after a high-sugar or high-starch (high NSC ) meal. Eventually the cells become resistant to insulin, and the concentrations of insulin and glucose rise and stay elevated.

Insulin Resistance: Causes

• Diet - A high NSC diet (>12%) can cause increased insulin resistance compared to high fiber and fat rations, even in non obese horses. The role of high NSC feeds is emerging as a major factor in the development of insulin resistance.
• Obesity - Overweight, obese horses tend to be insulin resistant, as are "easy keepers" even if they are not obese. Horses that appear to be relatively lean, but have fat accumulations above their eyes, in the crest of their neck or alongside the base of the tail also appear to be at risk of insulin resistance. Horses with Equine Cushing's Disease generally exhibit some level of insulin resistance.
• Age - Old horses (>20 years) seem to be more prone to insulin resistance, probably secondary to pituitary dysfunction (Cushing's disease).
• Breed - Ponies were found to have higher degrees of insulin resistance than Dutch Warmbloods or Standardbreds. Breeds that are prone to developing cresty necks and obesity, such as Morgans and some lines of Arabians, Quarterhorses, and Thoroughbreds may be more likely to develop the problem, although a study conducted at the University of Connecticut comparing exercising Morgans and exercising Thoroughbreds did not find a difference between breeds in insulin resistance.
• Laminitis - Horses with a family history of laminitis and horses that develop laminitis without an obvious cause (grain overload, sudden access to lush, green grass) may be insulin resistant

Insulin resistance is the reduced sensitivity of the cell to the effects of insulin on glucose uptake. If the supply of glucose into the bloodstream is increased, by feeding high NSC feeds, then the effect is exacerbated. High NSC feeds will supply high levels of circulating glucose. It is also postulated that the high levels of digestible sugars in the intestines can cause DYSBIOSIS, ie the overgrowth of normal populations of organisms, which can lead to "leaky gut syndrome". Under these conditions, there is flooding of sugar into the blood, which in turn cause irregular insulin production, or insulin resistance. The high levels of blood sugar can also cause the adrenal gland to increase cortisol production, in turn causing laminitis.

What Happens if a Horse has Insulin Resistance?

The most serious implication of insulin resistance is laminitis. Recent research conducted by Pollitt and co-workers at the University of Queensland has shown that high levels of insulin circulating in the blood induced Obel grade 1 laminitis within 36 hours which later progressed to Obel Grade 2 laminitis in all 4 feet in otherwise clinically normal ponies. Thus it is possible that if your horse is overweight and has insulin resistance it will be at a much higher risk of developing laminitis.

Research suggests that exercise, a controlled diet and a healthy weight-loss program can help to restore a horse's insulin sensitivity in obese horses. In a study conducted by Freestone and co-workers in 1992, they found that within 2 weeks of commencing controlled feed intake and an exercise program (which was 1 minute of walking, 1 minute trotting and 8 minutes of extended trot or canter) the ponies lost weight and regained some of their insulin sensitivity.

For horses with a lean body but patchy fat distribution it is possible that exercise will help to reduce the severity of insulin resistance. However, for horses with Cushing's Disease, insulin resistance is part of the syndrome, and careful dietary management is required to avoid the risk of laminitis.

A feeding program for insulin resistant horses should aim to:

1. Encourage weight loss where required; and
2. Avoid high NSC feeds that will cause a rise in post-feeding blood glucose and insulin concentrations.
3. Avoid feeding programs that cause insulin spikes (eg feeding only twice daily)

For horses needing to lose weight, feed a low NSC hay or fibre such as weather damaged lucerne, a very stemmy/mature grass hay , or a low NSC fibre based food such as CoolFibre together with a vitamin/mineral supplement as required. This diet should be combined with a gentle exercise program to help with the weight loss.

For leaner horses with insulin resistance, leaner horses that have previously had laminitis, horses prone to insulin resistance who are in work, or affected horses that just have trouble maintaining weight, a higher quality diet will need to be fed in conjunction with low NSC hay or pasture. The dilemma is to select a low NSC feed with a high energy content. A list of suitable feeds and forages and a list of those that should be avoided for these insulin resistant horses can be found below. The NSC content is a range of Australian horse feeds as measured by Dairy One is also shown below.

Avoid feeds with NSC >12% since these feeds release glucose into the horse's bloodstream which triggers the release of insulin.

Why should these feeds be avoided?

Avoid feeds with NSC >12% since these feeds release glucose into the horse's bloodstream which triggers the release of insulin.

Getting the Balance Right

Getting the dietary balance right is critical to maintaining insulin resistant horses in the best health possible.

1. Reduce an obese horse's energy intake,
2. Maintain the protein, vitamin and mineral requirements. Failure to meet these requirements can (and often does) result in poor skin, coat and hoof health and will probably predispose the horse to other diseases and health problems.
3. Feed a balance of low NSC (<12%) and non NSC (digestible fibre and oil) to provide energy