Effect of IA Triamcinolone Cetonide Injection on Insulin and Glucose Concentrations in Horses

A study measured systemic glucose and insulin levels in horses without insulin dysregulation following intra-articular corticosteroid injection.
A study measured systemic glucose and insulin levels in horses without ID following intra-articular corticosteroid injection.
Corticosteroids are commonly used in horses, but they can pose risks such as laminitis. | Getty Images

Corticosteroids are a commonly used, inexpensive intra-articular treatment for osteoarthritis which may increase the risk for laminitis in horses due, in part, to hyperinsulinaemia. Humans with metabolic syndrome experience increases in insulin and glucose concentrations post-injection, but responses in horses are unknown.

The aim of this study was to determine the effect of a single intra-articular (IA) dose of triamcinolone acetate (TA) on blood insulin and glucose concentrations.

Ten horses with normal insulin sensitivity as assessed by an oral sugar test received 18 mg of TA into one middle carpal joint. All horse were fed only grass hay during the study period. Insulin and glucose concentrations were evaluated at baseline and 4, 6, 8, 24, 48 and 72 h following IA corticosteroid injection. 

Mean ± SD blood insulin concentration post IA TA injection was increased at 6 h (15.8 ± 3.1 μIU/mL, p = 0.01), 24 h (23 ± 5.8 μIU/mL, p ≤ 0.001), and 48 h (29 ± 13 μIU/mL, p ≤ 0.01) compared to baseline (10 ± 12.3 μIU/mL), with the peak at 48 h. Median ± 95% CI blood glucose concentration post IA TA injection was increased at 6 h (112.7 ± 20.3 mg/dL, p = 0.006), 8 h (112.9 ± 21.4 mg/dL, p = 0.004), 24 h (122.6 ± 14.6, p ≤ 0.0001), and 48 h (123.5 ± 15.4 mg/dL, p ≤ 0.0001) compared to baseline (89.2 ± 6.6 mg/dL), with the peak at 48 h.

Bottom Line

Blood insulin and glucose concentrations modestly increased for 48 h following IA TA in horses with normal insulin sensitivity.

https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.14003

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