Results

1.   Insulin and Glucose. Once get to lab, Glucose results in 1 day, Insulin results in 2 days.

1. Normally after a meal, Insulin levels of baseline 5-20 u/U/ml will go up about 40-50.  When levels are above 60, this is abnormal.  We have had several over 400 which is slam dunk Insulin Resistance.  If over 60, you are Insulin Resistant. Some labs use pmol/L for Insulin - if so, divide this number by 7.175 to get to u/U/ml.
2. Glucose – Normally and in most Insulin Resistance horses, 80-100 mg/dl.  In very rare cases of early-stage Type II Diabetes, over 200.  If your lab uses mmol/L as Glucose unit, divide this number by .055 to get to mg/dl.
3. Glucose/Insulin ratios are of little value because Insulin Resistance Horses have normal Glucose ranges. High Glucose is very rare and low Glucose from improper testing procedures throw off this ratio. Do not count on this too heavily as a diagnostic tool.
   Dr Divers, Cornell University, 2008 J. of Equine Veterinary Science. "Because most horses with EMS maintain glucose within the normal range when fed only low NSC forage, the change in Insulin is the primary determinant of any ration change".
   

    

   Here is an example of why it is not helpful.
   Glucose levels are considered normal between 80 and 120.

   Horse A- glucose of 80, insulin of 40 has a 2:1 ratio.
   Horse B- glucose of 120 and an insulin of 30 has a 4:1 ratio.

   Both horses are normal but ratios are double on Horse B.

Conclusion:

Ratios are not going to find a problem. You know if the Insulin is over 60 there is a problem of Insulin Resistance and you know if the glucose is 40 the sample was handled poorly. Also you will know that if the glucose is sky high, your horse is Early Stage Type II Diabetic and quickly needs help. It is straight forward to diagnose and monitor progress.

Insulin Test Result Chart:

uIU/ml	pmol/L
5-40	<287	Fasting Normal
40-60	287-430	Peak Insulin 2 Hr after breakfast in a normal horse.
80	574	Abnormal- Insulin Resistance Confirmed If blood was taken without a grain challenge and you are in this range you are severely insulin resistant.
120	861
180	1,291
250	1,794
400	2,870
600	4,305

• To convert from uIU/ml to pmol/L, multiply by 7.175.
• To convert from pmol/L to uIU/ml, divide by 7.175.
• If your lab says you are greater then 200uIU/ml, ask them to titrate it out to a real number. This does not cost any extra. If your horse is at 550, and it drops to 210 with management, that is great progress, and you will miss it.
• Cornell and Antech use uIU/ml.
• Michigan State and Idexx use pmol/L.

2.   Thyroid – consult doctor.  Once at lab, results in 1 day.

3.   ACTH – once at lab, results in 2 days.  Normally, most horses are under 35 pg/ml.

1. In the fall, normal horses have elevated levels in our findings of about 75-100, but studies say it can get up to 200.
2. In the fall, you are looking for extreme ACTH elevations to diagnose Cushings of over 300.
3. During the rest of the year, horses over 60 are suspects and usually are retested in 30 days, while horses over 100 are treated with Pergo. Our highest level: 565.  Some labs have seen levels over 1000.