Tack n' Talk

Online Equestrian Resource

Insulin Resistance – What to Feed??

Now that Insulin Resistance has become the “talk of the day,” the equine market has exploded with low carb feeds and supplements to fix or cure this condition. Don’t believe it!  Firstly, understand that Insulin Resistance (IR) is not a disease, but a “metabolic type”.   The main goal for the IR Horse is no laminitis and to keep bloodwork as close to normal as possible, if not completely normal.  This is done by a lifestyle change, one that horse owners must be committed to and also know that there is no magic bullet cure.

Unfortunately, feed companies have conditioned us to think of our horses’ nutrition only in terms of what is inside the feed bag.  What is missing in the horse owner’s education is the knowledge that hay, which is not just fiber, is the single largest source of nutrients in the horse’s diet and that the main goal is to feed a slow, sustained release of these nutrients ALL DAY LONG with absolutely no periods of fasting.  This may be easier said than done,  especially if your horse is boarded.  Eating hay is essential in the prevention of laminitis.

The importance of hay:  Hay provides the fiber to steady Glucose levels.  Hay also provides an excellent activity for your horse (as they eat 70 – 80% of the day).  Hay decreases stress which in turn can steady hormones.  Hay stimulates gut tone and motility.  If your horse has fasted several hours and then is fed, he can get an Insulin surge beyond the normal which can be harmful…remember, we want the slow, constant, low level of hay moving through his system all day long.

As a side note on Fiber,  also a Carbohydrate,  requires the bacteria of the large intestine to break it down.  The  sugar/starch Carbohydrates go into the bloodstream at the small intestine where as the Fiber rolls past the small intestine and goes down the tract to the large intestine.  There are two types of Fiber,  soluble fiber which requires bacteria break it down with the nutrients absorbed, and insoluble  fiber.  Fiber is very important as it creates a sensation of fullness as it is not digested at the small  intestine level, so your horse eats less due to not being as hungry.  As mentioned above, it assists  in slow, steady delivery of Glucose to the small intestine due to its bulk  which slows the release out of stomach of sugars.  This soluble  fiber can account for 50% of the energy needs of your horse.  Hay  and beet pulp have excellent amounts of fiber with hay at about 30% and beet pulp about 20%.

Testing Terms:  NSC (non-structural carbohydrates) has been used by feed companies to categorize low carbohydrate feeds of about 10-15% NSC.   When you test your hay or fresh grass today, you will not see NSC listed any more due to recent changes in the way sugars are categorized. The new category for sugar content of hay/fresh grass is called ESC (ethanol soluble carbohydrate, also called Simple Sugars), referring to sugars and a partial amount of fructans. Know that NSC is not ESC and that past sugar tests cannot compare to current tests.

What Hay Do I Feed?  Timothy Grass Hay is a very good choice, and generally easy to acquire. When tested, you want 8-12% protein, low end of normal range of ESC (4.7-10.9%), and low end of normal range of starch (1.5-4%).  As an example, if the hay test shows 15% ESC and 6% starch, do not buy it as it’s a probable laminitis trigger. If the test shows 5.7% ESC and 1.8% starch, it’s okay to buy it and there is no need to soak.

Contrary to popular believe Alfalfa Hay is a very good choice.   Alfalfa actually has lower ESC, starch, and sugar than Timothy Hay. If someone tells you Alfalfa is a problem in Insulin Resistant horses, they do not have the facts. ESC is generally 4.2-8.2% and starch is around 0.8-3.2%.  If your horse is sensitive to Alfalfa and gets runny stools, mix 50:50 Timothy/Alfalfa.

Another solid hay choice is Orchard Grass Hay which is very similar to Timothy Grass Hay.

Bermuda or “Coastal” Hay has double the starch of Orchard or Timothy, so you would need to soak these hays before feeding to your horses.  The starch averages 6% (range 3.1-9.0). So if possible, Timothy, Orchard, Timothy/Alfalfa, Orchard/Alfalfa are far better choices.

Totally avoid Wheat hay, Oat hay, Barley hay as these are all very bad with very high starch levels.

Many  horse owners with IR horses stop feeding grain to their horses.  This is completely wrong as an all-hay diet could lead to problems due to vitamin, micro nutrient deficiency.  If you have been told that the best way to avoid laminitis in your insulin-resistant horse is to feed it only hay and keep it on a dirt lot, you have been given incorrect information.  The goal is some grass, some hay, some grain and some snacks.   You want a low ESC pellet feed with a high amount of protein which will provide the vitamins and micro nutrients for your horse. These  feeds are very concentrated, so you will only need to feed a small amount to your horse each day. Normal horses can get up to 1% of body weight in grain a day for maintenance: 10 pounds of grain in a 1,000 pound horse. With a low ESC concentrated feed, that same horse gets only 1 pound a day.  Please note that not all low ESC/low carb pellet feeds on the market today are good for an Insulin Resistant horse because some may also have a high fat quantity.  You want a low carbohydrate (low ESC), high protein (24 – 32%), and low fat diet.   High protein means more muscle and the muscles are the biggest users of insulin which helps lower blood glucose.  High protein also helps increase magnesium absorption which is very important as it helps lower insulin.  High protein diets lower glucose uptake in the intestine which in turn decreases insulin surges.

Equine Insulin Resistance puts your horse on the edge of a cliff and any form of stress can push them off that edge into laminitis. By being proactive and incorporating grass intake management, hay testing and regulating feeding of grain and snacks, you guide them away from the edge into a healthy lifestyle.

Be careful feeding fat to an IR horse!  In a 2002 study by the University of Kentucky’s Department of Veterinary Science  showed that an infusion of fat actually induced Insulin Resistance in horses in less than 2 hours time. This can lead to a laminitis trigger. High fat diets can cause a crisis.  High Insulin levels already are promoting fat which in turn releases toxins to further cause more and more Insulin. This cycle is not helped by promoting more fat with a high fat diet, so be sure to check your feed bag labels! Please note: Some fats, such as Omega 3 Fatty Acids can actually have benefits for IR horses when fed therapeutically in the diet.  Please consult your equine nutritionist before starting a therapeutic feeding regime with integrated fats for your horse.

Also no Rice Bran.  In an 1994 Rice Science Study, rice bran is approximately 16% fat. This is going to promote fat on your horse, add weight, and cause problems.  Rice bran is also high in starch,  approximately 5 to 7 times more than timothy/orchard hay or beet pulp.  More importantly, rice bran has an ESC level of about 25.

Giving snacks to your horse as a treat or just because is important, so we need to know what are the safe snacks.  Some excellent choices are roasted peanuts in the shell, Soy Pulp,  Strawberries, Cherries without the pits, Pumpkin seeds, Sugar-free candy for diabetics, Beet Pulp with no molasses added, and Alfalfa pellets.  Alfalfa pellets have an added bonus of helping to prevent stomach ulcers due to its buffering ability.   Another good snack selection is celery which has a very low glycemic index of 1 and only 1% carbs with very high fiber.

Both oral glucosamine and injectable (N-acetyl glucosamine) from compounding pharmacies should be AVOIDED for the IR horse.  Many studies are showing that glucosamine can induce peripheral insuline resistance (Diabetes Journal 1996) (J. Clinical Investigations 1995), and results in the reduction of the blood flow rate as well as the uptake of glucose (Diabetes Journal 2000) (Mayo Clinic 2007) (Harvard Medical School 2007).  As a word of caution when feeding joint supplements to your horses,  look at the label and if it has “Flex”, “Joint”, “Gluco” or “Glyco B” avoid these products.  It’s strange that many products out there to treat laminitis contain glucosamine.  Use only Chondroitin and MSM.  Adequan contains no Glucosamine, so it’s fine to use.

So, remember the goal is to control carbohydrate metabolism by having your horse eating the right foods in the  proper amounts to help your horse live a good, happy life!

For information on the nutritional needs of your horse, contact Aequus-therapy.com.



  silver price wrote @

Note: Not all chopped hay is safe for an Insulin Resistant horse – other types add molasses which we don’t want.

  tackandtalk wrote @

Agreed. As horse owners with special needs horses, we need to be knowledgeable on what is in the feed we give to our horses.

  silver price wrote @

Non-Structural Carbohydrates (NSC) include glucose, sucrose, fructose, starch and fructan. With the exception of fructan, non-structural carbohydrates are digested in the horse’s small intestine and absorbed into the blood as glucose. Once this glucose is absorbed it triggers the release of insulin in the blood. In insulin resistant horses, it is the non-structural carbohydrates that lead to high levels of blood insulin, which can in-turn lead to laminitis in susceptible horses.

  tackandtalk wrote @

Thank you for that description of how sugars can affect insulin resistance. Current classifications divide Non-Structural Carbohydrates into Water Soluble Carbohydrates or WSC (glucose, sucrose, fructose, and all fructans), Ethanol Soluble Carbohydrates or ESC (subgroup of WSC, with glucose, sucrose, fructose, and short-chain fructans), and starch. This new classification is excellent for managing different types of carbohydrate resistant problems such as laminitis or insulin resistance and equine metabolic syndrome. Laminitic horses can tolerate short-chain fructans better than IR or EMS horses, whereas IR/EMS horses can tolerate starch better. By only observing the NSC value, the specific sugars that could adversely affect your horse are not fully accounted for. Therefore, it is best to test for WSC, ESC, and starch to glean a full spectrum of carbohydrates and tailor feed for your horse specifically.

  gold account wrote @

If dieting it can be very beneficial to include an adaptogen supplement in the horses diet. One such supplement is APF Plus , an herbal supplement made up of a combination of 5 adaptogens. APF was found in independent field trials reported in the October 2002 issue of Horse Journal to be very effective in managing both primary insulin resistance as well as secondary insulin resistance associated with Cushing’s disease. In addition APF Plus has an anticatabolic effect in that it conserves skeletal muscle even when the subject is on a weight loss nutrition regime. There is little loss of muscle mass and a utilization of lipids.

  Amy Gill wrote @

The 2002 UK study intravenously INFUSED a 20% lipid solution to obtain the results it did where IR was induced. It is a misomer to imply that all fat is bad for IR horses when it is well known and scientifically documented that a therapeutic dose of Omega 3 fatty acid can have a large beneficial effect on inflammatory reduction in the whole body. This is of particular importance in the IR horse where adipose tissue produces cytokines which in turn up regulate inflammation. It is ambiguous to not differentiate the difference between feeding “high fat” diets, infusing lipid solution into a vein, and using an omega 3 fatty acid therapeutically.

  tackandtalk wrote @

Thank you for your clarification: Omega 3 Fatty Acids are beneficial in a horse’s diet. Also, I do believe that you are hitting on a key point with the importance of distinguishing “feeding high fat diets” and using “omega 3 fatty acids therapeutically” in the diet. I believe that it is important to get equine nutrition consultation where IR horses are concerned, as the types of fat in the diet and the dosages are all significant. For the general lay person owning an IR horse, who might not have access to an equine nutritionist, it might be better to err on the side of caution, and try to stay clear of fat, rather than accidentally feed the wrong fat, or get the balance wrong.

It has been found in a study published in Feb 2012 that massage actually works to reduce the pro-inflammatory cytokines, and stimulates mitochondria for glucose conversion, which are the benefits you mentioned when feeding Omega 3 Fatty Acids. It may be an option, therefore, for owners of IR horses, to schedule regular massages for their horse, which may be more accessible and easier than working with fat in the horse’s diet.

  Amy Gill wrote @

It indeed is an educational process for the horse’s caretaker to learn how to use therapeutic oils or any targeted nutrient in the equine diet to help improve the health of the horse. The information they receive in the process will hopefully be accurate and not misleading or confusing. The author of such information should be able to interpret scientific results properly before posting them on a web blog incorrectly.

It is not complicated to understand the basis for using Omega 3 fatty acids in the equine diet and is easy to do on a daily basis. While massages are wonderful and also therapeutic, they are not a practical or economically viable alternative to a daily therapuetic dose of Omega 3 fatty acids.

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