The effect of ertugliflozin on serum insulin and glucose in healthy horses receiving dexamethasone.

BACKGROUND

Sodium-glucose cotransporter 2 inhibitors (SGLT-2i) can be used to manage insulin dysregulation (ID). Their effect on corticosteroid-induced ID is unknown.

HYPOTHESIS/

OBJECTIVES

Evaluate effects of ertugliflozin on serum insulin and glucose concentrations in horses receiving dexamethasone (DEX). We hypothesized that DEX would induce ID and ertugliflozin coadministration would mitigate that effect.

ANIMALS: Seven healthy horses.

METHODS

Randomized crossover design; horses received DEX (0.06 mg/kg IV q48h; DEX)or ertugliflozin (0.05 mg/kg PO q24h) plus DEX (SGLT-2i group) for seven days. Oral sugar (OST) and insulin tolerance (ITT) tests were performed before and after treatment. Insulin and glucose concentrations were measured during treatment. Data were analyzed using mixed-effects linear models.

RESULTS

Mean daily insulin concentrations were lower in the SGLT-2i compared with the DEX group (P < .001), with a block effect-mean insulin (95% CI) μIU/mL: Block 1 DEX 50.6 (42.1-59.1) and SGLT-2i 35.9 (28.1-43.7); Block 2 DEX 34.5 (27.8-41.3) and SGLT-2i 18.9 (16.5-21.4). Glucose was lower in the SGLT-2i group on days 3 and 5 (P < .001)-mean glucose (95% CI) mg/dL: Day 3 DEX 117.3 (110.4-124.3) and SGLT-2i 101.0 (95.7-106.4); Day 5 DEX 116.6 (107.9-125.3) and SGLT-2i 101.0 (95.5-106.4). Post-treatment OST insulinT60 was higher in both groups (P = .01). Glucose concentrations decreased less during the ITT post-treatment in the SGLT-2i group compared with DEX (P < .001).

CONCLUSIONS AND CLINICAL

IMPORTANCE

Ertugliflozin lowered mean daily serum insulin concentrations in horses receiving DEX. Dynamic tests after drug discontinuation did not indicate ID improvement.