Principal Investigator

Johan Bröjer

Would you like to describe the project in short with a few sentences?

“Horses rarely develop type-2 diabetes. Instead, horses remain in a stage of insulin resistance with compensatory insulin response after feeding (excessive postprandial hyperinsulinemia). Hyperinsulinemia can cause endocrinopathic laminitis in the horse, an extremely painful hoof disorder. Therefore, reducing excessive hyperinsulinemia is a cornerstone in preventing laminitis in these horses. The project will evaluate the efficacy of the sodium-glucose transporter 2 (SGLT2) inhibitor canagliflozin in decreasing the insulin and glucose responses in horses with excessive postprandial hyperinsulinemia. Increased knowledge in this area could open up for pharmacological strategies to reduce excessive postprandial hyperinsulinemia in order to prevent horses from developing laminitis.”

Would you like to tell us a little about the cross-disciplinary aspects of the project?

“The project brings together researchers working with postprandial insulin hypersecretion in the horse at SLU with researchers who focus on delineating mechanisms underlying insulin hypersecretion in children with obesity at UU.”

How was the project and collaboration born?

“Anders Forslund, at the Department of Women’s and Children’s Health was a member of the examination committee for a PhD defense about equine insulin hypersecretion at the SLU. He recognized the similarities between horses with insulin dysregulation and obese children with insulin hypersecretion. Shortly after, my research group started to collaborate with Peter Bergsten’s research group at UU. Our first collaboration focused on translating the role of glucagon in insulin hypersecretion in obese children to the horse. Recently, we have finished a pilot study evaluating the effect of the sodium-glucose transporter 2 (SGLT2) inhibitor canagliflozin in attenuating the postprandial insulin hypersecretion in insulin dysregulated horses. The pilot study gave us background knowledge for the current PhD project.”

How can the UDC be of help in your research?

“UDC can create a platform and a professional network where the PhD student and the senior researchers in this project can interact with other researchers. A strong research environment created by UDC will be an important part of the development of the PhD student.”

What can the UDC do to make the PhD students feel like they belong to the centre?

“Seminar series, course work and social activities within the centre will bring the PhD students together and increase their network. It is important to give the PhD students an opportunity to participate in the design and contents of these activities.”

Which activities will be meaningful for this project?

“Seminars, course work, invited speakers and access to an environment that supports and facilitates networking with others in the same research area.”

Doctoral Candidate

Elin Svonni

Would you like to describe the project in short?

The name of my PhD-project is “A novel therapeutic option for treating horses with insulin dysregulation and preventing laminitis”. Laminitis is a disease affecting the horse’s hooves causing pain and lameness. Many laminitic horses are euthanized every year, which makes prevention of laminitis an important animal welfare issue. One of the most common causes of laminitis is hyperinsulinemia caused by insulin dysregulation (ID), a part of the equine metabolic syndrome (EMS). EMS has similarities with the human metabolic syndrome but it is uncommon for affected horses to develop diabetes, instead they can secrete pathologically increased levels of insulin for many years. The treatment recommendations for horses with EMS are the same as for people with metabolic syndrome - increased physical activity, weight reduction and a diet with a low carbohydrate content. However, these strategies are not enough for all horses with EMS and there is a need for pharmacological treatment in more severe cases. The aim of the project is to evaluate the effect of the sodium-glucose co-transporter 2 inhibitor canagliflozin to decrease hyperinsulinemia in EMS-horses with moderate to severe insulin dysregulation. Canagliflozin is a drug used in people with type 2 diabetes and it increases the loss of glucose in the urine by blocking the sodium-glucose co-transporter 2 in the kidneys. In a randomized and double-blinded study separated in two substudies the glucose and insulin metabolism in horses with ID are examined before and after three weeks of treatment with canagliflozin or placebo. The horses are examined with an oral glucose tolerance test, a meal tolerance test, a graded glucose infusion and an euglycemic hyperinsulinemic clamp. Additionally, a subgroup of horses evaluated in the short-term study are treated with canagliflozin on long-term basis in an open label study and are examined after four mouths, one and two years of treatment. By now, 34 respectively nine horses are examined in two different parts of the short-term study and six horses are followed for two years in the long-term study. The results are promising so far but a lot of work remains.

Why did you apply to work with this project

Since I graduated as a veterinarian, I have seen many horses suffering from laminitis and have experienced a feeling of frustration over the limited help we can offer these patients. In the cases where the pain medication is not enough to relieve the horses from suffering, nothing but euthanasia remains. When the research of treatment of horses with EMS started at SLU I followed the progress with great interest and when the opportunity to join the team in this new project came up I did not hesitated to take the chance.

How can the UDC be of help in your research?

UDC has so far been a great platform to meet other doctoral candidates and researchers in the diabetes research field and an important source of knowledge through courses and seminars. As a researcher in the veterinary medicine field human medicine research is really important. The veterinary medicine field is quite small and if we do not take advantage of the results in human medicine the progress in our own research will be too slow. On the other hand, I think our research can contribute to human medicine research due to some similarities between the metabolism in horses with EMS and some human patient groups.

What UDC activities have you participated in?

As often as I have the chance I participate in UDC activities. This autumn I attended the graduate student course Introduction to Diabetes research and I have participated in a lot of diabetes lunch seminars and meetings organized by UDC.

Something interesting about yourself?

Before I started as a doctoral candidate I have been working for many years as a veterinarian at different horse clinics in Sweden. The last years I have been teaching veterinary nurse students and veterinary students at SLU here in Uppsala. Beside insulin dysregulated horses I am most interested in the care of neonatal foals with medical disorders.