A Different Perspective
Most effort seems to be spent on diagnosis and treatment, conventionally, that requires careful dietary control and unlicensed Metformin administration (a human drug for Type II diabetes) that has low bio-availability in horses and little effect on insulin sensitiity at the commonly used dose levels. It is thought that it's main action is to reduce glucose absorption in the digestive tract when given prior to meals, but this is treating symptoms rather than getting to the underlying cause.
Roger has always been convinced that there is a management cause of EMS in order to explain it's emergence and increasing incidence. It would make sense that there is a toxicity involved that is effecting liver function and insulin sensitivity. Until recently, Roger had not discovered the probable cause of EMS but he has now been convinced that the increased use and higher doses of Glyphosate (the prime active ingredient of the weedkiller "RoundUp") is the most likely culprit. For more information see the page on Glyphosate and how it can effect not only horses but humans and other species too.
The good news is that although numbers are still quite low at present, Roger has had some success in treating horses and ponies diagnosed with EMS based on presuming it to be of toxic derivation. With his more recent understanding with regard to the probable role of Glyphosate, Roger is confident that a successful treatment regime can be achieved.
Of course treatment is only one aspect of this. It is crucial in order to maintain health that horses are not subjected to further Glyphosate or other toxicity, or at least as little as possible.