ems is also implicated in the development of laminitis. prolonged iv insulin administration can induce laminitis, possibly due to its effects on blood flow to the foot, changes of glucose metabolism and secondary matrix metalloproteinase activation, or altered cell function within the foot. however, recent research suggests that the situation is more complex, in that "compensated insulin resistance is essentially physiological and health sustaining", and only when this compensatory mechanism fails does laminitis ensue. - this may support the argument that ems is an evolved survival trait.