Fleeman Linda M, Rand Jacquie S
Department of Companion Animal Sciences, School of Veterinary Science, The University of Queensland, St Lucia, QLD 4072, Australia.
J Am Vet Med Assoc. 2003 Feb 1;222(3):317-21. doi: 10.2460/javma.2003.222.317.
To evaluate day-to-day variability of serial blood glucose concentration curves in dogs with diabetes mellitus.
Prospective clinical study.
10 dogs with diabetes mellitus.
Paired 12-hour serial blood glucose concentration curves performed during 2 consecutive days were obtained on 3 occasions from each dog. Dogs received the same dose of insulin and meal every 12 hours on both days. For each pair of curves, comparison was made between the results of days 1 and 2.
Mean absolute difference (without regard to sign) between days 1 and 2 for each parameter was significantly > 0, disproving the hypothesis that there is minimal day-to-day variability of serial blood glucose concentration curves when insulin dose and meals are kept constant. Coefficient of variation of the absolute difference between days 1 and 2 for each parameter ranged from 68 to 103%. Evaluation of the paired curves led to an opposite recommendation for adjustment of the insulin dose on day 2, compared with day 1, on 27% of occasions. Disparity between dosage recommendations was more pronounced when glucose concentration nadir was < 180 mg/dL (10 mmol/L) on 1 or both days. In this subset of 20 paired curves, an opposite recommendation for dosage adjustment was made on 40% of occasions.
There is large day-to-day variation in parameters of serial blood glucose concentration curves in diabetic dogs. Day-to-day variability of serial blood glucose concentration curves has important clinical implications, particularly in dogs with good glycemic control.
评估糖尿病犬连续血糖浓度曲线的每日变异性。
前瞻性临床研究。
10只糖尿病犬。
每只犬在3个不同时段获取连续2天的配对12小时连续血糖浓度曲线。两天内犬每12小时接受相同剂量的胰岛素和食物。对于每对曲线,比较第1天和第2天的结果。
每个参数在第1天和第2天之间的平均绝对差值(不考虑正负号)显著>0,这反驳了在胰岛素剂量和饮食保持恒定的情况下连续血糖浓度曲线每日变异性最小的假设。每个参数在第1天和第2天之间绝对差值的变异系数范围为68%至103%。对配对曲线的评估结果显示,在27%的情况下,与第1天相比,第2天胰岛素剂量调整的建议相反。当1天或两天的血糖浓度最低点<180 mg/dL(10 mmol/L)时,剂量建议的差异更为明显。在这一包含20对曲线的子集中,40%的情况下剂量调整建议相反。
糖尿病犬连续血糖浓度曲线参数存在较大的每日变化。连续血糖浓度曲线的每日变异性具有重要的临床意义,尤其是在血糖控制良好的犬中。