Alt Nina, Kley Saskia, Haessig Michael, Reusch Claudia E
Clinic for Small Animal Internal Medicine, Vetsuisse-Faculty University of Zurich, 8057 Zurich, Switzerland.
J Am Vet Med Assoc. 2007 Apr 1;230(7):1011-7. doi: 10.2460/javma.230.7.1011.
To evaluate day-to-day variability in blood glucose curves (BGCs) generated at home and at the clinic for cats with diabetes mellitus.
Prospective study.
7 cats with diabetes mellitus. Procedures-BGCs generated at home on 2 consecutive days and within 1 week at the clinic were obtained twice. On each occasion, insulin dose, amount of food, and type of food were consistent for all 3 BGCs. Results of curves generated at home were compared with each other and with the corresponding clinic curve.
Differences between blood glucose concentration determined after food was withheld (fasting), nadir concentration, time to nadir concentration, maximum concentration, and mean concentration during 12 hours had high coefficients of variation, as did the difference between fasting blood glucose and nadir concentrations and area under the curve of home curves. Differences between home curve variables were not smaller than those between home and clinic curves, indicating large day-to-day variability in both home and clinic curves. Evaluation of the paired home curves led to the same theoretical recommendation for adjustment of insulin dose on 6 of 14 occasions, and evaluation of home and clinic curves resulted in the same recommendation on 14 of 28 occasions. Four of the 6 paired home curves in cats with good glycemic control and 2 of the 8 paired home curves in cats with poor glycemic control led to the same recommendation.
Considerable day-to-day variability was detected in BGCs generated at home. Cats with good glycemic control may have more reproducible curves generated during blood collection at home than cats with poorer control.
评估在家中和诊所生成的糖尿病猫血糖曲线(BGCs)的日常变异性。
前瞻性研究。
7只糖尿病猫。程序——在家中连续2天以及在诊所1周内两次获取BGCs。每次,所有3条BGCs的胰岛素剂量、食物量和食物类型均保持一致。将在家中生成的曲线结果相互比较,并与相应的诊所曲线进行比较。
禁食后测定的血糖浓度、最低点浓度、达到最低点浓度的时间、最高浓度以及12小时内的平均浓度之间的差异具有较高的变异系数,禁食血糖与最低点浓度之间的差异以及家曲线的曲线下面积的变异系数也较高。家曲线变量之间的差异并不小于家曲线与诊所曲线之间的差异,表明家曲线和诊所曲线均存在较大的日常变异性。对配对的家曲线进行评估,在14次中有6次得出了相同的胰岛素剂量调整理论建议,对家曲线和诊所曲线进行评估,在28次中有14次得出了相同的建议。血糖控制良好的猫的6对配对家曲线中有4对,血糖控制不佳的猫的8对配对家曲线中有2对得出了相同的建议。
在家中生成的BGCs存在相当大的日常变异性。血糖控制良好的猫在家中采血期间生成的曲线可能比控制较差的猫更具可重复性。