Del Baldo Francesca, Canton Claudia, Testa Silvia, Swales Harry, Drudi Ignazio, Golinelli Stefania, Fracassi Federico
Department of Veterinary Medical Science, University of Bologna, Ozzano dell'Emilia, Bologna, Italy.
Small Animal Teaching Hospital, Leahurst Campus, University of Liverpool, Wirral, United Kingdom.
J Vet Intern Med. 2020 Nov;34(6):2296-2305. doi: 10.1111/jvim.15930. Epub 2020 Oct 30.
Flash glucose monitoring system (FGMS; FreeStyle Libre) was recently validated for use in diabetic dogs (DD). It is not known if this system is clinically useful in monitoring DD.
To compare the clinical utility of FGMS against blood glucose curves (BGCs) obtained with a portable blood glucose meter (PBGM) in monitoring DD.
Twenty dogs with diabetes mellitus.
Prospective study. Dogs with diabetes mellitus on insulin treatment for at least 1 month were included. Comparisons of insulin dose recommendations based on the in-hospital GCs acquired using FGMS and a PBGM, consecutive-day interstitial GCs (IGCs) acquired at home using the FGMS, and consecutive-day, home vs hospital IGCs acquired using the FGMS were made using concordance analysis.
There was good concordance between insulin dose recommendations based on FGMS and PBGM generated GCs and IGCs obtained in the 2 different environments on 2 consecutive days, but almost absent concordance between IGCs obtained on 2 consecutive days at home. Glucose nadirs were detected in 34/43 (79%) of Ambulatory Glucose Profile (AGP) reports of the FGMS. In comparison, concordant glucose nadirs were identified in 14/34 (41%) BGCs using PBGM. The individual FGMS scans and PBGM identified 60% and 9% of low IG/hypoglycemic episodes, respectively.
Insulin dose adjustments based on BGCs can be suboptimal. The FGMS allows a more accurate identification of the glucose nadirs and hypoglycemic episodes compared to the use of a PBGM and assessment of day-to-day variations in glycemic control.
动态血糖监测系统(FGMS;FreeStyle Libre)最近已被验证可用于糖尿病犬(DD)。尚不清楚该系统在监测糖尿病犬方面是否具有临床实用性。
比较FGMS与便携式血糖仪(PBGM)所获血糖曲线(BGCs)在监测糖尿病犬方面的临床实用性。
20只患有糖尿病的犬。
前瞻性研究。纳入接受胰岛素治疗至少1个月的糖尿病犬。使用一致性分析比较基于FGMS和PBGM在医院获得的血糖曲线(GCs)、基于FGMS在家中获得的连续日间组织间液血糖曲线(IGCs)以及基于FGMS在家中和医院获得的连续日间IGCs所给出的胰岛素剂量建议。
基于FGMS和PBGM生成的GCs以及在2个不同环境中连续2天获得的IGCs所给出的胰岛素剂量建议之间具有良好的一致性,但在家中连续2天获得的IGCs之间几乎没有一致性。在FGMS的34/43(79%)份动态血糖图谱(AGP)报告中检测到血糖最低点。相比之下,使用PBGM在14/34(41%)的BGCs中识别出一致的血糖最低点。FGMS单次扫描和PBGM分别识别出60%和9%的低IG/低血糖事件。
基于BGCs进行胰岛素剂量调整可能并非最佳。与使用PBGM相比,FGMS能够更准确地识别血糖最低点和低血糖事件,并评估血糖控制的每日变化。