Comparison of a continuous indwelling glucometer with a point-of-care device in healthy adult horses.
Abstract: Blood glucose is tightly regulated in horses; however, since hypoglycaemia and hyperglycaemia are associated with poor prognosis, close monitoring is warranted. This study aimed at evaluating a continuous indwelling glucometer (CIG) by comparing performance with a point-of-care glucometer (POC). Ten horses were equipped with CIG and an intravenous catheter. Interstitial glucose concentrations were determined by CIG every 5 min at rest, during insulin-induced hypoglycaemia and dextrose-induced hyperglycaemia, and compared with blood glucose determined by POC. Glucose concentrations were compared by two-way repeated measures analysis of variance and weighted kappa with Bland-Altman plots to determine agreement between assays. Horses tolerated CIG well; however, five devices had to be replaced. There were no statistically significant differences between assays at rest or during hyperglycaemia; however, during hypoglycaemia, glucose concentrations determined by CIG were significantly higher (P=0.01). The mean bias (95% limits of agreement) between assays ranged from -0.03 (-2.46 to 2.52) mmol/l (hyperglycaemia) to 0.97 (-1.23 to 3.16) mmol/l (hypoglycaemia). Assay agreement was 'good' with observed agreements of 87.04% (κ=0.67). CIG has acceptable accuracy in horses as compared with POC but overestimates glucose concentrations during hypoglycaemia and requires frequent replacement, limiting its clinical application.
© British Veterinary Association 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Publication Date: 2020-03-16 PubMed ID: 32179578DOI: 10.1136/vr.105607Google Scholar: Lookup
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- Comparative Study
- Journal Article
Summary
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The study compared the performance of a Continuous Indwelling Glucometer (CIG) used for monitoring blood sugar levels continuously, with a Point-Of-Care (POC) glucometer in healthy horses. The results showed that while the CIG performed well under normal and hyperglycemia conditions, it overestimated glucose levels during hypoglycemia, and needed more frequent replacements than the POC glucometer.
Objective of the Research
- The primary aim of the study was to assess the efficiency and reliability of a Continuous Indwelling Glucometer (CIG), used for ongoing blood glucose monitoring, in comparison to a Point-of-Care (POC) glucometer.
- The researchers intended to understand the performance of the CIG under different conditions–at rest, during insulin-induced hypoglycemia, and dextrose-induced hyperglycemia, by comparing the blood glucose levels determined by the POC glucometer.
Methodology
- Ten healthy horses were monitored using both types of glucometers. The CIG was set to log interstitial glucose concentrations every five minutes, while an intravenous catheter was used alongside for the POC device.
- The comparison was done using two-way repeated measures analysis of variance and weighted kappa statistics, with Bland-Altman plots serving to determine the agreement between assays (tests).
Key Findings
- While the horses coped well with the CIG, five of the devices had to be replaced indicating potential practicality issues in their use.
- There were no significant differences in glucose readings at rest or during hyperglycemia (high sugar levels) for both devices.
- During hypoglycemia (low sugar levels), the CIG registered significantly higher glucose concentrations compared to POC (statistically relevant at P=0.01).
- Agreement between both assays was found to be ‘good’ with an observed agreement of 87.04% (κ=0.67).
Conclusion
- Overall, the study concluded that the CIG has an acceptable accuracy compared to the POC glucometer for horses.
- However, it overstated the glucose concentrations during hypoglycemia, and required frequent replacement, which makes its clinical application somewhat limited.
Cite This Article
APA
Cunneen A, Wood KA, Mathison K, Herndon AM, Bertin FR.
(2020).
Comparison of a continuous indwelling glucometer with a point-of-care device in healthy adult horses.
Vet Rec, 187(3), e21.
https://doi.org/10.1136/vr.105607 Publication
Researcher Affiliations
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia f.bertin@uq.edu.au.
MeSH Terms
- Animals
- Blood Glucose / analysis
- Blood Glucose Self-Monitoring / instrumentation
- Blood Glucose Self-Monitoring / veterinary
- Horses / blood
- Point-of-Care Systems
- Reproducibility of Results
Conflict of Interest Statement
Competing interests: FRB has consulted for and received funding from Boehringer Ingelheim Pty Ltd for his research.
Citations
This article has been cited 2 times.- Wong D, Malik C, Dembek K, Estell K, Marchitello M, Wilson K. Evaluation of a continuous glucose monitoring system in neonatal foals.. J Vet Intern Med 2021 Jul;35(4):1995-2001.
- Hicks GR, Fraser NS, Bertin FR. Changes Associated with the Peri-Ovulatory Period, Age and Pregnancy in ACTH, Cortisol, Glucose and Insulin Concentrations in Mares.. Animals (Basel) 2021 Mar 20;11(3).
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