Evaluation of a continuous glucose monitoring system compared with an in-house standard laboratory assay and a handheld point-of-care glucometer in critically ill neonatal foals.
Abstract: To evaluate the applicability and accuracy of a continuous glucose monitoring system (CGMS) in critically ill foals by comparing the performance of the CGMS, a point-of-care (POC) glucometer, and an in-house standard laboratory assay (SLA). Methods: Prospective study. Methods: University teaching hospital. Methods: Seven critically ill neonatal foals requiring intensive care. Methods: Foals were instrumented with a CGMS that measured interstitial glucose concentration every 5 minutes for the duration of 15-79 hours. Capillary and venous blood samples were taken every 4-6 hours for POC and SLA measurements, respectively. Results: Bland-Altman analysis showed a mean bias (95% limits of agreement) of -0.1 (-3.9 to 3.5) mmol/L for comparison of CGMS versus SLA, 0.06 (-3.9 to 4.0) mmol/L for comparison of CGMS versus POC glucometer, and -0.16 (-1.8 to 1.5) mmol/L for comparison of POC glucometer versus SLA. Percent agreement and weighted kappa for classification in hypoglycemia, normoglycemia, and hyperglycemia were 68.4% and 0.296 for CGMS versus SLA, 72.4% and 0.442 for CGMS versus POC glucometer, and 80.7% and 0.568 for POC glucometer versus SLA. Conclusions: The CGMS may be helpful for monitoring a trend in interstitial glucose concentration in critically ill neonatal foals. However, considering the wide limits of agreement between methods, the CGMS should only be used as an adjunctive device to other, more accurate and readily available methods that are able to detect acute changes in glucose concentration. Its use is further limited by the relatively high costs of the sensors, the mandatory 2-hour initialization period, and the difficulties of keeping the transducer in place in an active foal. The POC glucometer used in this study is easy to use and proved to be sufficiently accurate for repeated, stall-sided glucose monitoring in neonatal foals.
© Veterinary Emergency and Critical Care Society 2013.
Publication Date: 2013-07-16 PubMed ID: 23859299DOI: 10.1111/vec.12072Google Scholar: Lookup
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- Journal Article
- Blood Analysis
- Clinical Examination
- Clinical Findings
- Clinical Pathology
- Clinical Study
- Comparative Study
- Diagnosis
- Diagnostic Technique
- Disease Diagnosis
- Disease Treatment
- Emergency Care
- Equine Diseases
- Equine Health
- Foals
- Glucose
- Hospitalization
- In Vivo
- Laboratory Methods
- Veterinary Medicine
- Veterinary Procedure
- Veterinary Research
Summary
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The article reports on a study that evaluates the effectiveness of a continuous glucose monitoring system (CGMS) in comparison with a commonly used handheld glucometer and an in-house standard laboratory assay (SLA) for tracking glucose levels in critically ill newborn foals. The study concludes that while the CGMS can be beneficial for tracking glucose trends, it is best used alongside other more accurate methods.
Research Paper Explanation
Methods
- The study was conducted in a University teaching hospital, focusing on seven critically ill newborn foals needing intensive care.
- The foals were fitted with a CGMS that monitored interstitial glucose concentration every 5 minutes for periods ranging from 15 to 79 hours.
- Capillary and venous blood samples were also taken every 4 to 6 hours for comparison measurements using a point-of-care (POC) glucometer and a standard laboratory assay (SLA), respectively.
Results
- Using Bland-Altman analysis, the researchers evaluated the differences between CGMS, POC, and SLA. The results showed a minimal bias, suggesting a fair level of agreement between the methods.
- The comparison rated 68.4% for CGMS against SLA, 72.4% for CGMS versus the POC glucometer, and 80.7% for the POC glucometer against the SLA for classification in hypoglycemia, normoglycemia, and hyperglycemia.
- The weighted kappa measures, which assess the agreement level for qualitative data, also showed fair to moderate agreement.
Conclusions
- The researchers concluded that while the CGMS may be useful in monitoring glucose trends in critically ill foals, it should only be used as a supporting device due to its wide limits of agreement with other methods.
- The CGMS has limitations including high sensor cost, a mandatory 2-hour initialization period, and difficulties keeping the transducer on active foals.
- The POC glucometer, on the other hand, was deemed easy to use and accurate enough for repeated glucose monitoring in neonatal foals.
Cite This Article
APA
Hug SA, Riond B, Schwarzwald CC.
(2013).
Evaluation of a continuous glucose monitoring system compared with an in-house standard laboratory assay and a handheld point-of-care glucometer in critically ill neonatal foals.
J Vet Emerg Crit Care (San Antonio), 23(4), 408-415.
https://doi.org/10.1111/vec.12072 Publication
Researcher Affiliations
- Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland.
MeSH Terms
- Animals
- Animals, Newborn
- Blood Glucose / analysis
- Critical Illness
- Female
- Horse Diseases / blood
- Horse Diseases / diagnosis
- Horses
- Hyperglycemia / diagnosis
- Hyperglycemia / veterinary
- Hypoglycemia / diagnosis
- Hypoglycemia / veterinary
- Male
- Monitoring, Physiologic / methods
- Point-of-Care Systems / standards
- Reproducibility of Results
Citations
This article has been cited 4 times.- Byrd MKH, Arneson AG, Soffa DR, Stewart JW, Rhoads ML. Human continuous glucose monitors for measurement of glucose in dairy cows.. JDS Commun 2022 Jan;3(1):78-83.
- 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.
- Vitale V, Berg LC, Larsen BB, Hannesdottir A, Dybdahl Thomsen P, Laursen SH, Verwilghen D, van Galen G. Blood glucose and subcutaneous continuous glucose monitoring in critically ill horses: A pilot study.. PLoS One 2021;16(2):e0247561.
- Staarvik T, Framstad T, Heggelund M, Brynjulvsrud Fremgaarden S, Kielland C. Blood-glucose levels in newborn piglets and the associations between blood-glucose levels, intrauterine growth restriction and pre-weaning mortality.. Porcine Health Manag 2019;5:22.
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