Validation of a Flash Glucose Monitoring System in Outpatient Diabetic Cats

Overview

Journal J Vet Intern Med

Specialties General Medicine
Veterinary Medicine

Date 2021 Jul 5

PMID 34223655

Citations 7

Authors

Emily K Shea

Rebecka S Hess

Affiliations

Soon will be listed here.

Abstract

Background: Interstitial glucose (IG) concentration measurement using a flash glucose monitoring system (FGMS) is a noninvasive, affordable, and informative method to regulate patients with diabetes mellitus (DM) but has not been fully validated in outpatient cats with DM.

Objectives: To further validate the FreeStyle Libre FGMS in outpatient diabetic cats.

Animals: Eight client-owned cats with DM.

Methods: Prospective observational validation study. Tissue glue was used to attach the sensor to the cat. Lin's concordance correlation coefficient (ρ ) was used to compare IG concentrations measured by the FGMS to blood glucose concentrations measured using an automated biochemistry analyzer (ABA) and point-of-care glucometer (POCG).

Results: Data from 15 sensor placements in 8 cats were analyzed. Paired IG and ABA glucose concentrations (139 samples) had excellent correlation (ρ = 0.96) as did IG and POCG glucose concentrations (142 samples, ρ = 0.92). Sensor failure or displacement were recorded for 12/15 (80%) sensor placements. Median time of sensor activity was 7 days (range, 2-13 days).

Conclusions And Clinical Importance: In outpatient cats with DM, the FGMS-measured IG concentration correlated well with ABA-measured blood glucose concentration, but a high rate of sensor failures was observed.

Citing Articles

Evaluation of the Accuracy of FreeStyle Libre 2 for Glucose Monitoring in White New Zealand Rabbits.

Choi M, Chae Y, Park J, Lee Y, Park K, Jeong D Vet Med Sci. 2024; 11(1):e70166.

PMID: 39688518 PMC: 11651090. DOI: 10.1002/vms3.70166.

Comparison between a Flash Glucose Monitoring System and a Portable Blood Glucose Meter for Monitoring of Cats with Diabetic Ketosis or Ketoacidosis.

Eiermann J, Hazuchova K, Vidondo B, Campos M, Schuller S, Cui Y Animals (Basel). 2024; 14(19).

PMID: 39409736 PMC: 11475600. DOI: 10.3390/ani14192787.

A concept for human use of real-time and remote monitoring of diabetic subjects using intermittent scanned continuous glucose measurement.

Goez-Mora J, Arbelaez-Cordoba N, Balcazar-Morales N, Rivadeneira P Biomed Eng Online. 2024; 23(1):26.

PMID: 38419031 PMC: 10903066. DOI: 10.1186/s12938-024-01217-z.

Assessment of the FreeStyle Libre 2 interstitial glucose monitor in hypo- and euglycemic cats.

Berg A, Crews C, Adin C, Alfonso-Castro A, Hill S, Mott J J Vet Intern Med. 2023; 37(5):1703-1709.

PMID: 37534946 PMC: 10472992. DOI: 10.1111/jvim.16820.

Evaluation of the FreeStyle Libre, a flash glucose monitoring system, in client-owned cats with diabetes mellitus.

Knies M, Teske E, Kooistra H J Feline Med Surg. 2022; 24(8):e223-e231.

PMID: 35762266 PMC: 9315169. DOI: 10.1177/1098612X221104051.

References

Silva D, Cecci G, Biz G, Chiaro F, Zanutto M . Evaluation of a flash glucose monitoring system in dogs with diabetic ketoacidosis. Domest Anim Endocrinol. 2020; 74:106525. DOI: 10.1016/j.domaniend.2020.106525. View

Hoenig M, Pach N, Thomaseth K, deVries F, Ferguson D . Evaluation of long-term glucose homeostasis in lean and obese cats by use of continuous glucose monitoring. Am J Vet Res. 2012; 73(7):1100-6. DOI: 10.2460/ajvr.73.7.1100. View

Lutz T, Rand J, Ryan E . Fructosamine concentrations in hyperglycemic cats. Can Vet J. 1995; 36(3):155-9. PMC: 1686902. View

Shea E, Hess R . Assessment of postprandial hyperglycemia and circadian fluctuation of glucose concentrations in diabetic dogs using a flash glucose monitoring system. J Vet Intern Med. 2021; 35(2):843-852. PMC: 7995415. DOI: 10.1111/jvim.16046. View

Elliott D, Nelson R, Reusch C, Feldman E, Neal L . Comparison of serum fructosamine and blood glycosylated hemoglobin concentrations for assessment of glycemic control in cats with diabetes mellitus. J Am Vet Med Assoc. 1999; 214(12):1794-8. View

Shoelson A, Mahony O, Pavlick M . Complications associated with a flash glucose monitoring system in diabetic cats. J Feline Med Surg. 2020; 23(6):557-562. PMC: 10741285. DOI: 10.1177/1098612X20965012. View

Nelson R . Stress hyperglycemia and diabetes mellitus in cats. J Vet Intern Med. 2002; 16(2):121-2. DOI: 10.1892/0891-6640(2002)16<121:shadmi>2.0.co;2. View

Basu A, Dube S, Slama M, Errazuriz I, Amezcua J, Kudva Y . Time lag of glucose from intravascular to interstitial compartment in humans. Diabetes. 2013; 62(12):4083-7. PMC: 3837059. DOI: 10.2337/db13-1132. View

Reusch C, Tomsa K . Serum fructosamine concentration in cats with overt hyperthyroidism. J Am Vet Med Assoc. 1999; 215(9):1297-300. View

10.

Hafner M, Lutz T, Reusch C, Zini E . Evaluation of sensor sites for continuous glucose monitoring in cats with diabetes mellitus. J Feline Med Surg. 2012; 15(2):117-23. PMC: 10816666. DOI: 10.1177/1098612X12463925. View

11.

Ohlund M, Egenvall A, Fall T, Hansson-Hamlin H, Rocklinsberg H, Holst B . Environmental Risk Factors for Diabetes Mellitus in Cats. J Vet Intern Med. 2016; 31(1):29-35. PMC: 5259626. DOI: 10.1111/jvim.14618. View

12.

Ohlund M, Fall T, Holst B, Hansson-Hamlin H, Bonnett B, Egenvall A . Incidence of Diabetes Mellitus in Insured Swedish Cats in Relation to Age, Breed and Sex. J Vet Intern Med. 2015; 29(5):1342-7. PMC: 4858030. DOI: 10.1111/jvim.13584. View

13.

Bailey T, Bode B, Christiansen M, Klaff L, Alva S . The Performance and Usability of a Factory-Calibrated Flash Glucose Monitoring System. Diabetes Technol Ther. 2015; 17(11):787-94. PMC: 4649725. DOI: 10.1089/dia.2014.0378. View

14.

Crenshaw K, Peterson M, Heeb L, Moroff S, Nichols R . Serum fructosamine concentration as an index of glycemia in cats with diabetes mellitus and stress hyperglycemia. J Vet Intern Med. 1996; 10(6):360-4. DOI: 10.1111/j.1939-1676.1996.tb02081.x. View

15.

Rebrin K, Steil G, van Antwerp W, Mastrototaro J . Subcutaneous glucose predicts plasma glucose independent of insulin: implications for continuous monitoring. Am J Physiol. 1999; 277(3):E561-71. DOI: 10.1152/ajpendo.1999.277.3.E561. View

16.

Baldo F, Canton C, Testa S, Swales H, Drudi I, Golinelli S . Comparison between a flash glucose monitoring system and a portable blood glucose meter for monitoring dogs with diabetes mellitus. J Vet Intern Med. 2020; 34(6):2296-2305. PMC: 7694810. DOI: 10.1111/jvim.15930. View

17.

Reineke E, Fletcher D, King L, Drobatz K . Accuracy of a continuous glucose monitoring system in dogs and cats with diabetic ketoacidosis. J Vet Emerg Crit Care (San Antonio). 2010; 20(3):303-12. DOI: 10.1111/j.1476-4431.2010.00538.x. View

18.

Malerba E, Cattani C, Baldo F, Carotenuto G, Corradini S, Golinelli S . Accuracy of a flash glucose monitoring system in dogs with diabetic ketoacidosis. J Vet Intern Med. 2019; 34(1):83-91. PMC: 6979271. DOI: 10.1111/jvim.15657. View

19.

Moretti S, Tschuor F, Osto M, Franchini M, Wichert B, Ackermann M . Evaluation of a novel real-time continuous glucose-monitoring system for use in cats. J Vet Intern Med. 2009; 24(1):120-6. DOI: 10.1111/j.1939-1676.2009.0425.x. View

20.

Corradini S, Pilosio B, Dondi F, Linari G, Testa S, Brugnoli F . Accuracy of a Flash Glucose Monitoring System in Diabetic Dogs. J Vet Intern Med. 2016; 30(4):983-8. PMC: 5094557. DOI: 10.1111/jvim.14355. View