Comparison of a continuous indwelling glucometer with a point‐of‐care device in healthy adult horses

Abstract

BackgroundBlood 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).MethodsTen 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.ResultsHorses 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).Conclusions of the studyCIG has acceptable accuracy in horses as compared with POC but overestimates glucose concentrations during hypoglycaemia and requires frequent replacement, limiting its clinical application.

Comparison of two glucose-monitoring systems for use in horses

“…A recent study evaluated the use of the Libre in horses, 15 comparing the Libre with the AlphaTRAK POC glucometer. Sensors were left in place for a maximum of 31 hours, whereas the study reported here evaluated sensors for approximately 108 hours.…”

“…Additionally, although these devices are marketed for use for up to 10 to 14 days, no studies have evaluated their accuracy in adult horses past 31 hours (1.29 days) of use. [12][13][14][15] Advancements in CGMS technology have produced more readily available and affordable devices, making their use a potentially viable tool for clinical application.…”

Evaluation of a continuous glucose monitoring system in neonatal foals

“… 22 This lag effect can range between 4 and 10 minutes in people using the CGMS (Dexcom G6), 7 , 22 , 23 and a delay of 10‐60 minutes was detected in a study in adult horses using a different type of glucose monitoring system. 11 , 24 , 25 , 26 Thus, the clinician should be aware of the fact that CGMS (interstitial) measurements may lag behind blood glucose concentration in situations in which rapid changes in blood glucose concentration occur (eg, IV dextrose bolus, stress‐induced hyperglycemia). Another point of interest is that after the first 30 hours of glucose monitoring (Figure 2 ), the CGMS had subjectively improved correlation with CHEM over time.…”

“…This change, or equilibration, between blood and interstitial glucose concentrations can take up to 5‐10 minutes in people 22 . This lag effect can range between 4 and 10 minutes in people using the CGMS (Dexcom G6), 7,22,23 and a delay of 10‐60 minutes was detected in a study in adult horses using a different type of glucose monitoring system 11,24‐26 . Thus, the clinician should be aware of the fact that CGMS (interstitial) measurements may lag behind blood glucose concentration in situations in which rapid changes in blood glucose concentration occur (eg, IV dextrose bolus, stress‐induced hyperglycemia).…”

Effect of 5′‐adenosine monophosphate‐activated protein kinase agonists on insulin and glucose dynamics in experimentally induced insulin dysregulation in horses

“…Plasma and serum samples were then collected from the IV catheter after a minimum collection of 10 mL of waste blood at time points: 30, 60, 90, 120, 180, 240, 300, and 360 minutes. Blood glucose values were measured stall‐side at each time point (including baseline [Time 0]) using a handheld glucometer previously evaluated with equine samples (AlphaTrak2, Zoetis Services LLC, Parsippany, NJ) immediately after collection of the blood sample 25,26 . Muzzles that had been placed for withholding feed pre‐testing were removed at the 120‐minute time point.…”