Evaluation of portable blood glucose meters using canine and feline pooled blood samples

Abstract

This study evaluated the accuracy and reproducibility of a human portable blood glucose meter (PBGM) for canine and feline whole blood. Reference plasma glucose values (RPGV) were concurrently measured using glucose oxidation methods. Fifteen healthy dogs and 6 healthy cats were used for blood sampling. Blood glucose concentrations and hematocrits were adjusted using pooled blood samples for our targeted values. A positive correlation between the PBGM and RPGV was found for both dogs (y = 0.877, x = -24.38, r = 0.9982, n = 73) and cats (y = 1.048, x = -27.06, r = 0.9984, n = 69). Acceptable results were obtained in error grid analysis between PBGM and RPGV in both dogs and cats; 100% of these results were within zones A and B. Following ISO recommendations, a PBGM is considered accurate if 95% of the measurements are within ± 15 mg/dl of the RPGV when the glucose concentration is <100 mg/dl and within ±15% when it is ≥100 mg/dl; however, small numbers of samples were observed inside the acceptable limits for both dogs (11%, 8 of 73 dogs) and cats (39%, 27 of 69 cats). Blood samples with high hematocrits induced lower whole blood glucose values measured by the PBGM than RPGV under hypoglycemic, normoglycemic, and hyperglycemic conditions in both dogs and cats. Therefore, this device is not clinically useful in dogs and cats. New PBGMs which automatically compensate for the hematocrit should be developed in veterinary practice.

Evaluation of newly developed veterinary portable blood glucose meter with hematocrit correction in dogs and cats

“…Furthermore, 100% of the data points were within zone A of the error grid for both dogs and cats, indicating highly accurate PBGM performance. These percentages are higher than the results of similar previous studies that used human PBGMs (99.1% for dogs and 92.5% for cats plotted in zone A [ 5 ]; 38.4% for dogs and 76.8% for cats plotted in zone A [ 12 ]). Furthermore, according to the ISO 15197:2013 requirements, >95% of samples were within the calculated acceptable limits in dogs and cats in the current study [ 9 ].…”

“…Various PBGMs for human medicine are commercially available from several companies. However, canine and feline blood glucose concentrations obtained with human PBGMs are commonly lower than those obtained with gold standard methods (the hexokinase or glucose oxidase reaction) [ 1 , 12 ]. Therefore, PBGMs specifically for veterinary medicine are required for accurate measurement and diagnosis.…”

“…A previous study found that nine human PBGM devices did not fulfill ISO 15197:2013 accuracy requirements when used in dogs, with all devices having <74% of total measurements within acceptable limits [ 1 ]. Our previous study using human PBGMs also had few samples within the calculated acceptable limits (11% of dogs, 39% of cats) [ 12 ]. With respect to the Bland–Altman plots, 62% of dogs and 68% of cats of the samples were plotted within the calculated acceptability limits.…”

“…In our previous study, WB glucose concentrations measured with the PBGM without hematocrit correction were lower than plasma glucose concentrations measured with the reference method in samples with high hematocrit [ 12 ]. Specific PBGMs are affected by hematocrit values; anemic dogs and cats have higher glucose concentration results with WB PBGM measurement than with plasma reference methods [ 1 , 13 , 15 , 16 ].…”

Statistical and Experimental Evidence in a Design of Pooled Serum Sample Measurements to Improve Research Efficiency

“…The scientific research usually addresses a group issue rather than individual issue, therefore, the design of pooled sample is accepted [5][6][7][8] . The pooled samples were Patients in the ICUs of hospitals are mostly those in the end stages of a terminal disease, which is usually accompanied by multiple organ failure [9,10] .…”