Premium
Clinical utility of serum fructosamine in long‐term monitoring of diabetes mellitus in dogs
Author(s) -
Kuzi Sharon,
MazakiTovi Michal,
Ahmad Wiessam Abu,
Ovadia Yael,
Aroch Itamar
Publication year - 2022
Publication title -
veterinary record
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.261
H-Index - 99
eISSN - 2042-7670
pISSN - 0042-4900
DOI - 10.1002/vetr.2236
Subject(s) - fructosamine , diabetes mellitus , medicine , term (time) , endocrinology , intensive care medicine , physics , quantum mechanics
Background Serum fructosamine (sFA) is used to assess glycaemic control in dogs with diabetes mellitus (DM). Nevertheless, its interpretation is hindered by several limitations. Methods This retrospective study evaluates the long‐term diagnostic performance of sFA for monitoring clinical control of DM. sFA, bodyweight, appetite, presence of polyuria/polydipsia and clinical scores (CS; well‐controlled DM, CS‐0; uncontrolled DM, CS‐1) were recorded. Results The study included 75 dogs (321 visits; median 3 visits/dog; range 1–19). Mean sFA was higher ( p < 0.001) on visits with CS‐1 (584 μmol/L; 95% confidence interval [95% CI] 561–608) than on visits with CS‐0 (506 μmol/L; 95% CI 484–528). Increases in sFA increased the odds ratio for CS‐1 (1.37; 95% CI 1.24–1.52, p < 0.001). sFA was moderately predictive of the CS (area under receiver operating characteristic curve = 0.75; 95% CI 0.70–0.80; p < 0.0001), with a 486 μmol/L cutoff yielding 80% sensitivity and 59% specificity. Mean sFA was lower ( p = 0.005) when hypoglycaemic episodes were suspected (496 μmol/L; 95% CI 450–541) than in their absence (572 μmol/L; 95% CI 548–596). sFA is moderately accurate for classifying CS in diabetic dogs. Decreasing sFA over follow‐ups indicates improved CS but might suggest occurrence of hypoglycaemic episodes. Limitations Retrospective design, variable treatments and comorbidities are limitations of this study. Conclusion sFA has a moderate clinical utility in the long‐term monitoring of diabetic dogs, but may serve as a first‐line, accessible diagnostic tool. Discordant CS and sFA evaluation, or decreased sFA, warrants additional monitoring (i.e., continuous glucose monitoring).