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Comparison of a continuous indwelling glucometer with a point‐of‐care device in healthy adult horses
Author(s) -
Cunneen Alexandra,
Wood Kelly A,
Mathison Kylie,
Herndon Aaron M,
Bertin Francois R
Publication year - 2020
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 - 10.1136/vr.105607
Subject(s) - medicine , limiting , point of care , limits of agreement , insulin , anesthesia , nuclear medicine , pathology , mechanical engineering , engineering
Background Blood 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). Methods Ten 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. Results Horses 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 study CIG has acceptable accuracy in horses as compared with POC but overestimates glucose concentrations during hypoglycaemia and requires frequent replacement, limiting its clinical application.