Continuous Glucose Monitoring in Dogs and Cats

Abstract

Use of continuous glucose monitoring in veterinary medicine is gaining popularity. Through use of a commercially available continuous glucose monitor system, insights into daily glucose changes in dogs and cats are achievable. The continuous glucose monitoring system measures glucose concentrations in the interstitial fluid of the subcutaneous space by use of a small, flexible probe. When placed in the subcutaneous tissue, the probe is connected to a recording device that is attached to the animal and records the interstitial fluid glucose concentration every 5 minutes (288 readings per 24 hours). Once attached and properly calibrated, the instrument can remain in place for several days, hospitalization of the patient is not necessary, and the normal daily routine of the animal can be maintained. The data from the recording device are then downloaded and a very detailed picture of the interstitial fluid glucose concentration over that time period can be obtained. Subcutaneous interstitial fluid glucose concentrations have a good correlation to blood glucose concentrations within a defined range. The continuous glucose monitoring system has distinct advantages over traditional blood glucose curves and is a valuable tool for managing diabetic dogs and cats. In addition, other clinical uses for continuous glucose monitoring are being developed. This review is designed to outline the technology behind the continuous glucose monitoring system, describe the clinical use of the instrument, provide clinical examples in which it may be useful, and discuss future directions for continuous glucose monitoring in dogs and cats.

Evaluation of sensor sites for continuous glucose monitoring in cats with diabetes mellitus

“…In most studies, the thoracic region has been used. 3,8,9 We hypothesise that the position of the sensor interferes with its function in cats. The purpose of this study was to determine which sensor site in the subcutaneous tissue of diabetic cats is more practical and provides the most accurate results.…”

“…A good correlation between interstitial fluid and blood glucose concentrations was shown with the first generation of CGMSs in cats and dogs. [1][2][3][4] However, these older systems necessitate attachment of the monitor to the animal and manual downloading of the recorded data to a computer for analysis. The Guardian Real-Time (Medtronic) is a new generation CGMS that enables onscreen date recording over a 72-h period.…”

“…[1][2][3][4] This system measures glucose concentrations in the subcutaneous interstitial fluid every 5 mins for up to 72 h via a glucose oxidase-containing sensor. The technique provides a potentially less stressful alternative to blood glucose measurements and generates detailed glucose curves.…”

Update on insulin treatment of dogs and cats with non-complicated diabetes mellitus

“…These systems use a small, flexible and disposable sensor that is inserted into SC tissue to constantly measure glucose concentration in the interstitial fluid with the glucose oxidase reaction; since blood and interstitial fluid glucose concentrations equilibrate relatively fast (5-12 min) and CGMSs are calibrated based on the former, they have the ability to accurately measure glucose concentration every 1-10sec, average and display the results every 3-5min and work constantly for up to 48-144h (Wiedmeyer and DeClue, 2008;Affenzeller et al, 2010;Moretti et al, 2010;Affenzeller et al, 2011;Dietiker-Moretti et al, 2011;Fleeman, 2011;Hafner et al, 2013;Mori et al, 2013;Surman and Fleeman, 2013).…”

Comparison of continuous and intermittent glucose monitoring systems in a dog with diabetic ketoacidosis: a case report

“…Certainly, repeated venipuncture in hospitalised animal patients can cause pain and stress for the animal. Assessing the blood glucose A continuous glucose monitoring system (CGMS) is a monitoring device that evaluates glucose levels from a flexible sensor electrode every five minutes, and allows real-time recording of changes in glucose levels, continuously on a separate screen, for up to 72 h. The CGMS measures the change in interstitial glucose levels, which closely mimic blood glucose levels (Wiedmeyer and DeClue 2008;Surman and Fleeman 2013;Corradini 2016). The CGMS can detect and alert clinicians to short-term variations, such as hypoglycaemia, hyperglycaemia, and the Somogyi phenomenon, that may not be detected between two measurements of traditional glucose monitoring.…”