Evaluation of Glucose Response to 3 Types of Insulin Using a Continuous Glucose Monitoring System in Healthy Alpacas

Abstract

BackgroundPersistent hyperglycemia is common in alpacas and typically requires insulin administration for resolution; however, little is known about alpacas’ response to different insulin formulations.ObjectivesTo evaluate the effects of 3 insulin formulations on blood glucose concentrations and the use of a continuous glucose monitoring (CGM) system in alpacas.AnimalsSix healthy alpacas.MethodsThe CGM was installed in the left paralumbar fossa at the start of this crossover study and recorded data every 5 minutes. Regular insulin, NPH insulin, insulin glargine, and dextrose were administered to each alpaca over a 2‐week period. Blood samples were collected for glucose testing at 0, 1, 2, 4, 6, 8, and 12 hours, and then every 6 hours after each administration of insulin or dextrose. Data were compared by using method comparison techniques, error grid plots, and ANOVA.ResultsBlood glucose concentrations decreased most rapidly after regular insulin administration when administered IV or SC as compared to the other formulations. The NPH insulin produced the longest suppression of blood glucose. The mean CGM interstitial compartment glucose concentrations were typically lower than the intravascular compartment glucose concentrations. The alpacas had no adverse reactions to the different insulin formulations.Conclusions and Clinical ImportanceThe NPH insulin might be more appropriate for long‐term use in hyperglycemic alpacas because of its extended duration of action. A CGM is useful in monitoring glucose trends and reducing blood collection events, but it should not be the sole method for determining treatment protocols.

Comparative evaluation of clinical findings and prognostic outcome parameters in hospitalized, critically ill neonatal foals and crias

“…The latter may delay a decision for euthanasia in the face of severe or irreversible illness. Increased or continuous stall‐side monitoring (such as assessment of heart rate variability, 32 placement of glucose sensors, 33 measurement of lactate clearance 34 ) and more advanced diagnostic imaging to better characterize the severity of pulmonary disease 35 as a significant contributor to neonatal mortality, may be particularly useful in crias to advance critical care and improve outcome going forward. However, more targeted recommendations need to be developed once the specific cause of a higher natural death rate compared to euthanasia has been further elucidated in crias.…”