EN03 - Evaluating a Second-generation Flash Glucose Monitoring System in Nondiabetic Dogs with Rapidly Induced Hypoglycemia

Abstract: Background:
A flash glucose monitoring system (FGMS; FreeStyle Libre 14-day system, Abbott Laboratories) was commonly utilized for the management of canine diabetes but has been discontinued and replaced by a second-generation system (FreeStyle Libre2, Abbott Laboratories).

Objective(s):
To assess the utility of a second-generation FGMS in non-diabetic dogs during rapidly induced hypoglycemia.

Animals:
Twenty-three apparently healthy teaching dogs.

Methods:
Prospective, observational study performed in tandem with a teaching laboratory. Regular insulin was administered to dogs and resulting hypoglycemia corrected. Before insulin administration and every 10 minutes over a 90-minute period, serial measurements of interstitial glucose (IG) with FGMS and blood glucose (BG) with a portable blood glucose meter (PBGM) were made. At each time point, readings of both PBGM and FGMS were compared to a clinical chemistry analyzer BG concentration as a gold standard. Analytical and clinical accuracy were assessed using ISO 15197:2013 criteria, including Parkes error grid analysis.

Results:
The proportions of readings in the low BG range (BG < 100 mg/dL) for which the test method measurement was within ±15 mg/dL of the reference BG for the PBGM and FGMS were 66.7% (132/198) and 45.1% (69/153), respectively. The proportions of readings for the PBGM and FGMS, which were not likely to affect clinical outcome according to Parkes error grid analysis, were 94.92% (217/230) and 88.2% (157/178), respectively.

Conclusions and Clinical Importance:
In this model, there was limited agreement between the FGMS and reference standard BG measurements. The FGMS failed to reliably detect hypoglycemia.