Evaluation of Clinical Accuracy of Portable Glucometers in Sheep at the Beginning of the Breeding Season

Abstract

Measurements of blood glucose concentrations are frequently used to diagnose and monitor diseases in sheep. Portable blood glucometers are widely used in human medicine because of their practicality. However, there are not enough studies on the accuracy of these devices in sheep. In this study, it was aimed to determine the changes in the measurement values of two different portable blood glucometers and biochemistry autoanalyzer devices. The study was carried out on a total of 47 Kangal sheep, 17-18 months old, healthy and sick. According to the clinical examination, 35 healthy sheep (Group 1) and 12 patients whose hematocrit and total protein values were higher than the reference values were included in the study (Group 2). Glucose concentrations measured with portable glucometers were compared with the result obtained using the biochemistry autoanalyzer device. The agreement between the measured values was evaluated by Pearson correlation analysis and Bland-Altman plots. In addition, Tukey's test was performed to evaluate glucose measurement between groups. In the study found that there were -3.63% and 6.83% differences in the blood glucose measurement readings between the Optium Xceed (OX), On Call Pluss (CP), and biochemistry autoanalyzer devices in Group 1. These figures were found to be 6.08% and 9.66% in Group 2. The variety of measurement differences between the biochemistry autoanalyzer and glucometers should therefore be known in the clinical evaluation of blood glucose levels.

Keywords

• Glucose
• Sheep
• Hematocrit
• Glucometer
• Glukometre

Project Number

Yok

Üreme Sezonu Başlangıcında Koyunlarda Portatif Şeker Ölçüm Cihazlarının Klinik Doğruluğunun Değerlendirilmesi

Abstract

Koyunlarda hastalıkların tanısını koymak ve takibini izlemek için sıklıkla kan glikoz konsantrasyonlarının ölçümlerinden yararlanılmaktadır. Taşınabilir kan glukometreler beşerî hekimlikte pratiklikleri nedeniyle yaygın olarak kullanılmaktadır. Ancak, bu cihazların koyunlarda doğruluğu üzerine yeterli sayıda çalışma yoktur. Bu çalışmada iki farklı taşınabilir kan glukometre ile biyokimya otoanalizör cihazı ölçüm değerlerinin değişimlerinin belirlenmesi amaçlandı. Çalışma 17-18 aylık sağlıklı ve hasta olmak üzere toplam 47 kangal ırkı koyun üzerinde gerçekleştirildi. Yapılan klinik muayene göre 35 sağlıklı koyun (kontrol grubu) ile hematokrit ve total protein değerlerinin referans değerleri dışında yüksek olan 12 hasta koyun çalışmaya dâhil edildi (hasta grubu). Taşınabilir glukometreler ile ölçülen glikoz konsantrasyonları, biyokimya otoanalizör cihazı kullanılarak elde edilen sonuçlarla karşılaştırıldı. Ölçülen değerler arasındaki uyum Pearson korelasyon analizi ve Bland-Altman grafikleri ile değerlendirildi. Ayrıca gruplar arasındaki glikoz ölçümünü değerlendirmek için Tukey testi yapıldı. Çalışmada Grup 1’de Optium Xceed (OX), On Call Pluss (CP) ve biyokimya otoanalizör cihazları arasındaki kan glukoz ölçüm değerlerinin değişimleri sırasıyla, -3.63% ve 6.83% olarak belirlendi. Grup 2 ‘de ise bu değerler 6.08%, 9.66% olarak saptanmıştır. Sonuç olarak; Klinik olarak kan glikoz seviyelerinin değerlendirilmesinde, biyokimya otoanalizör ile glukometrelerin arasındaki ölçüm farklarının değişimleri bilinmelidir.

Keywords

• Glikoz
• Koyun
• Hematokrit
• Glukometre

Supporting Institution

Yok

Project Number

Yok

Thanks

Bu çalışma Sivas Cumhuriyet Üniversitesine bağlı SİVKOÇ Ltd. Şti.’nde gerçekleştirilmiştir. Kendilerine teşekkür ederiz.

References

1. Aly M, Elshahawy I (2016). Clinico-biochemical diagnosis of pregnancy toxemia in ewes with special reference to novel biomarkers. Alex J Vet Sci, 48 (2), 96-102.
2. Arens S, Moons V, Meuleman P et al. (1998). Evaluation of Glucocard Memory 2 and Accutrend sensor blood glucose meters. Clin Chem Lab Med, 36 (1), 47–52.
3. Aykal G, Erkal FA, Yeğin A, Eren E, Yılmaz N (2016). HbA2 ölçümü için BioRad D-10TM ve Tosoh HLC 723 G8 HPLC sistemlerinin karşılaştırılması. Turk Hij Den Biyol Derg, 73 (3), 245-252.
4. Bland JM, Altman DG (1999). Measuring agreement in method comparison studies. Stat Methods Med Res, 8 (2), 135-160.
5. Brozos, C, Mavrogianni VS, Fthenakis GC (2011). Treatment and control of peri-parturient metabolic diseases: pregnancy toxemia, hypocalcemia, hypomagnesemia. Vet Clin North Am Small Anim Pract, 27 (1), 105-113.
6. Cohen TA, Nelson RW, Kass PH et al. (2009). Evaluation of six portable blood glucose meters for measuring blood glucose concentration in dogs. J Am Vet Med Assoc, 235 (3), 276-280.
7. Devreese K, Leroux-Roels G (1993). Laboratory assessment of five glucose meters designed for self-monitoring of blood glucose concentration. Eur J Clin Chem Clin Biochem, 31 (12), 829–837.
8. Domori A, Sunahara A, Tateno M et al. (2014). The clinical utility of two human portable blood glucose meters in canine and feline practice. Vet Clin Pathol, 43 (1), 55–62.

9. Ekici M, Takcı A, Kıvrak MB (2021). Comparison of some hematological and serum biochemical variables in Kangal Akkaraman, Texel and Île De France ewes in lactation period within Sivas province. Eurasian J Vet Sci, 37 (4), 296-302.
10. Eren SE, Çaycı B, Atikeler G et al. (2013). Koagülasyon Cihazı Değişiminde Karşılaştırılan Hasta Sonuçları. Türk Klinik Biyokimya Derg, 11 (1), 7-14.
11. Frye EA, Behling‐Kelly EL, Lejuene M, Webb JL (2022). Complete blood count and biochemistry reference intervals for healthy adult sheep in the northeastern United States. Vet Clin Path, 51 (1), 119-125.
12. Giavarina, D (2015). Understanding bland altman analysis. Biochem Med, 25 (2), 141-151.
13. Ginsberg BH (2009). Factors affecting blood glucose monitoring: sources of errors in measurement. J Diabetes Sci Technol, 3 (4), 903-913.
14. Johnson BM, Fry MM, Flatland B, Kirk CA (2009). Comparison of a human portable blood glucose meter, veterinary portable blood glucose meter, and automated chemistry analyzer for measurement of blood glucose concentrations in dogs. J Am Vet Med Assoc, 235 (11), 1309–1313.
15. Kabakci, N, Yarim G, Yarim M et al. (2003). Pathological, clinical and biochemical investigation of naturally occurring pregnancy toxemia of sheep. Acta Vet, 53 (2-3), 161-169.
16. Karon BS, Griesmann L, Scott R et al. (2008). Evaluation of the impact of hematocrit and other interference on the accuracy of hospitalbased glucose meters. Diabetes Technol Ther, 10 (2),111- 120.
17. Lane SL, Koenig A, Brainard BM (2015). Formulation and validation of a predictive model to correct blood glucose concentrations obtained with a veterinary point-of-care glucometer in hemodiluted and hemoconcentrated canine blood samples. J Am Vet Med Assoc, 246, 307-312.
18. Mair B, Drillich M, Klein-Jöbstl D, et al. (2016). Glucose concentration in capillary blood of dairy cows obtained by a minimally invasive lancet technique and determined with three different hand-held devices. BMC Vet Res, 12 (1), 1-11.
19. Paul AE, Shiel RE, Juvet F, Mooney CT, Mansfield CS (2011). Effect of hematocrit on accuracy of two point-of-care glucometers for use in dogs. Am J Vet Res, 72 (9), 1204- 1208.
20. Renaud DL, Hare KS, Wood KM, Steele MA, Cantor MC (2022). Evaluation of a point-of-care meter for measuring glucose concentrations in dairy calves: A diagnostic accuracy study. JDS Communications, 3 (4), 301-306.
21. Tang Z, Lee JH, Louie RF, Kost GJ (2000). Effects of different hematocrit levels on glucose measurements with handheld meters for point-of-care testing. Arch Pathol Lab Med, 124 (8), 1135-1140.
22. Tauk BS, Drobatz KJ, Wallace KA, Hess RS (2015). Correlation between glucose concentrations in serum, plasma, and whole blood measured by a point-of-care glucometer and serum glucose concentration measured by an automated biochemical analyzer for canine and feline blood samples. J Am Vet Med Assoc, 246 (12), 1327-1333.
23. Van Stralen KJ, Jager KJ, Zoccali C, Dekker FW (2008). Agreement between methods. Kidney Int, 74 (9), 1116-1120.
24. Wiedmeyer CE, Johnson PJ, Cohn LA et al. (2005). Evaluation of a continuous glucose monitoring system for use in veterinary medicine. Diabetes Technol Ther, 7 (6), 885-895.