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Estudo comparativo entre diferentes métodos analíticos utilizados na medição da glicemia em cães e gatos com diabetes mellitus
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Resumo(s)
A diabetes mellitus (DM) requer um controlo adequado e contínuo, no sentido de manter as
concentrações sanguíneas de glucose dentro de valores aceitáveis e atrasar o aparecimento de
complicações. Os glucómetros são uma excelente ferramenta para que, facilmente, se possa
aceder ao valor de glicemia, tomar decisões rápidas e, ainda, permitem a realização curvas de
glicemia em casa. Assim, os valores de glicemia medidos por estes equipamentos devem ser o
mais fidedignos possíveis, a fim de se tomarem as decisões mais acertadas. O aparecimento
de novos glucómetros específicos para o uso em cães e gatos (GPMS-CG) são uma excelente
alternativa aos glucómetros de uso humano (GPMS-H), os quais são amplamente utilizados
em Medicina Veterinária. Assim, levanta-se a questão se é justificável fazer esta substituição,
tendo em conta a relação custo-benefício.
Este estudo teve como principal objetivo avaliar a precisão analítica de 3 glucómetros
distintos: 1 específico para uso em cães e gatos e 2 validados para uso em pessoas. Os
resultados obtidos foram comparados com o método laboratorial de referência, que utiliza a
enzima glucose oxidase para obtenção dos valores de glucose. As concentrações sanguíneas e
plasmáticas correspondentes de glucose foram analisadas em 76 amostras frescas de sangue
venoso total e plasma, colhidas de animais diagnosticados com diabetes mellitus não
complicada.
Todos os glucómetros apresentaram uma boa correlação com o método de referência (r ≥
0.96). Contudo, a média das diferenças dos resultados obtidos entre os dois GPMS-H e o
método referência (-77.2 mg/dL e -28.9 mg/dL) foi superior à apresentada entre o GPMS-CG
e o método de referência (-5.1 mg/dL). O valor de concordância observado entre o GPMS-CG
e o método de referência (k=0.88) foi superior ao observado entre os dois GPMS-H e o
método de referência (k=0.83 e k= 0.70). Os resultados obtidos sugerem que o GPMS-CG
obteve melhor desempenho, comparativamente, aos outros dois GPMS-H. Para além disso, a
probabilidade de ocorrência de erros nos ajustes das doses de insulina em animais diabéticos,
poderá ser maior quando se utilizam GPMS-H na medição da glicemia nestes animais.
ABSTRACT - Comparative study between different analytical methods used to measure glycemia in dogs and cats with diabetes mellitus - It is well known that diabetes mellitus (DM) requires a continuous and accurate control to keep glycemia within satisfactory values and delay the appearance of the feared complications. There is no doubt that portable blood glucose meters (PBGM) are an excellent tool to easily assess patients’ glycemia and make instant decisions. They’re also used to carry out blood glucose curves, in animals with DM. So, the values of glycemia measured by them should be the more accurate and as trustworthy as possible in order to make right and adequate decisions. The development of dogs and cats specific portable blood glucose meters (PBGM-D&C) is happening fast and they can replace the widely used portable blood glucose meters validated for humans (PBGM-H). This raises the question if it is justified to make this replacement, regarding the cost-benefit ratio. The main goal of this study was to assess analytical accuracy of 3 PBGMs, one PBGM-D&C and the other two PBGM-H, by comparing the values of these meters with the values obtained from a glucose oxidase-based analyzer used as reference method. Blood concentrations and corresponding plasma glucose were analysed in 76 samples of fresh venous whole blood and plasma samples collected from animals diagnosed with uncomplicated diabetes mellitus. All PBGMs had significant correlations with the reference method (r ≥ 0.96). However, the mean difference between the 2 PBGM-H and the reference method (-77.2 mg/dL and -28.9 mg/dL) were greater than the mean difference between PBGM-D&C and the reference method (-5.1 mg/dL). The agreement observed between PBGM-D&C and the reference method (k=0.88) was higher than the agreement seen between the 2 PBGM-H and the reference method (k=0.83 and k= 0.70). The results suggest that PBGM-D&C had a higher performance compared to the other 2 PBGM-H in study. Furthermore, errors in insulin dose adjustment in diabetic animals may be more common when using PBGM-H to measure blood glucose concentrations in diabetic animals.
ABSTRACT - Comparative study between different analytical methods used to measure glycemia in dogs and cats with diabetes mellitus - It is well known that diabetes mellitus (DM) requires a continuous and accurate control to keep glycemia within satisfactory values and delay the appearance of the feared complications. There is no doubt that portable blood glucose meters (PBGM) are an excellent tool to easily assess patients’ glycemia and make instant decisions. They’re also used to carry out blood glucose curves, in animals with DM. So, the values of glycemia measured by them should be the more accurate and as trustworthy as possible in order to make right and adequate decisions. The development of dogs and cats specific portable blood glucose meters (PBGM-D&C) is happening fast and they can replace the widely used portable blood glucose meters validated for humans (PBGM-H). This raises the question if it is justified to make this replacement, regarding the cost-benefit ratio. The main goal of this study was to assess analytical accuracy of 3 PBGMs, one PBGM-D&C and the other two PBGM-H, by comparing the values of these meters with the values obtained from a glucose oxidase-based analyzer used as reference method. Blood concentrations and corresponding plasma glucose were analysed in 76 samples of fresh venous whole blood and plasma samples collected from animals diagnosed with uncomplicated diabetes mellitus. All PBGMs had significant correlations with the reference method (r ≥ 0.96). However, the mean difference between the 2 PBGM-H and the reference method (-77.2 mg/dL and -28.9 mg/dL) were greater than the mean difference between PBGM-D&C and the reference method (-5.1 mg/dL). The agreement observed between PBGM-D&C and the reference method (k=0.88) was higher than the agreement seen between the 2 PBGM-H and the reference method (k=0.83 and k= 0.70). The results suggest that PBGM-D&C had a higher performance compared to the other 2 PBGM-H in study. Furthermore, errors in insulin dose adjustment in diabetic animals may be more common when using PBGM-H to measure blood glucose concentrations in diabetic animals.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Diabetes mellitus curvas de glicemia glucómetros cães gatos blood glucose curves portable blood glucose meters dogs cats
Contexto Educativo
Citação
Medeiros, M.B.T. (2016). Estudo comparativo entre diferentes métodos analíticos utilizados na medição da glicemia em cães e gatos com diabetes mellitus. Dissertação de mestrado. Universidade de Lisboa, Faculdade de Medicina Veterinária, Lisboa.
Editora
Universidade de Lisboa, Faculdade de Medicina Veterinária