Monitoring diabetic patients can be challenging. Management of diabetes means monitoring blood sugar. In humans this has meant frequent finger pricks for blood samples. In veterinary patients it has meant glucose curves done in the hospital or at home. For a glucose curve, a blood sample is obtained every 2 hours for a 12 hour period to get a data trend, or curve. This data shows how well the insulin is working and if a pet is getting the correct dose. These samples are obtained in the hospital with a venous blood draw, or at home with a prick on the ear, lip, or paw. While these results are extremely valuable they are not without error. Some problems with glucose curves include:
Not all pets appreciate having their blood sugar checked every 2 hours for an entire day
Staying in the hospital for 12 hours of blood draws can create stress, which could falsely elevate the blood sugar.
People cannot always be home for the exact timing of the curve, or may not be able to get blood samples from their pets.
The act of collecting a sample can cause a stress response that spikes the sugar higher.
There is data missing in between the two hour samples....
Well, the days of these traditional curves may soon be in the past as technology advances. The newest method of glucose monitoring in humans is the flash glucometer. A flash glucometer is a device that is essentially glued onto the skin (in humans it goes on the back of the arm) and provides continuous glucose monitoring by sampling the area just under the skin (the interstitial space). This provides constant, accurate, sugar readings with a 5-10 minute delay from blood glucose. For more information, watch this video. The flash glucometer that has been most used in veterinary medicine is the Freestyle Libre by Abbot. There is a 10 day or 14 day version, with the 14 day usually preferred.
The Freestyle Libre 14 day glucometer is a prescription device. You will need a prescription from your veterinarian to obtain it, or your veterinarian may dispense it to you. You will then need your veterinarian to apply it like this to your dog or cat. Please understand that this device does not replace your veterinarian, but rather provides more information for your veterinarian to interpret and help manage your pet's diabetes.
The device is made for humans, but seems to be accurate for dogs in a recent study. Further studies in animals are in the works.
The Freestyle Libre 14 day is ready to read 1 hour after placing it on your pet, and continues to read for 14 days. The device has an 8 hour memory, so now rather than being present every 2 hours and poking your pet with a needle, you only need to swipe the wireless reader over the sensor at least every 8 hours. There is an app for iPhone that can replace the reader, and a desktop download that can help you evaluate even more data.
The flash glucometers are also being used by some veterinarians in the hospital setting to help new diabetics become regulated.
Pets don't need continuous monitoring once regulated, since their diet is much more consistent than in humans. Your veterinarian can tell you how often you need to use this device.
All in all, this is pretty cool technology, and I am excited to see how we can adapt it for use in veterinary medicine.