Accuracy of the Freestyle Libre 3 Continuous Glucose Monitoring System in Hypo‐ and Euglycemic Cats
ABSTRACT Background The FreeStyle Libre 3 (FSL3) has several improvements compared to previous FreeStyle Libre systems, but its accuracy has not yet been determined in cats. In diabetic people, FSL3 offers increased accuracy, and its smaller size could be advantageous for use in veterinary patients....
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-03-01
|
| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.70048 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850192953543229440 |
|---|---|
| author | Antonio M. Tardo Chiquitha Crews Jocelyn Mott Lauren T. Porter Christopher Adin Chen Gilor |
| author_facet | Antonio M. Tardo Chiquitha Crews Jocelyn Mott Lauren T. Porter Christopher Adin Chen Gilor |
| author_sort | Antonio M. Tardo |
| collection | DOAJ |
| description | ABSTRACT Background The FreeStyle Libre 3 (FSL3) has several improvements compared to previous FreeStyle Libre systems, but its accuracy has not yet been determined in cats. In diabetic people, FSL3 offers increased accuracy, and its smaller size could be advantageous for use in veterinary patients. Objectives Assess the accuracy of FSL3 in cats with experimentally induced hypoglycemia. Animals Seven healthy, purpose‐bred cats. Methods Hyperinsulinemic‐hypoglycemic clamps were performed. Interstitial glucose concentration (IG), measured by FSL3, was compared to blood glucose concentration (BG) measured by AlphaTrak2. Data were analyzed for all paired measurements (n = 474) and during stable BG (≤ 1 mg/dL/min change over 10 min). Pearson's r test, Bland–Altman test, and Parkes Error Grid analysis (EGA) respectively used to determine correlation, bias, and clinical accuracy. Results Blood glucose concentration and IG correlated strongly (r = 0.86, p < 0.0001) in stable glycemia and moderately at all rates of change (r = 0.73, p < 0.0001). Analytical accuracy was not achieved, whereas clinical accuracy was demonstrated with 99%–100% of the results in zones A + B of the Parkes EGA. Interstitial glucose concentration underestimated BG in euglycemia and mild hypoglycemia (mean −11.7 ± 11.2, −5.5 ± 9.1, −1.5 ± 6.0 mg/dL in the ranges 91–120, 66–90, and 56–65 mg/dL, respectively), but overestimated BG in marked hypoglycemia (mean 6.3 ± 5.7, 15.7 ± 5.6 mg/dL in the ranges 46–55 and < 45 mg/dL, respectively). Conclusions The FSL3 underestimates BG across most of the hypo‐euglycemic range but overestimates BG in marked hypoglycemia (< 55 mg/dL). Recognizing the proportional, glycemic‐dependent bias of FSL3 improves the safety of its clinical application in cats. |
| format | Article |
| id | doaj-art-529807cdb2e042fc9e730fbd98965c98 |
| institution | OA Journals |
| issn | 0891-6640 1939-1676 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj-art-529807cdb2e042fc9e730fbd98965c982025-08-20T02:14:23ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762025-03-01392n/an/a10.1111/jvim.70048Accuracy of the Freestyle Libre 3 Continuous Glucose Monitoring System in Hypo‐ and Euglycemic CatsAntonio M. Tardo0Chiquitha Crews1Jocelyn Mott2Lauren T. Porter3Christopher Adin4Chen Gilor5Department of Veterinary Medical Sciences University of Bologna Ozzano dell'Emilia ItalyDepartment of Small Animal Clinical Sciences University of Florida, College of Veterinary Medicine Gainesville Florida USADepartment of Small Animal Clinical Sciences University of Florida, College of Veterinary Medicine Gainesville Florida USADepartment of Small Animal Clinical Sciences University of Florida, College of Veterinary Medicine Gainesville Florida USADepartment of Small Animal Clinical Sciences University of Florida, College of Veterinary Medicine Gainesville Florida USADepartment of Small Animal Clinical Sciences University of Florida, College of Veterinary Medicine Gainesville Florida USAABSTRACT Background The FreeStyle Libre 3 (FSL3) has several improvements compared to previous FreeStyle Libre systems, but its accuracy has not yet been determined in cats. In diabetic people, FSL3 offers increased accuracy, and its smaller size could be advantageous for use in veterinary patients. Objectives Assess the accuracy of FSL3 in cats with experimentally induced hypoglycemia. Animals Seven healthy, purpose‐bred cats. Methods Hyperinsulinemic‐hypoglycemic clamps were performed. Interstitial glucose concentration (IG), measured by FSL3, was compared to blood glucose concentration (BG) measured by AlphaTrak2. Data were analyzed for all paired measurements (n = 474) and during stable BG (≤ 1 mg/dL/min change over 10 min). Pearson's r test, Bland–Altman test, and Parkes Error Grid analysis (EGA) respectively used to determine correlation, bias, and clinical accuracy. Results Blood glucose concentration and IG correlated strongly (r = 0.86, p < 0.0001) in stable glycemia and moderately at all rates of change (r = 0.73, p < 0.0001). Analytical accuracy was not achieved, whereas clinical accuracy was demonstrated with 99%–100% of the results in zones A + B of the Parkes EGA. Interstitial glucose concentration underestimated BG in euglycemia and mild hypoglycemia (mean −11.7 ± 11.2, −5.5 ± 9.1, −1.5 ± 6.0 mg/dL in the ranges 91–120, 66–90, and 56–65 mg/dL, respectively), but overestimated BG in marked hypoglycemia (mean 6.3 ± 5.7, 15.7 ± 5.6 mg/dL in the ranges 46–55 and < 45 mg/dL, respectively). Conclusions The FSL3 underestimates BG across most of the hypo‐euglycemic range but overestimates BG in marked hypoglycemia (< 55 mg/dL). Recognizing the proportional, glycemic‐dependent bias of FSL3 improves the safety of its clinical application in cats.https://doi.org/10.1111/jvim.70048diabetes mellitusflash glucose monitoring systemhypoglycemiainsulininterstitial glucose |
| spellingShingle | Antonio M. Tardo Chiquitha Crews Jocelyn Mott Lauren T. Porter Christopher Adin Chen Gilor Accuracy of the Freestyle Libre 3 Continuous Glucose Monitoring System in Hypo‐ and Euglycemic Cats Journal of Veterinary Internal Medicine diabetes mellitus flash glucose monitoring system hypoglycemia insulin interstitial glucose |
| title | Accuracy of the Freestyle Libre 3 Continuous Glucose Monitoring System in Hypo‐ and Euglycemic Cats |
| title_full | Accuracy of the Freestyle Libre 3 Continuous Glucose Monitoring System in Hypo‐ and Euglycemic Cats |
| title_fullStr | Accuracy of the Freestyle Libre 3 Continuous Glucose Monitoring System in Hypo‐ and Euglycemic Cats |
| title_full_unstemmed | Accuracy of the Freestyle Libre 3 Continuous Glucose Monitoring System in Hypo‐ and Euglycemic Cats |
| title_short | Accuracy of the Freestyle Libre 3 Continuous Glucose Monitoring System in Hypo‐ and Euglycemic Cats |
| title_sort | accuracy of the freestyle libre 3 continuous glucose monitoring system in hypo and euglycemic cats |
| topic | diabetes mellitus flash glucose monitoring system hypoglycemia insulin interstitial glucose |
| url | https://doi.org/10.1111/jvim.70048 |
| work_keys_str_mv | AT antoniomtardo accuracyofthefreestylelibre3continuousglucosemonitoringsysteminhypoandeuglycemiccats AT chiquithacrews accuracyofthefreestylelibre3continuousglucosemonitoringsysteminhypoandeuglycemiccats AT jocelynmott accuracyofthefreestylelibre3continuousglucosemonitoringsysteminhypoandeuglycemiccats AT laurentporter accuracyofthefreestylelibre3continuousglucosemonitoringsysteminhypoandeuglycemiccats AT christopheradin accuracyofthefreestylelibre3continuousglucosemonitoringsysteminhypoandeuglycemiccats AT chengilor accuracyofthefreestylelibre3continuousglucosemonitoringsysteminhypoandeuglycemiccats |