Evaluating the correlation between serum fructosamine concentration and interstitial glucose concentration in cats with diabetes mellitus

Abstract

Abstract Background Continuous monitoring of interstitial glucose concentration (CGM) is used in cats with diabetes mellitus (DM), but challenges remain with cat tolerance, affordability, global accessibility, and owner technophobia. Serum fructosamine (SF) concentration is an alternative, but its correlation to CGM has not been assessed. sec1a Hypothesis/Objectives Serum fructosamine concentration correlates with mean interstitial glucose in cats. sec1b Animals Twelve client-owned cats with DM. sec1c Methods This was a prospective cohort study. Cats with poorly controlled DM were treated with insulin with the goal of improving glycemic control, while monitored using CGM and SF concentration for a period of 6-12 weeks. At each recheck of SF concentration, CGM was applied. Mean interstitial glucose concentration was calculated over 72 h (IG) surrounding SF concentration measurement. Paired IGand SF concentration measurements were collected at the time of enrollment, and at 3- to 6-week and 9- to 12-week time points. Correlation was evaluated by Spearman’s rank test and simple linear regression. Serum fructosamine concentration was categorized based on reference laboratory interpretive guidelines, then by physiologically relevant cut-points of IGand evaluated for overlap between groups. sec1d Results There was a strong correlation between SF concentration and IG(= 0.87; [95% CI, 0.73-0.94];< .0001;= 0.81). When SF concentration was categorized based on reference laboratory interpretive guidelines, there was significant overlap between groups. This effect was also seen when categorizing SF concentration by physiologically relevant cut-points of IG. sec1e Conclusions and clinical importance Trends in SF concentration can serve as a viable monitoring tool to evaluate short-term changes in glycemia when CGM is not an option. sec1f