Blood glucose and subcutaneous continuous glucose monitoring in critically ill horses: A pilot study.
Authors: Vitale Valentina, Berg Lise C, Larsen Bettina Birch, Hannesdottir Andrea, Dybdahl Thomsen Preben, Laursen Sigrid Hyldahl, Verwilghen Denis, van Galen Gaby
Journal: PloS one
Summary
# Editorial Summary: Continuous Glucose Monitoring in Critically Ill Horses Hyperglycaemia and glucose dysregulation are recognised complications in equine critical care, yet traditional point-of-care blood glucose testing only captures snapshots of a dynamic metabolic process. Vitale and colleagues piloted the use of subcutaneous continuous glucose monitoring (CGM) devices in six adult horses and four neonatal foals presenting with systemic inflammatory response syndrome, comparing interstitial fluid glucose readings against simultaneous blood samples analysed via glucometer and blood gas analyser over the study period (March–May 2016). Although successful CGM recordings were achieved in only four adults and one foal due to technical and practical challenges, the data revealed important clinical insights: glucose concentrations showed reasonable correlation between blood and interstitial measurements, but a consistent lag time in interstitial glucose response was observed, and glucose fluctuations in interstitial fluid did not always mirror blood trends, meaning CGM identified significant peaks and troughs that would have been missed with conventional 4-hourly blood sampling alone. For equine practitioners managing critically ill cases, CGM technology offers the potential to detect clinically relevant glucose dynamics and guide nutritional and medical interventions more precisely; however, the authors highlight that equipment durability, sensor placement challenges, and data interpretation protocols require further refinement before widespread clinical adoption becomes practical in the intensive care setting.
Read the full abstract on PubMed
Practical Takeaways
- •CGM technology shows promise for detecting glucose instability in critically ill horses but requires further development before routine clinical adoption
- •Standard 4-hourly blood glucose monitoring may miss clinically significant peaks and troughs—consider CGM for high-risk cases if access improves
- •Be aware that CGM lag time means real-time clinical decisions should still be based on blood glucose values, not CGM readings alone
Key Findings
- •Continuous glucose monitoring (CGM) was successfully implemented in 4 of 6 adult horses and 1 of 4 foals, demonstrating feasibility despite technical challenges
- •CGM measurements correlated fairly well with blood glucose but showed lag time in interstitial glucose detection
- •CGM identified glucose peaks and drops that would have been missed by conventional 4-hourly point-of-care monitoring
- •Interstitial fluid glucose fluctuations did not always track blood glucose trends, suggesting different physiological information from each method