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Unfortunately, you have to sign in as a member of NAVC to view their articles, so thought I'd hit some of the good points. Overall, it's a good article that treats doing blood glucose curves at home as equal to veterinary curves and describes some of the disadvantages of curves done at the vet.
The Role of the Glucose Curve
by Thomas Schermerhorn, VMD, Kansas State University
November 2010, NAVC Clinician's Brief
http://www.cliniciansbrief.com/sites...ucoseCurve.pdf
Serum glucose, at any single time point during the GC, represents the
sum effects in the rate of:
- Exogenous insulin absorption - how the injected insulin is absorbed
- Intracellular uptake of exogenous and endogenous insulin
- Insulin degradation and elimination
- Intestinal glucose absorption
- Endogenous glucose production
(glucose released from stores in the body by the liver)
- Tissue glucose uptake and utilization
The Role of the Glucose Curve
by Thomas Schermerhorn, VMD, Kansas State University
November 2010, NAVC Clinician's Brief
http://www.cliniciansbrief.com/sites...ucoseCurve.pdf
Serum glucose, at any single time point during the GC, represents the
sum effects in the rate of:
- Exogenous insulin absorption - how the injected insulin is absorbed
- Intracellular uptake of exogenous and endogenous insulin
- Insulin degradation and elimination
- Intestinal glucose absorption
- Endogenous glucose production
(glucose released from stores in the body by the liver)
- Tissue glucose uptake and utilization
Acceptable methods include curves performed in the hospital or at home. In these settings, samples may be obtained, respectively, by veterinary personnel or by the pet owner.
- In-hospital curves may use an indwelling venous catheter method or repeat venipuncture method to obtain samples.
- Home sampling is usually performed using a lancet to obtain capillary blood, but venous sampling may be appropriate in some circumstances
- In-hospital curves may use an indwelling venous catheter method or repeat venipuncture method to obtain samples.
- Home sampling is usually performed using a lancet to obtain capillary blood, but venous sampling may be appropriate in some circumstances
Failure to adhere to the patient’s insulin protocol may produce a GC that does not reflect the patient’s normal situation. Insulin administered at an incorrect dose, injected into a different skin site, or variation in the time of administration are potential errors that can affect GC accuracy. Feeding a different diet during the GC may have similar detrimental effects on the quality of the data.
A 24-hour glucose curve: Clinical information that can be gleaned from the GC includes onset of insulin action, duration of insulin efffect, and glucose nadir. Time of onset is determined by the first glucose reading that is less than the preinjection value; duration of insulin effect is measured from the onset time until the glucose value equals or exceeds preinjection glucose level; glucose nadir is the lowest glucose concentration detected during the GC.
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