Introduction

• Performing a blood glucose curve is a vital step in achieving accurate stabilization of a diabetic patient.
• A blood glucose curve should be performed in all diabetic animals around 1-3 weeks after the start of treatment and at any stage where stabilization is in question.
• It can be useful in determining the reason for poor stabilization.

• In order to be of value a blood glucose curve should portray as closely as possible the blood glucose concentrations experienced by the patient in a normal day.
• The normal management regime should be followed during the time of sampling for the blood glucose curve.
• Meals and insulin injection must be given at the normal times and exercise programmes should match those of the home environment.

  To monitor owner technique it might be advisable to get the owner to give the insulin injection before admission.

• In reality most animals undergoing a day long blood glucose monitoring are hospitalized which immediately creates problems.
• The novel environment of the veterinary surgery inevitably will trigger a stress response and release of stress hormones may have an insulin-antagonizing effect.
• Blood glucose readings may therefore be higher than normal. Dogs may be hospitalized for 24-48 h before the test to acclimatize to the environment but this may increase stress in some animals.
• Repeated venipuncture for collection of blood samples may also increase stress and for this reason the placement of an indwelling venous catheter for the duration of the study is advocated.
• Catheter placement increases the volume of blood that needs to be withdrawn during the course of the study and this can be significant in very small animals.

  If a glucometer is available this may be a useful alternative for measuring blood glucose as it requires only a single drop of blood at each measurement.

• If using a glucometer at least one sample should be checked in the laboratory to confirm the accuracy of the glucometer.
• If any alterations in regime are made then the glucose curve must be repeated after a period of adjustment to the new regime to confirm adequate stabilization.
• For details on how to obtain results for a blood glucose curve see the technique Glucometer use.

Plotting the graph

Interpreting the graph

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Fleeman L M & Rand J S (2003) Evaluation of day-to-day variability of serial blood glucose concentration curves in diabetic dogs. JAVMA 222 (3), 317-321 PubMed.
• Goossens M M, Nelson R W, Feldman E C et al (1998) Response to insulin treatment and survival in 104 dogs with diabetes mellitus (1985-1995). JVIM 12 (1), 1-6 PubMed.