ISO-Based Assessment of Accuracy and Precision of Glucose Meters in Dogs

Abstract

Portable blood glucose meters (PBGMs) allow easy glucose measurements. As animal-specific PBGMs are not available everywhere, those for humans are widely used.Objectives: To assess the accuracy and precision of 9 PBGMs in canine whole blood (WB) and plasma, based on the ISO 15197: 2013.Animals: Fifty-nine client-owned dogs attending the Veterinary Teaching Hospital.Methods: Analytical evaluation of 100 blood samples was performed for accuracy and 23 for precision (glucose 29-579 mg/dL) following ISO recommendations. A PBGM was considered accurate if 95% of the measurements were within +/- 15 mg/dL from the reference when glucose was < 100 mg/dL and within +/- 15% when it was >= 100 mg/dL, and if 99% of them were within zones A and B in error grid analysis (EG). A hexokinase-based analyzer was used as reference. Ninety samples were assessed for hematocrit interferences.Results: Accuracy requirements were not fulfilled by any PBGM in WB (74% of measurements within the limits for the most accurate) and by 1 only in plasma. However, the EG analysis in WB was passed by 6 PBGM and by all in plasma. The most accurate were also the most precise, with coefficients of variation < 5% in WB and < 3% in plasma. Hematocrit correlated with bias against the reference method in 4 PBGM (r = -0.243 - [-0.371]; P <.021).Conclusions and Clinical Importance: This disparity among PBGM suggests that meters approved for humans need to be evaluated before use in other species.