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

Serial serum fructosamine trends are a viable glycemic monitoring alternative when CGM is unavailable in diabetic cats.

This prospective cohort study evaluated the correlation between serum fructosamine (SF) concentration and continuous glucose monitoring (CGM)-derived interstitial glucose in 12 client-owned diabetic cats. Cats with poorly controlled diabetes mellitus (DM) were treated with insulin and monitored simultaneously with CGM and SF concentration measurements over 6–12 weeks. Mean interstitial glucose was calculated over 72-hour windows (IG72h) surrounding each SF measurement, yielding paired data points at enrollment and at 3–6 and 9–12 week rechecks. Statistical analysis using Spearman's rank correlation and simple linear regression demonstrated a strong positive correlation between SF concentration and IG72h (r = 0.87; 95% CI, 0.73–0.94; P < .0001; R² = 0.81), indicating that SF explains approximately 81% of the variability in mean interstitial glucose. However, when SF values were categorized using reference laboratory interpretive guidelines or physiologically relevant IG72h cut-points, significant overlap was observed between glycemic categories, limiting the utility of single SF measurements for precise glycemic classification. The authors conclude that while SF concentration cannot reliably differentiate discrete glycemic control categories in a cross-sectional manner, serial SF trends remain a clinically viable tool for monitoring short-term changes in glycemia when CGM is unavailable due to cost, accessibility, patient tolerance, or owner compliance barriers. This study supports a complementary rather than equivalent role for SF relative to CGM in feline diabetic management.

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