Relion Prime meter testing against a Alphatrak 2

[Marianne M]

I used a Relion Prime human meter for the last two days waiting for the reorder of my test strips for the Alphatrak 2 meter. Alphatrak was 100% higher than the Relion Prime meter! PMPS Relion Prime tested at 179 Alphatrak 2 tested at 357. I was shocked to see the difference in the readings.

 

[MrWorfMen's Mom]

The AT2 meter generally reads higher than a human meter and the difference between the readings is greater the higher the BG. I've done copious comparision readings and your results are not particularly unusual. All meters have an acceptable variance and if one meter reads low and the other reads high for a particular reading, the difference can be even more pronounced. There is no math calculation you can do to convert human to pet meter or vice versa.
Pick which meter you want to use on a regular basis and use it. Keep the other meter as a backup.

 

[Marianne M]

The AT2 meter generally reads higher than a human meter and the difference between the readings is greater the higher the BG. I've done copious comparision readings and your results are not particularly unusual. All meters have an acceptable variance and if one meter reads low and the other reads high for a particular reading, the difference can be even more pronounced. There is no math calculation you can do to convert human to pet meter or vice versa.
Pick which meter you want to use on a regular basis and use it. Keep the other meter as a backup.

Thank you for the information. I will stick with the AT2 because it's so easy to use.

 

[Chachi's Mom]

I may be speaking out of turn here, I'm a newbie, but I have read that the Relion Prime and such require a control solution to test accuracy of the meter. I wonder if your Prime should be tested with the control solution to see if it is still working properly. I am not familiar with the AT2 but according to ReliOn MFG, all control solutions are specific to each particular meter. I just bought a Relion Confirm and called the company to get a complimentary bottle.

 

[Margie and Jackson]

I used a Relion Prime human meter for the last two days waiting for the reorder of my test strips for the Alphatrak 2 meter. Alphatrak was 100% higher than the Relion Prime meter! PMPS Relion Prime tested at 179 Alphatrak 2 tested at 357. I was shocked to see the difference in the readings.

Holy cow. What I’m thinking is my cat’s blood sugar measures low 300 on AT. Is that a good healthy number on this meter? How do we detect hypos? I know the protocols are based on human meters so this is another reason to switch. I was going to buy a Prime, then my AT2 strips arrived and I put it off.

 

[Idjit's mom]

Holy cow. What I’m thinking is my cat’s blood sugar measures low 300 on AT. Is that a good healthy number on this meter? How do we detect hypos? I know the protocols are based on human meters so this is another reason to switch. I was going to buy a Prime, then my AT2 strips arrived and I put it off.

Human meters do read lower than pet meters, and BG range in the dosing protocols are adjusted accordingly. For example, a normal range on a human meter is 50-120, while on a pet meter it is 68-150. You cannot compare numbers from a human to a pet meter because you're using a different point of reference for them. It's more important that a meter be consistent, (we are generally looking for trends in data to adjust the dose, not single, exact numbers). There is also a +/- 20% variable allowed in any glucose meter, including pet meters.
You can’t translate numbers from a human meter to what they would be on a pet meter. Then are no studies which provide a correlation between the two. However, it’s equally important to note that 50 on a human meter does not equal 68 on a pet meter. Those are the numbers which have been determined to provide a safety net.

When you look at the color coding on the spreadsheet you can see the "ranges" of BG. Ideally, the BG level is in the green (not lime green) color. Lime green is the "take action" number or indicating an active hypo event. A BG of 300 on either meter is not low, it's in the middle between very high and the ideal numbers you are working for.
You can review hypo information here:

• How to treat HYPOS - THEY CAN KILL! Print this Out!!
• jojo and bunny's HYPO TOOL BOX

 

[MrWorfMen's Mom]

You are correct that the meter manufacturers suggest checking with control solution to make sure the meter is working correctly particularly with each new supply of strips. That said, tests with the control solution will only tell you the meter is working with the strips and producing readings within a certain range. It won't tell you anything about the accuracy of the readings you take. It's great to have control solution around to check if one starts getting odd results but I seriously think the recommendation to routinely check is a bit of a marketing ploy on the part of the manufacturers. I have never been able to get control solution at the pharmacy where I bought my human meter and my strips or any other pharmacy I've checked. I can call the company for a bottle and some even provide it gratis but that doesn't help much if I need to test the meter that day. And the few times I've seen control solution available the price is ridiculous and it usually is only good for about 3 months. IMHO I think if it were that critical, the solution would be included with the meter purchase which is usually not the case and the solution would also be easily available at retailers selling the meter.

Interestingly, control solution is included with the AT2 meter and is usually available where you can purchase the AT2 strips but that meter needs to be coded unlike most if not all current human meters. One would think checking might be a way to ensure you had the meter coded correctly but it doesn't because the control solution range for cats is so huge and doesn't differentiate for all the possible codes. Another way to get folks to spend their hard earned money me thinks!

On the AT2 meter, a reading of 68 would be your cue to feed your kitty some food to prevent BG from dropping any lower. 68 is NOT a hypo reading and a non diabetic cat might read lower than 68 on a routine basis. We just don't want to allow our diabetic kitties to drop too low because of the insulin we are giving them. We don't assume a kitty is hypo unless they display physical symptoms including frantic hunger, confusion, staggering, seizures or comatose. We intervene early to prevent hypoglycemic episode.

While a readings in the 300s on any meter (human or pet) are higher than desired, I'd call it high on a pet meter. Your goal with the pet meter is to get kitty into normal range of 68 to about 150 and definitely not over 175. Different animal labs have different highs noted in their normal range.

 

[Marianne M]

I may be speaking out of turn here, I'm a newbie, but I have read that the Relion Prime and such require a control solution to test accuracy of the meter. I wonder if your Prime should be tested with the control solution to see if it is still working properly. I am not familiar with the AT2 but according to ReliOn MFG, all control solutions are specific to each particular meter. I just bought a Relion Confirm and called the company to get a complimentary bottle.

I am not the one to answer if your cat's BS reading of 300 on the AT2 is a good healthy number as I am only three weeks into insulin. My cat is on Vetsulin. I'd have been hoping for the 200 or high 100 readings. Since I am new to having a diabetic cat it's not so easy figuring out what is my cat's best numbers and I am not sure what his correct dosage of the Vetulin should be. I started with 2U as advised by my vet and told I could go up to 3U. I find out that the starting dose should have been 1U not 2U. I have not tried 1U. I have tried 1 1/2U up to 3U. I went off of his behavior. On 3U he was still drinking water like crazy, wanting to eat all the time and not so active. On 2U he was a bit more active and still wanting to eat and drink lots of water. On 1 1/2 units he is not drinking as much water, not wanting to eat all the time and more active. So where do I go from here!

 

[CandyH & Catcat]

according to human friends using ReliOn meters (very small sample), they've been advised to use control solution only if they've dropped their meter , gotten it wet (or immersed ), or are suddenly seeing values that don't make sense at all (given how they feel) -- in other words, when something has happened that is likely to have damaged the meter == routine use doesn't seem to call for "check" with control solution -- some of the much earlier meters did need this, technology has improved

 

[MrWorfMen's Mom]

Marianne, your observations speak volumes. Good job being so attentive and acting accordingly. Your spidey sense is keen. Your observations and Mango's readings suggest to me that Mango definitely doesn't need the higher dose and some of the higher numbers you are seeing (like that nasty black a few nights ago) are most likely from a bounce. Bouncing happens when BG drops quickly, drops a lot, or drops to levels the cat perceives to be too low. Our diabetics tend to get used to higher BG levels and their defence systems kick into play prematurely before there is any danger of BG going too low. This is a natural phenomenon and usually calms down with time.

Looks to me like 1.5u may be a good dose for Mango and I wouldn't increase the dose just because the pre-shot is higher than yesterday as that likely is a bounce number and you have no idea when the elevated BG from a bounce will suddenly dissipate. Higher readings from a bounce can persist for up to 6 cycles. I'd stick with one dose for a period of 4 to 6 cycles and see what he does. If you are using syringes and his numbers are staying pretty stable, then try a dose of 1.25u. If you are using the pen mechanism, then drop him down to 1u and see what he does.

 

[Marianne M]

I may be speaking out of turn here, I'm a newbie, but I have read that the Relion Prime and such require a control solution to test accuracy of the meter. I wonder if your Prime should be tested with the control solution to see if it is still working properly. I am not familiar with the AT2 but according to ReliOn MFG, all control solutions are specific to each particular meter. I just bought a Relion Confirm and called the company to get a complimentary bottle.

I did a control test on my AT2 meter and it was in range of what was on the side of the bottle which is 100-185. I used the same control testing bottle (it is only a sugar solution) from my AT2 meter to test the Relion Prime. The AT2 control was 11

You are correct that the meter manufacturers suggest checking with control solution to make sure the meter is working correctly particularly with each new supply of strips. That said, tests with the control solution will only tell you the meter is working with the strips and producing readings within a certain range. It won't tell you anything about the accuracy of the readings you take. It's great to have control solution around to check if one starts getting odd results but I seriously think the recommendation to routinely check is a bit of a marketing ploy on the part of the manufacturers. I have never been able to get control solution at the pharmacy where I bought my human meter and my strips or any other pharmacy I've checked. I can call the company for a bottle and some even provide it gratis but that doesn't help much if I need to test the meter that day. And the few times I've seen control solution available the price is ridiculous and it usually is only good for about 3 months. IMHO I think if it were that critical, the solution would be included with the meter purchase which is usually not the case and the solution would also be easily available at retailers selling the meter.

Interestingly, control solution is included with the AT2 meter and is usually available where you can purchase the AT2 strips but that meter needs to be coded unlike most if not all current human meters. One would think checking might be a way to ensure you had the meter coded correctly but it doesn't because the control solution range for cats is so huge and doesn't differentiate for all the possible codes. Another way to get folks to spend their hard earned money me thinks!

On the AT2 meter, a reading of 68 would be your cue to feed your kitty some food to prevent BG from dropping any lower. 68 is NOT a hypo reading and a non diabetic cat might read lower than 68 on a routine basis. We just don't want to allow our diabetic kitties to drop too low because of the insulin we are giving them. We don't assume a kitty is hypo unless they display physical symptoms including frantic hunger, confusion, staggering, seizures or comatose. We intervene early to prevent hypoglycemic episode.

While a readings in the 300s on any meter (human or pet) are higher than desired, I'd call it high on a pet meter. Your goal with the pet meter is to get kitty into normal range of 68 to about 150 and definitely not over 175. Different animal labs have different highs noted in their normal range.

Wow you are a wealth of info and it sure is appreciated. You know how us newbie are feeling. Overwhelmed and at time frustrated wondering am I do the right thing.

 

[Marianne M]

Marianne, your observations speak volumes. Good job being so attentive and acting accordingly. Your spidey sense is keen. Your observations and Mango's readings suggest to me that Mango definitely doesn't need the higher dose and some of the higher numbers you are seeing (like that nasty black a few nights ago) are most likely from a bounce. Bouncing happens when BG drops quickly, drops a lot, or drops to levels the cat perceives to be too low. Our diabetics tend to get used to higher BG levels and their defence systems kick into play prematurely before there is any danger of BG going too low. This is a natural phenomenon and usually calms down with time.

Looks to me like 1.5u may be a good dose for Mango and I wouldn't increase the dose just because the pre-shot is higher than yesterday as that likely is a bounce number and you have no idea when the elevated BG from a bounce will suddenly dissipate. Higher readings from a bounce can persist for up to 6 cycles. I'd stick with one dose for a period of 4 to 6 cycles and see what he does. If you are using syringes and his numbers are staying pretty stable, then try a dose of 1.25u. If you are using the pen mechanism, then drop him down to 1u and see what he does. I use the U40 needles with the 1/2 units.

 

[FurBabiesMama]

I just thought I would add... With an AlphaTrak2, 65 and below is considered hypo, and 250 is the approximate renal threshold (to over simplify it, that is the point at which glucose gets into the urine). So, being at/over 250 is not desirable. There are some slightly differing opinions of the exact 'ideal' range to be in (and really, like everything else, it can vary slightly by cat), but about 70 to 150 is a good target zone.

 

[Marianne M]

I just thought I would add... With an AlphaTrak2, 65 and below is considered hypo, and 250 is the approximate renal threshold (to over simplify it, that is the point at which glucose gets into the urine). So, being at/over 250 is not desirable. There are some slightly differing opinions of the exact 'ideal' range to be in (and really, like everything else, it can vary slightly by cat), but about 70 to 150 is a good target zone.

Thanks so much for this information. I've read so much info that I am in overload and my brain isn't into recalling everything I've read. At what AT2 reading should you NOT give insulin?

 

[FurBabiesMama]

Thanks so much for this information. I've read so much info that I am in overload and my brain isn't into recalling everything I've read. At what AT2 reading should you NOT give insulin?

Well, there is not a black-and-white answer to that question. When someone is just starting out and not aware of how their cat will respond to insulin given at lower numbers, I believe the recommendation is not to give insulin if you get 250 on AT2 (or 200 on human meter). Over time, as you gather more data and become more comfortable, you can begin to adjust that number down. The type of insulin being given is also a factor. For example, a shot of Lantus or Levemir can usually be given on a lower pre-shot number than Vetsulin can because they have a slower onset and the drops are not normally as steep.

 

[Marianne M]

Well, there is not a black-and-white answer to that question. When someone is just starting out and not aware of how their cat will respond to insulin given at lower numbers, I believe the recommendation is not to give insulin if you get 250 on AT2 (or 200 on human meter). Over time, as you gather more data and become more comfortable, you can begin to adjust that number down. The type of insulin being given is also a factor. For example, a shot of Lantus or Levemir can usually be given on a lower pre-shot number than Vetsulin can because they have a slower onset and the drops are not normally as steep.

Appreciate the valuable information. Someday I won't be a newbie anymore!