10/27/14 Keiko 514 human meter - help

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KeikosHuman

KeikosHuman

Member Since 2014
I'm using the human glucometer for the first time today and the reading was 514 at +4 10/27/14. On Alphatrak it was 495 or 371 human meter equivalent. What is going on? Any ideas? This is a brand new meter. Akray glucocard 01-mini.

Question 2, since he was as low as 333 or 250 human meter equivalent on 10/25, is he having a bounce?
Previous post:
viewtopic.php?f=9&t=127465
 
Just tested the meter with control solution and it is testing in range. Why would it be so off? By 38%? cat(2)_steam nailbite_smile

Any help appreciated.
Thank you.
 
Can you elaborate on your Alphatrak reading to human-meter-equivalent numbers?
Sorry if it was mentioned in an earlier post, but it sounds like you have been using AT and only recently tested with a human meter, so I don't know how you are calculating these human equivalents. I was always under the impression that AT and human meters were most dissimilar at the lower readings, not the high ones, so 495 and 514 are very similar.

MJ
 
I may be wrong but I thought multiplying an Alphatrak reading by .75 gives the human meter reading equivalent.
 
Hmmm, this may confuse the matter even further, but:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=127203

and

atajev said:
Ah, thanks, Carl! That's exactly what I was looking for. Why didn't I think to search for Roomp & Rand articles specifically? Silly me.

So (from K. Roomp & J.S. Rand, Management of Diabetic Cats with Long-acting Insulin, Vet Clin Small Anim 43 (2013) 251–266):

If a serum chemistry analyzer or plasma-equivalent meter calibrated for
feline blood is used (eg, AlphaTRAK, Abbott Animal Health, Abbott Laboratories, Abott
Park, Illinois), the measurements at the low end of the range need to be adjusted and
are 30% to 40% higher than for a whole-blood meter calibrated for human blood. The
doses, when using such measuring devices, should be changed as follows: the lower
limit of the range should be adjusted accordingly by adding approximately 18 mg/dL
(1 mmol/L) to the value listed in the protocol in Table 2. For example, a target value of
more than 54 mg/dL (>3 mmol/L) becomes more than 72 mg/dL (>4 mmol/L) when
using a serum chemistry analyzer or a meter calibrated for feline use.
Click to expand...

So, we're clear on the 68 being the cut-off for hypo. And the recommendation here is to treat all the numbers as +18, rather than 30. Presumably since (as we've been discussing), though it may be much greater difference at higher levels, that really doesn't matter because in all protocols/situations, too high is too high and 50 points in either direction doesn't matter much.

Therefore, does it make sense to simply have the spreadsheet calculate Alphatrak as +18 for all testing results? This would also mean a wider campaign to re-educate people to give +18 rather than +30 as the default response as to how the numbers differ.
Click to expand...
 
Hi,
I think it is counter-productive to try to compare meters. You will drive yourself crazy and question every reading. There are so many variables, even when blood from the same ear-prick is used on the same meter (strips can differ; strips may have been left out too long; the amount of blood on the strips may be different, etc. And when you are trying to "compare" two very different meters and one of them is the AT, there are even more variables). My suggestion would be to pick a meter and stick to that one. When blood-glucose readings are at the high end of the scale, it is common for there to be a large spread between numbers, even when the test is done on the same meter at about the same time.
The Arkray Glucocard 01 Mini is an excellent meter. We have been using it for years. Don't panic! If the meter tested out with the control solution, it is almost certainly OK.

Ella & Rusty
 
Maria, I agree with Ella - high blood glucose is just high and needs to come down. Whether the reading is in the 400's or 500's doesn't matter. The protocol only cares if numbers are below 100, in the 100's, 200's, or 300's. The meters are supposed to be much closer when they get to normal number range, and that's where you need the accuracy.

You had asked about how to mark in your spreadsheet that you are switching meters. Most people just take a line in their spreadsheet and mark it to show the change. I did the same thing when we switched from Lantus to Levemir. You just want something to draw the readers attention to the change. If you look at Neko's 2012 SS, I switched from the Freestyle to the Relion after a few weeks. The high end numbers looked awful when I made the switch and they were. :sad:
 
Wendy & Ella are absolutely right. Let go of comparing the two meters - Keiko is high and that's the main message.

You got the multiply by 0.75 to convert from AT to human meters from me. The problem we've got is exactly what MJ pointed out. We have 3 different conflicting sets of info on how the AT and the human glucometers compare.

Several years ago the conventional wisdom was that the AT read 30 points higher than the glucometers. Many people still posting here (including me) started with that information. We've had members that had both AT and human glucometers do comparisons for us, and based upon those, we could see that the numbers were fairly close in low numbers and farther apart in higher numbers. The next info came out that they read 30-40% higher, which was consistent with the tests that people did on their AT/human glucometers. That's what I used to give you the "multiply AT # by 0.75 = human glucometer", which is the same as adding 35%.

100AT x 0.75 = 75 human glucometer equivalent.

75 human glucometer x 135% (adding on 35%) = 101 (AT equivalent)

THEN, to add to the fun, the latest thing that's come out is what MJ quoted atajev as referring to above - in the PDF called "Management of Diabetic Cats Using Long-Lasting Insulin" that Rand published in 2012, it says to add 18 points to a human glucometer reading to get an AT reading. That, however, doesn't jive with the little comparisons people here have done between ATs and human glucometers.

It doesn't help that the human glucometers either measure plasma or whole blood, and they also result in different numbers. We pretty much ignore that on this board.

All in all it's a bit of chaos. That's why it's going to be easiest for you to just take the human glucometer at face value. NOw you will have numbers to use that are on the same scale as the protocol. Just go with it! Almost makes my brain hurt to have all that out there - this is why we encourage people to get a human glucometer, so we can trust what we see.

With a +5 higher than the amps (were those both on the same meters?) Keiko might be starting a bounce. You've done a great job the past couple of days of getting tests in. If you can keep getting the preshots and even just one mid-cycle (something between +3 and +9) tests in we should be able to see if he's got too much insulin or if he needs an increase. Today's numbers might also be New Dose Wonkiness.
 
Thanks. The human meter requires a different technique I'm getting used to.
I posted the human meter numbers from yesterday on the spreadsheet.

Thank you so much!
Maria & Keiko
 
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