4/12 Merlin AMPS/513; PMPS 473

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Merlin

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4/12
AlphaTrak2
AMPS - 513

I will be working today and tomorrow from 7-6pm. I will be able to come home at +5 to check on his BG.
 
Re: 4/12 Merlin AM/513

Merlin is living up to his "man of mystery" name, Cindi. On the 7th, he had a high amps and you gave .8 and he dropped nicely for nadir. Yesterday, same range, same dose and although a 50% drop for nadir, not as good midcycle.

He still is at a low dose and you could easily raise it. I don't see any numbers in the past few cycles to bounce from. His amps is generally higher than his pmps, so he could be dropping lower at night. It would be helpful to get some numbers at night sometime, when you don't have to get up early for work the next day. And if you aren't, give him some food at night. He got into dogfood recently, didn't he? Any chance of contraband? Is he still on antibiotics for his cold? I wonder if that is impacting the numbers....

I'd see what happens this weekend and be sure to get a ketone test daily, if possible. Then, I think raise the dose the first day you can monitor. Up the scale by .2 maybe?

Let's see what Jen thinks.
 
Re: 4/12 Merlin AM/513

4/12
AlphaTrak2
AMPS - 513 .8U
+5 - 395 (with AlphaTrak) & 269 (with Confirm Micro)

Got to run back to work and will read when I get home tonight. He only got into dog food once back on 4/4. No possible other contraband since then. I will be able to monitor again on Monday. I gave him .8U this morning. I bought the Micro last night but decided to use both over the weekend. I am very perplexed at the numbers at +5 today. Will continue to use both over the weekend to see if still a variance. Got to run....talk to you all later.
 
Re: 4/12 Merlin AM/513

I agree with Sue. Backing off the scale recently has resulted in him not dropping so fast and low at nadir, but recently, his nadirs look a bit higher. I am also wondering if maybe he's still fighting a cold that's raising his BG a bit. I think I'm with Sue on very gradually and slowly raising your scale 0.2 when you can monitor to see if his midcycle numbers will come back down into better ranges.

With the results you got from your brand shiny new Relion today, I'm really curious to see if Merlin's pre-shot numbers look a bit less drastic on the Relion versus the Alpahtrack.
 
Re: 4/12 Merlin AM/513

Hi Cindi -

I'm deferring to Sue & Jen on the dosing, but will add something that might save you a minute with your SS. I did side-by-side-by side comparisons of 3 meters a year ago January. If your SS is autoformatting the colors normally, then you're doing multiple readings in one cell, use a decimal point and let it continue to auto-format. One less thing to worry about!

I tested my Accu-Chek Aviva against a Bayer Contour and a ReliOn Confirm (same mfr as your micro). There were some minor variations between ACA and the other two, but nothing alarming. The both read lower by about 10 points in middle greens; fairly consistent in middle pinks. I would feel comfortable using any of them. I would caution you about the side-by-side testing... sometimes it makes you really scratch your head and wonder what's going on. If you start to get overwhelmed (or even before), just make a decision which you want to use.

The value of frequent testing and logging your numbers is to see the patterns your cat gives you. It can be very stressful to get "wonky" readings, as I did with my first meter (ReliOn Ultima - by a DIFFERENT mfr), which would give me readings all over the place within 5 minutes of one another (as much as 150 point difference). It's important to use a meter you trust, as well as one you can afford to use for frequent testing (you can get the Arkey strips on line for your meter - I think about $.18 each). I've not used the AlphaTrak, but my vet does. I have taken my meter and tested it side-by-side with theirs. The readings were fairly close when we were at higher numbers; G was rarely low while at the vet until recently. Like I said, you want to see patterns.

Keep up the good work. I'll look forward to seeing your progress!

Lu-Ann
 
Re: 4/12 Merlin AM/513

Jen, Sue and Lu Ann - Thank you so much for your notes today. Just to answer some of your questions. No - he has not had any contraband. Yes - he still has a little cold and runny nose. He has three more days on doxycycline. Looks like I have two things to work on or transition; 1) deciding what to do with these two different meters and 2) confirm my understanding of the sliding scale. As always, I like to throw things out there with my thoughts just to see if I am going down the right path or not. I know you know this, but I can't help but to say again...I so look forward to your input every day. I am always looking to see what I can learn from you and to get your advice...so invaluable. Thank you, thank you, thank you.

4/12
AlphaTrak2
AMPS - 513 .8U
+5 - 395 (with AlphaTrak) & 269 (with Confirm Micro)
PMPS - 473 (with AlphaTrak) & 341 (with Confirm Micro)

Why is it so different? I don't know what to go with? Is it because the numbers are so high that there is such a variance (like the graph you sent me yesterday)? Even if you add 30 points to the Micro, it still is 100 points different. I don't know if I can go with just one or even the Micro if there is such a variance. I am sure there is an explanation. Even if I just pick one...say the Micro, is it giving me the right numbers? Will Merlin get the right dose? What would you suggest?

Thanks for the suggestion of adding .2 to my sliding scales. So just to make sure that I understand, is it .2 to every number range? This is my current sliding scale (I have modified it a little based on shots that I have given since our initial sliding scale).
505+ - .8
422+ - .6
350+ - .4
250+ - .2
200 skinny .2

Now if I add .2 to every number it should look like this:
505+ - 1 Unit
422+ - .8
350+ - .6
250+ - .4
200 skinny .4

So am I correct with this line of thought?

Ok so now, won't this change with the new human meter i.e. Micro? So maybe if I drop everything by 30 points, it should look like this:
475+ - 1 Unit
392+ - .8
320+ - .6
220+ - .4
170+ skinny .4

So - how much insulin do I give tonight. If I go with AlphaTrak (and I add .2), I would be giving him .8. If I was going with the Micro, then I would be giving him .6.


Hi Lu Ann. My name is Cindi. Thank you so much for your note and I will be sure to introduce Merlin later on. I fixed my SS so thanks for your suggestion. You mentioned Arkay test strips. Is that for the AlphaTrak or the Confirm Micro? I was really surprised that the two meters were so different and it really scared me. If they continue to be such a large variance, I don't know which one I should trust??? My initial thought was to start using the Micro on Monday when I am at home again but thought I would practice with it this weekend. Jen and Sue have been instrumental in helping me with Merlin's doses. I really have to watch him for extreme dips and can never tell when he might do this. I long for the day where all I have to do is test him maybe once a day (instead of every hour).
 
Let's see what others say, but I like the scale that has 505 1 unit. As long as you can do a before bed check, I think you could go with that tonight. If you get a high amps, we might think about upping it again.

It's a difficult balance, Cindi. We don't want him sitting in high numbers, but if he were bouncing, we don't want the dose to cause lows he can bounce from. The last few cycles don't look like bounces so I am thinking an increase is good.

Let's see if others weigh in.
 
Ok - I am going to go ahead and give him .8 tonight (based on the AlphaTrak number) and can check him at bed time. Looking forward to still discussing my other dilemma regarding the meters. Thanks.
 
Arkay strips are for the Relion Micro and Confirm meters - interchangeably. You can always buy them at Walmart, but they are more economical on line - I think Marcy and others got theirs with a "buy 4 boxes, get 1 free" deal.

Will check on you tomorrow. G'night
 
4/12
AMPS - 513 .8U
+5 - 395 (with AlphaTrak) & 269 (with Confirm Micro)
PMPS - 473 (with AlphaTrak) & 341 (with Confirm Micro); gave .8U per sliding scale below
+4 - 232 (AT) & 158 (CM); gave LC
+5 - 215 (AT) & 116 (CM)
+6 - 167 (AT) & 94 (CM)

Merlin had a good night meeting nadir targets!

AlphaTrak Sliding Scale (added .2 to all increments)
505+ - 1 Unit
422+ - .8
350+ - .6
250+ - .4
200 skinny .4
 
Re the meters. So we know that AlphaTrak reads 30 points lower than human meters, every day, each time. So starting with the 395 and 269, we can subtract 30 from the Alpha Trak. So now it's 365 and 269. Meters have a 20% variance. 20% lower on the AlphaTrak would be 292. 20% higher on the ReliOn would be 296. So now they are in the same ball park.

I am not suggesting this is a comfortable distance. I would be a little puzzled also. I know other people have taken their ReliOn to the vet and compared it to the Alphatrak on the same sample of blood and it is more in the 30-50 point lower range. I don't know why yours have a wider range. I do know you'll drive yourself crazy going back and forth between the two. People on the forum overwhelmingly use the ReliOn meters.

The ultimate decider will be a fructosamine test at some point. It will give you an average of the numbers over 2 weeks. And I would guess it would all "average" out. :mrgreen:

You might post on Health, Cindi, and ask people about the differences they have seen between the two meters. Maybe others will have other insights.
 
PM cycle looked pretty good!

On the meters, if/when you transition to the Relion, it looks like ballpark, on the lower numbers, (under 250 or so) the difference is about a hundred points. On the higher ranges, the difference looks to be around 100-150 points. For purposes of your sliding scale, I think you may be able to basically adjust your scale down about a hundred points, for example:

Desertdog271 said:
AlphaTrak Sliding Scale (added .2 to all increments)
505+ - 1 Unit
422+ - .8
350+ - .6
250+ - .4
200 skinny .4

For the Relion, something that would be a similar scale might be:

400+: 1unit
322+: 0.8u
250+: 0.6u

For right now, I'd be a little more cautious if you're seeing pre-shots under 200 on the Relion. You may want to try 0.4u on the 200-250 range, and maybe 0.2 on a 175-200 range if you're able to monitor.

Interestingly, it does look like Merlin's cycles look a little less dramatic on the Relion versus the Alpahtrack. Again, it's really a matter of interpreting the data, but interesting nonetheless.
 
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