Blood Glucose Meters

Status
Not open for further replies.
dodgingwrenches

dodgingwrenches

Member Since 2010
Hi all,

I've been using the Freedom Freestyle Lite for four years now. I bought it at the time because of the small blood sample size (0.3 uL) which has saved me a fortune in test strips, but also because Consumer Reports recommended it and gave it a top rating for meters of the same blood sample size

Today I compared it to the Bayer Contour Next USB that I got for free (thanks to someone's post on this site) last fall

What a difference.... FreeStyle Lite - 176. Bayer Contour Next 221.

So I ordered the control solutions for both. I'm running low on strips for both so wasn't sure which one to get, so I started reading. Someone on here compared the two and found that the Bayer consistently reported higher results. But, some people gave the Freestyle negative reviews. So I did some more googling and found this research study comparing the reliability of a whole bunch of meters. Thought I'd share

http://www.jdst.org/September2012/PDF/V ... CKMANN.pdf

I'm leaning towards buying more test strips for my old faithful Freestyle...

Sophia
 
For cats, meters with Free in the name show lower than actual numbers. The report you mention is for humans.
 
BJM said:
For cats, meters with Free in the name show lower than actual numbers. The report you mention is for humans.
Click to expand...

Hi BJM, I've noticed in my searches your comments stating that. Can I ask though based on what you assume that it is the Freestyles that are the unreliable ones, and not the Bayer showing too high a value? I've been searching but haven't found anything except for the Freestyle being rated as more accurate than the Bayer.
 
If you search the forum using the search function in the upper right corner, you may come across the individuals here who have reported that they thought they had good glucose control for the cat, then went to the vet with cats that were essentially unregulated, too high, and sometimes in DKA.

Here are a few posts mentioning the Freestyle.

Here's one from way back.
Post by Nancy and Cody » January 16th, 2010, 10:27 am
This morning's prefood, preshot, all from the SAME DROP of blood:
Freestyle 258
one touch mini 348
ascensia breeze 407

Years ago, after I spent $70 on the Freestyle, I read here that it gave lower readings at higher sugar levels.


And some graph comparisons here.

I quess so.... 100 points?
Click to expand...
 
If I lived in the US and could get the ReliOn, this all wouldn't be an issue. Need something that does tiny blood samples though like the Freestyle lite since my guys ears don't bleed much. Ugh. $80 for a box of 100 here. :sad:
 
I started out on the Freestyle (check out Neko's 2012 SS). After a few weeks I switched to the Relion with a Bayer Contour backup. I've cross tested the Bayer and Relion and been happy enough with the comparisons. I'm close enough to the border I can get things sent to a US post box. I think the Freestyle is out in the higher numbers. Unfortunately Neko was one of those cats who liked those floors. We've had people successfully use the Freestyle if their cats mostly hang out on the blue and green floors.
 
Human blood and serum is different in composition from feline. Using a human glucometer on feline blood is not going to be the same because of that. You have to be very cautious about applying the results from a study on one species to another species.
 
Blood Glucose Meter for Cats
Facts:
Blood has two constituents, the red and white blood cells and the liquid (serum). Blood plasma is blood serum without the clotting factor
The blood glucose value obtained via laboratory analysis is the glucose level in the serum/plasma constituents of blood
The glucose is in both the serum and red-blood cells (RBC) themselves. However, the distribution of glucose is different between humans and cats (and dog too)1
In Humans 58% is in plasma/serum and 42% in RBCs
In cats 93% is in plasma/serum and 7% in RBCs
In dogs 87.5 % in plasma/serum and 12.5% in RBCs.
The point-of-use blood glucose meters (the ones we use at home) all use whole blood.2 However, what specific blood glucose they measure varies with the manufacturer. Some manufacturers only measure the glucose in the serum/plasma. Others lyse (disrupt the cell walls of the RBCs) and thus mix the glucose that was in the RBC into the liquid and thus measure total glucose. The meters then correct/adjust the reading to be equivalent to human blood plasma
Discussion:
Since the glucose distribution is different n humans and cats/dogs the resulting BG valve obtained from the human meters will be different that lab values and animal-calibrated meters. Also, some manufacturer's meters will be much different that lab values for animals depending upon which method (lyse cells or only use plasma/serum) they use to measure glucose.

Animal calibrated meters correct the value to be equivalent to lab values.

What clouds any BGs obtained from hand-held meter is that they are only accurate to +/- 20 %. That includes the animal-calibrated meter. Also, do not confuse accuracy with reproducibility. It is expected that one meter with one lot of tests strips to be relatively repeatable, that is if you use the same drop of blood, you BG value will be much close than +/- 20%

References:
1. WHY DO YOU NEED A SPECIES SPECIFIC METER?
2. Glucose Meters: A Review of Technical Challenges to Obtaining Accurate Results
 
BJM:

Okay so where is the evidence speaking to the reliability of human BG meters on felines? We're the ones taking a product designed for humans and applying it to another species ;) And now we're stating one is more reliable than the other based on what seems to be anecdotes. I know you refer to those posters that then went to the vet and found the BGs were high, after thinking their cats were regulated, but we all know the stress of a vet visit will shoot up a cat's BG (plus the stress of getting blood drawn). I did once with the vet take the syringe he drew blood with, and put a drop from that same syringe onto one of my test strips before we sent it off to the lab. Unfortunately at the time I was more interested in how well my expired tests strips still worked. Wish I had done that experiment with fresh test strips! But then that also has to be repeated several times to draw any conclusions. Either way, my expired test strips was ~1.5 mmol lower than the lab - so not that big a difference.

We could start our very own research project here - have everyone when they get bloodwork done at the vet, test the same blood on their meters and start collecting results - that would be an interesting study :)

Larry:

This research study I found was comparing the meters with the new ISO standard that is supposed to bring them into a 15% range - so a step in the right direction from 20%!


Anyways, the whole point of this post was to share a research study I found and try and gather evidence (not anecdotes). It was not to argue people's personal preferences
 
Dr Janice Rand, co-author of the Roomp and Rand article that served as the foundation for the Lantus Tight Regulation protocol, published the following article
The blood glucose values were based on using portable glucose meters (Ascensia Contour, Bayer,Leverkusen, Germany; Accu-Chek Aviva, Roche Diagnos
tics, Basel, Switzerland) which use≤0.6 μL of blood per test. These meters measure blood glucose concentration in whole blood and are calibrated for
use with human blood. Measurements from meters calibrated for human blood which provide plasma-equivalent values are approximately 10% higher.
NB. It is very important to note that blood glucose concentrations measured using a whole blood glucose meter calibrated for human blood may measure 30-40% lower in the low end of the range than glucose concentrations measured using a serum chemistry analyser or a plasma-equivalent meter calibrated for feline use.
Therefore, if using a meter calibrated for feline use (eg. AlphaTRAK, Abbott Laboratories, CA, USA), or a serum chemistry analyzer, add approximately 30 mg/dL (1.7 mmol/L) to the target glucose concentrations (see Table 3B)
. For example, a target > 50 mg/dL (2.8 mmol/L) becomes > 80 mg/dL (4.4 mmo/L) when using a meter calibrated for feline use.
Instead of aiming for 50-100mg/dL (2.8-5.6 mmol/L) , aim for 80-130 mg/dL (4.4-7.2 mmol/L [round numbers 4.5-7.0 mmol/L). Meters calibrated for feline use may read higher or lower than the actual value, in contrast to consistently lower readings for meters validated for human blood.
Click to expand...
 
Yeah, I have a copy of that article - and that's exactly it. It's already not so reliable, and the higher the values, the more off we will be. But what we don't have is something comparing the different meters specifically for felines with a valid lab result. Comparing to other meters - it is the other meters that could generally be reading too high for example. Would be nice to have real data like that study I posted above, but for felines. Anyway, since we're dosing to the nadirs, and trying to find a low nadir in a range in which all meters are still fairly accurate, then it shouldn't matter as much which meter someone uses. If a cat is truly regulated, the nadirs will be in a normal range that is comparable across all meters. As long as the nadirs are outside of the normal range, we're still adjusting the dose.

Tried using my Bayer Contour Next USB again last night. Stupid thing doesn't read half of the strips I put into it and then thinks they are used. What a waste! cat(2)_steam Anybody have any tricks for use of that one? Won't make it south of the border for a ReliOn for at least a few weeks.
 
Working with the paw pad is fine, so if that is going OK, stick with it.

If you want to use the ears eventually, you can try starting at the scruff and gradually moving towards the ears.

Also, see my signature link Secondary Monitoring nools for some other assessments to help you track how he is doing.
 
Status
Not open for further replies.
Back
Top