? Confusion on SLGS RE warning to only use human calibrated meters

[Eric Minor]

Snickers has been out of the ER for one month now after severe DKA episode which was our introduction to diabetes.

AlphaTrak2 meter was ordered straight-away and many readings have been taken. We started low, and (largely) went pretty slow, though we weren't necessarily religiously following SLGS. My internist was not in favor of lots of home readings and tweakings as I mentioned on another thread some time back. That won't necessarily dictate my strategy going forward, but I mention it as background as it has influenced me a bit as far as sticking firm with a dose of 3.0 for the past 3 weeks.

Both the SLGS and TR protocol pages start out with a bold warning that the protocols are gauged for use with human meters and not to use pet specific meters. Conversely, the spreadsheet advises to use a pet specific meter like AlphaTrak.

As a result, I'm confused as to how exactly to follow SLGS using an AlphaTrak 2. I would think that, if the BG readings are not the same between human meters and pet meters, that there would be a standard multiplier to convert between the two along the lines of 1 kilogram equaling 2.2 pounds.

Any guidance on this?

 

[tiffmaxee]

Hi Erik. You can't really convert numbers between pet and human meters. Believe many have tried. The reason why human meters are recommended is because the protocols were written based on human meters. The test strips for the human meters are half the price btw. That being said, many do use the AT. There's even a spreadsheet for it which I see you are using. So if you are more comfortable use it.

If you are following SLGS Snickers has earned a reduction from 3.0 units to 2.75 by dropping under 90.

 

[MJW]

Conversely, the spreadsheet advises to use a pet specific meter like AlphaTrak.

There are 2 available spreadsheets. One for AlphaTrak meters, one for Human meters. I don't think they say use a pet meter.

As a result, I'm confused as to how exactly to follow SLGS using an AlphaTrak 2. I would think that, if the BG readings are not the same between human meters and pet meters, that there would be a standard multiplier to convert between the two along the lines of 1 kilogram equaling 2.2 pounds.

I use an AlphaTrak meter. I wish there was a standard multiplier, but there isn't. I add to a personal table of comparisons whenever a member posts numbers using both meters. I can't even use the table to convert between the 2 meters---too chaotic. The rule is that the numbers are shifted by about 18 at the low end (human=50, AT2=68), and by more at the high end. The AlphaTrak company says the difference is 20% to 30%. I see percentages more like 20% to 50%. Because the protocols describe a process, the color transitions are really rather arbitrary. I use TR, and the 68 makes sense as the low end of normal for feline blood glucose. I guess people using SLGS with an AT2 either: (1) establish a rough equivalent to 90 on the AT2 (what would that be? 120?); or just use 90. I can't find the posts just now that describe normal for the human meters: I seem to recall 50 to 120. Normal for the AlphaTrak or lab blood work is 72-175 or 71-159, depending on the lab. Good luck.

 

[Eric Minor]

If you are following SLGS Snickers has earned a reduction from 3.0 units to 2.75 by dropping under 90.

Problem is, she earned an increase from 3.0 to 3.25 the day before when her nadir was in the 350's. There are quite a few other days as well that would have warranted an increase. (I think so at least...but if there is in fact no standard multiplier to convert from human meter readings to pet meter readings then I guess there is no way to know.)

 

[Wendy&Neko]

Problem is, she earned an increase from 3.0 to 3.25 the day before when her nadir was in the 350'

You don't look at the nadirs for one cycle or one day to determine dose, but rather over a period of time, for SLGS it is over seven days. You ask the question " how low can this dose take my kitty". If it's below the reduction point, then you reduce. You ignore the cycles when there is bouncing or other factors that can raise the BG. In the SLGS method, it says to immediately lower the dose if you see a number under 90. Cats have the unique ability to heal their pancreas, if they are spending time in normal numbers. A healing pancreas means less insulin is needed. And can eventually potentially lead to diabetic remission.

As for comparing AT and human meters, you have to do your own comparisons. There are differences between AT meters too. What numbers one person gets on their AT doesn't mean they will be the same on your AT meter.

 

[Marje and Gracie]

Snickers has been out of the ER for one month now after severe DKA episode which was our introduction to diabetes.

AlphaTrak2 meter was ordered straight-away and many readings have been taken. We started low, and (largely) went pretty slow, though we weren't necessarily religiously following SLGS. My internist was not in favor of lots of home readings and tweakings as I mentioned on another thread some time back. That won't necessarily dictate my strategy going forward, but I mention it as background as it has influenced me a bit as far as sticking firm with a dose of 3.0 for the past 3 weeks.

Both the SLGS and TR protocol pages start out with a bold warning that the protocols are gauged for use with human meters and not to use pet specific meters. Conversely, the spreadsheet advises to use a pet specific meter like AlphaTrak.

As a result, I'm confused as to how exactly to follow SLGS using an AlphaTrak 2. I would think that, if the BG readings are not the same between human meters and pet meters, that there would be a standard multiplier to convert between the two along the lines of 1 kilogram equaling 2.2 pounds.

Any guidance on this?

We used to only have one SS for the US and one for World and they were only for human meters.

We started getting more and more members who had spent the money to buy the AT at the insistence of their vet so we developed the SSs for use with pet meters. The SS used has no bearing on the method used; in other words, they are totally separate and a SS is not even required to be used with either method, TR or SLGS.

However, due to the action of the L insulins, it's very difficult to provide solid dosing suggestions without seeing a SS and most of us won't put a kitty at risk by giving dosing suggestions without a SS.

 

[Jill & Alex (GA)]

Both the SLGS and TR protocol pages start out with a bold warning that the protocols are gauged for use with human meters and not to use pet specific meters.

Correct. All protocols used on the FDMB were created using blood glucose meters calibrated for humans.

Conversely, the spreadsheet advises to use a pet specific meter like AlphaTrak.

It's only been in recent years that a spreadsheet was put togeter as nothing more than a convenience for those using pet-specific meters at the insistence of their vet.

Rather than re-typing the same info, you might be interested in reading a post I wrote less than a month ago on the subject of protocols used on the FDMB, pet-specific meters, and meters calibrated for humans: http://www.felinediabetes.com/FDMB/...-3-4-7-3-25-4-9-3-50-5-8.178169/#post-1966702

Hope this helps...

 

[Tricia Cinco(GA) & Harvey]

The main reason so many of us use human meters here is the exorbitant cost of using an AT - the strips are ridiculously expensive, and if you are testing regularly, it costs an arm and a leg. Plus, you can't just go to your local pharmacy and buy strips for an AT. Perhaps that's why all the guidelines are based on human meter readings. There really is no benefit to using a pet specific meter, except maybe for harmony with your vet. Tons of us have gotten our kitties well regulated or OTJ using human meters. That said, it is within your rights to use whatever meter you wish, and we try to help as much as we can, regardless of which kind of meter you use. It's just a bit more complicated with a pet meter, as there is no direct comparison. Basically, the higher the BG, the bigger the difference between the two meters.