Human glucose meter conversion to pet meter numbers for SLGS method | Feline Diabetes Message Board - FDMB

Human glucose meter conversion to pet meter numbers for SLGS method

S

soreto

Member since 2025
I've been following the Start Low Go Slow method for almost 2 months using this sticky- Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR).

However, today i noticed this at the top of that thread. -

THE USE OF PET-SPECIFIC METERS IS DISCOURAGED BECAUSE THE DOSING METHODS USED ON THE FDMB WERE CREATED WITH METERS CALIBRATED FOR HUMANS. ALL REFERENCED NUMBERS CORRESPOND WITH METERS FOR HUMANS, NOT PET METERS.
I missed this before & the numbers I've been using to match the SLGS instructions have been from my Alphatrak3 pet meter. These are the instructions I have been following-
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
...but these are human meter numbers, i guess? So what is the correct conversion of these numbers to pet meter? i found this in an old post-

human meter / 0.65 = pet meter estimate
pet meter * 0.65 = human meter estimate

...is this correct? i'm confused because that would mean "if nadirs are below 138, decrease the dose by 0.25 unit" which doesn't seem right. this whole time i thought the goal was to find the right dose of insulin where the cat will land between 80-120 in most of their readings. is this wrong? should the numbers be different because i'm using a pet meter?
 
There is no conversion for human to per meters. The instructions on this site were developed for pet meters (edit: were developed for human meters not pet meters) and the old hands that most rely upon for guidance don’t use pet meters so have more experience with them. (Edit: more experience with human meters). That said, they advise just fine if you’re using an AT just be sure it’s noted on your spread sheet.
 
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To add, that conversion factor you quote SHOULD NOT BE RELIED UPON.

The number you get with an AT will be closer to whatever the blood would read on an actual lab test. Meter tests (human and pet) are calibrated to produce an estimate of the blood glucose based on species-specific features in how glucose is carried in the blood. But using human meter is cheaper so most use them and as I said, people here are more familiar. The main point of concern for the normal run of the mill diabetic cat is human meters for the most part give an estimated BG lower than what an AT (or a lab test) would show. So as an AT user I would take seriously any low numbers. This is especially true since the variation above 100 is a percent of the blood value (it’s been a while I want to say 10% but don’t quote me) HOWEVER below 100 is is plus/minus 15 mg/dl.

In other words if you’re using a human meter and it says 80 likely higher than 80. (Perhaps quite a bit). If you’re using an AT it may be as high as 95 or it may be AS LOW AS 65. So the lows need extra attention

(Edit: I realize this is still not clear. For the most part a human meter will give a number slightly lower than the true number—yes both human and pet meters vary but the overall trend is that a human meter number is lower than the true blood result from a lab. The AT will be closer to the real value. For high BG or high normal BG this doesn’t matter —say it’s 200. This is neither likely to be dka nor hypoglycemia no matter what meter is used. The only time for big concern when you’re getting into green especially if you’re planning on giving insulin to a number below 100 but really anytime. I always subtracted 15 from any AT result 100 or lower and treated that as my worst case number but you can do as you feel comfortable. Just if using an AT there is no “cushion” in the lowest range, hence I believe different numbers for the lime green)
End edit

The one time a human meter would be more accurate is if your cat is fairly anemic (remember, the meter estimates based on normal blood for species, anemic blood isn’t normal). In a fairly anemic cat the human meter may be closer to accurate (so you can’t rely that it’s a bit higher than it actually is) and the AT will read HIGHER than it should.

The AT has a feature you can turn on that will warn you if the blood is so low that it can affect the BG. Look in the manual how to turn on the HctLOW alert. That said, the design of the alert sucks it doesn’t flash so you have to be on the lookout for it among all the other info the meter displays (iirc it’s bottom right)
 
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Finally, I BELIEVE (I never asked) that the advisors here use the same numbers for increasing/decreasing decisions except what the floor (lowest number) is before considering getting help on dosing. I think if you compare the spreadsheet for someone using an AT and someone not using one the lime green has different values but I could be wrong. My goal for my cat was stay well clear of anything that low (or even lower green) so I didn’t investigate further but I think the floor is different
 
SmallestSparrow said:
There is no conversion for human to per meters. The instructions on this site were developed for pet meters and the old hands that most rely upon for guidance don’t use pet meters so have more experience with them. (Edit: more experience with human meters). That said, they advise just fine if you’re using an AT just be sure it’s noted on your spread sheet.
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did you mean 'human meters' here?

thanks so much for taking the time to write out your experience! this was super helpful! especially this tip-

The only time for big concern when you’re getting into green especially if you’re planning on giving insulin to a number below 100 but really anytime. I always subtracted 15 from any AT result 100 or lower and treated that as my worst case number but you can do as you feel comfortable.

I got a couple of 95s this week & was a bit nervous to shoot. I ended up shooting anyway & just giving a higher carb food. (It worked out ok.)

I'd asked my vet at what # should I not shoot at & she said 80. However, she also gave the (questionable) advice that the goal BG should be 180-220. What # do you not shoot at?
 
SmallestSparrow said:
The instructions on this site were developed for pet meters
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Correction, the dosing methods developed and in use on this site were developed with human meters, well before the pet meters were developed and heavily marketed to vets by the manufacturer. As such, the bulk of experience here is with human meters. Plus with much cheaper test strips, people can afford to test more.

If you are following SLGS and using the AT, use the same values as those written for use by human meters. In other words, reductions if they go below 90 on the AT. Increases if nadirs are above 150. In lower numbers (under 90), the two types of meters are much closer together in number. It is still safe if you do reductions below 90 on your meter. We've even seen some people do side by side comparisons with human and pet meters, where occasionally the pet meter read lower in low numbers.
 
soreto said:
did you mean 'human meters' here?

thanks so much for taking the time to write out your experience! this was super helpful! especially this tip-

The only time for big concern when you’re getting into green especially if you’re planning on giving insulin to a number below 100 but really anytime. I always subtracted 15 from any AT result 100 or lower and treated that as my worst case number but you can do as you feel comfortable.

I got a couple of 95s this week & was a bit nervous to shoot. I ended up shooting anyway & just giving a higher carb food. (It worked out ok.)

I'd asked my vet at what # should I not shoot at & she said 80. However, she also gave the (questionable) advice that the goal BG should be 180-220. What # do you not shoot at?
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Yes. I will change that thanks.

I will let the experienced folks here address the what to shoot when more definitively. My opinion is merely the opinion of one relatively inexperienced person. I will say I worked with my vet and followed her advice. Others here ignore their vet and follow only board advice. I think most do some of both. My cat was a special case because of his adrenal tumor—I couldn’t count on him making his own glucose if his BG dropped low.

The goals of the board and the goals of many vets are slightly at odds. For vets the overarching concerns are avoiding hypoglycemia and helping pet parents do a marathon (of diabetes control) vs a sprint. They don’t want a cat to become hypoglycemic or parents become so overwhelmed (by stress, financial burden, etc) that they choose euthanasia. Also, AAHA guidelines exist that vets can feel compelled to follow just as MDs adhere to guideline from thr CDC or FDA (in the US). I will attach those and they will seem probably similar to what your vet says. Those were developed by vets and supported by research to keep cats safe and other best to lower BG and improve health.

This is not to criticize what’s done here and the guidelines used here were developed by a vet doing research on how to strictly control a cats BG. People here often think getting the BG as low as possible will bring remission. I disagree. Studies have also shown cats on Prozinc who had NO at home testing and were seen (I can’t recall if weekly or every two weeks) for a single BG at vet went into remission at rates equal to those in the tight control study with Lantis. In a year of obsessing over the spreadsheet of others I’ve seen cats on very stringent control for years never in remission and others much more relaxed control remission soon. I believe cats will go into remission bc of the cat. Of course decent control helps the cat live long enough and avoid complications.

The more experience you have the more comfortable you become in judging when or how much to shoot and you can always ask for help here.
 
Side by side comparisons of human and pet meters aren’t reliable. This is because of significant differences between the makers of human meters, and the variance allowed for precision and accuracy, as well as the algorithms and test subjects used in developing the meters.

Again there is no comparison. I don’t argue with the vast majority who prefer human meters as they are much cheaper and for the most part accurate enough. And the guidelines used here are made using the human meters. But I would NOT say (nor would any maker of any meter) that the human meters are more likely to provide an accurate reading (in terms of being close to what a lab would give if the blood were tested) at lower glucose levels. They are simply not going to be as accurate but for what people are doing with them for the average cat it doesn’t matter.

the only time this can be critical is when an AT is reading low. Because it is very likely to be a truly low (or even lower) number. As long as everyone know what meter is being used when discussing those low numbers it doesn’t matter because everyone here should be aware of that
 
I think in these most recent AAHA guidelines it probably mentions reducing for numbers higher than here in the forum (as the forum uses a different paper that is posted somewhere on here), and BG targets are also different. This isn’t to praise or condemn either but to illustrate why you can get conflicting advice. IMHO listen to everyone but if choosing other than your vets method consider making sure they are kept in the loop with what you are doing in case there’s an emergency
 

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SmallestSparrow said:
Others here ignore their vet and follow only board advice.
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The vet who pointed me here told me to follow what FDMB said for dosing. You could say I both followed what my vet and the board suggested.
SmallestSparrow said:
This is not to criticize what’s done here and the guidelines used here were developed by a vet doing research on how to strictly control a cats BG.
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Slight variation on this, the original work for the Tight Regulation Protocol was done by laypersons on German Diabetes-Katzen Forum Tilly's Diabetes Homepage - Diabetes in Cats - Feline Diabetes started by Kirsten Roomp, who later worked with Jacquie Rand (the vet researcher) to develop the Tight Regulation protocol. The SLGS dosing method used here were developed over time by FDMB members.
 
SmallestSparrow said:
The goals of the board and the goals of many vets are slightly at odds. For vets the overarching concerns are avoiding hypoglycemia and helping pet parents do a marathon (of diabetes control) vs a sprint. They don’t want a cat to become hypoglycemic or parents become so overwhelmed (by stress, financial burden, etc) that they choose euthanasia.
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Not to hijack this thread, but this is something I’m interested in. There does seem to be a disconnect between some veterinarian’s advice and what we do here. You make good points above. I would also say our goals are slightly inline as well right, that we want what’s best for the cats. I do wonder if there’s a money aspect to it for some veterinarians. Bringing the cat back to the vet for curves, new CGMs, or prescription food is easy money. There’s also the thing about some veterinarians maybe not knowing the intricacies of a more tightly-controlled treatment plan. And sadly, what percentage of cat parents even care to provide this level of treatment. So, lots of factors.

I’m interested in this personally because I want this board to grow and us to be able to find and help more cats. There are plenty of vets that send people here already, but that’s an area of improvement for us.
 
@Tim & Pookey @SmallestSparrow

good point that the vet may have different goals. if they are trying to keep the cat from hypoglycemia in case the owner is not as responsible with dosing on time, i can see it from that perspective. still, it was shocking to hear that she didn't want me to test at home daily, that testing ketones is unnecessary & that goal BG should be 180-220.

that said, i do feel that i am getting upsold every time i go to the vet. like i have to prepare to say no to various tests that add up to hundreds of dollars. it feels like it's every single time so i start questioning whether it is necessary or if they are just trying to see how much money they can get off of 1 visit.
 
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Tim & Pookey said:
Not to hijack this thread, but this is something I’m interested in. There does seem to be a disconnect between some veterinarian’s advice and what we do here. You make good points above. I would also say our goals are slightly inline as well right, that we want what’s best for the cats. I do wonder if there’s a money aspect to it for some veterinarians. Bringing the cat back to the vet for curves, new CGMs, or prescription food is easy money. There’s also the thing about some veterinarians maybe not knowing the intricacies of a more tightly-controlled treatment plan. And sadly, what percentage of cat parents even care to provide this level of treatment. So, lots of factors.

I’m interested in this personally because I want this board to grow and us to be able to find and help more cats. There are plenty of vets that send people here already, but that’s an area of improvement for us.
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Well imo it appears AAHA is the authoritative guidelines (no offense to this board)—a vet can justify following AAHA guidelines. Following “an internet board” not so much. As a physician I would follow guidelines from a medical association over something from the internet.

Yes yes yes—I read the study that forms the bedrock here. I also read the study where cats did just as well on prozinc with zero at home testing. In fact the remission rate might have been slightly though insignificantly better.

I seriously doubt up-selling but if people are concerned they need to find a vet they trust. My vet has at times recommended food they sell and each and every time she has been 1000% correct. When Muz had pancreatitis and wouldn’t eat—Hill urgent care A&D. I believe I shared that with Ivy’s mom when she was struggling to save her and it also worked. Fortiflora isn’t a great probiotic but she was right—got my cats to eat. I’ve never done a test on my cats that wasn’t needed.

I have seen several cats here do great with minimal testing, even go into remission on regimens that are very loose. I’ve seen plenty of cats get tested relentlessly and do poorly. There is a trade off in what is actually achieved for the effort and pain put in and each cat is different.

I grant a lot of credit to those who advise here—it’s a tough job and no pay. I also grant they’ve seen way more curves than the average vet. Otoh, they are not vets and I see a tendency here to say, when vet advice is different, that the vet doesn’t understand diabetes. I think the vet has been to vet school, very hard to get into, and we should not assume they are the ones giving bad advice.

No one here is going to admit someone’s cat when the poop hits the fan. So I encourage everyone to find a vet you trust and can work with—and keep them informed of what you are doing. If they can’t work with you that way that’s their right—don’t hide things from them. If they disagree with advice here don’t default to “vets don’t understand”—ask for an explanation.
 
This study used prozinc, no home testing but parents were told to monitor urine output, thirst etc. Recheck at vet every 1-2 weeks (just for a single blood glucose not a curve ) until stable dose and then every 6 weeks. Many went into remission which again proves to me a cat is what determines remission not the number of times an ear is poked or how green their numbers become.

I’m not advocating loose control necessarily I’m just trying to let people know that just because a vet has a different approach from this board is not a reason to distrust what they say—as them why they say X when you’ve read Y.

Edit: the advantage of the 1-2 week check is a vet is actually laying eyes on the cat
 

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soreto said:
@Tim & Pookey @SmallestSparrow

good point that the vet may have different goals. if they are trying to keep the cat from hypoglycemia in case the owner is not as responsible with dosing on time, i can see it from that perspective. still, it was shocking to hear that she didn't want me to test at home daily, that testing ketones is unnecessary & that goal BG should be 180-220.

that said, i do feel that i am getting upsold every time i go to the vet. like i have to prepare to say no to various tests that add up to hundreds of dollars. it feels like it's every single time so i start questioning whether it is necessary or if they are just trying to see how much money they can get off of 1 visit.
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The goal sounds a bit high I think AAHA puts the goal nadir 80-150 (and they would be assuming with an AT not human meter). I’m sorry to be late to this but I’m guessing you are new to diabetes. If that’s the case she may be starting out higher and working toward lower once you’ve been at it a while. Otoh if that 180-200 was the high point and she has a lower nadir goal then that would be in line with guidelines given for vets to follow.

My suggestion is to ask her if that’s the goal nadir or ceiling (if you don’t know) and then ask if that’s the current goal or the forever goal and ask for explanations why (in the most respectful way possible as I’m sure you would), and explain you’ve mastered home testing, kitty doesn’t mind it, and you will stay on top of her numbers

Good luck

Edit : also, if you were the one with sticker shock over AT cost (that’s all of us) one potential solution might be using both a human and AT meter —use the human one for the bazillion tests you may be doing and then use AT either at same time as human for preshot and nadir, or even just for a curve every now and then for you dr to review (I’m assuming they asked you to get the AT). Obviously if you chose it yourself bc you liked the accuracy then I’m afraid you’re stuck with the crazy cost. I couldn’t do that with Methos bc I really needed to know his numbers as close as possible especially the lows bc of his tumor but I’ve seen others use both to have something for their vet
 
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