Inconsistent Glucometer Readings with Alpha Trak II

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sulile

Member Since 2012
I just started home testing using the AlphaTRAK 2 glucometer. It is what my vet's office recommended and what they use.
I thought I was getting the hang of it, but yesterday I took 3 readings all within the same 10 minute span and they varied widely. I did them all on his paw pads:

475
342
435

What would cause such an inconsistency in BG readings?
I thought the AlphaTRAK 2 was supposed to be pretty good.

I tried again this morning, once on his paw and another on his ear:

495 - Paw
444 - Ear

I don't know whether to trust these numbers. We just started my Buddy on Lantus, 1 unit once a day.

Susan
 
The numbers are really not that different. Here's why:

1. All meters have a 20% variance - which means the higher the number, the bigger the variance. So a 200 reading is really between 160 and 240. That means when you got the 475, it really could have been 360 (20% lower) which isn't really that different from the 342 and 435.

2. Glucose fluctuates all the time, so unless you used the same blood drop, the numbers will be different.

And really, you are looking for trends when you test - warnings that numbers are going too low, too high or just plain erratic. That it's safe to give insulin. If there's a hypo. The number, plus the way your cat is acting, lets you know where you stand.
 
When using a human glucometer, there is a +/- 20% variation allowed by the FDA. All human glucose meters must stay within that range. So at numbers above 400, you may see an 80+ point difference from one test to the next. That's fine. What you are looking for in hometesting are patterns and trends over time, so a 350 and a 400 are pretty much the same thing in terms of interpreting your daily data. If you haven't set up a spreadsheet yet, I would do so, because this will be the most helpful tool you have in understanding and making dosing decisions with your testing. With Lantus, you want to test at least 3 times a day--once before each shot to make sure it's safe to give insulin, and a mid-cycle check (about 6 hours after the shot) in at least one of the cycles.

Here is spreadsheet instructions: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

However, there is a great than 20% variance between that 475 and 342. Unfortunately, there is no FDA regulation of pet glucometers, so any variance between readings is allowed.

I would encourage you to switch to a human glucometer. While there's nothing wrong with using the Alphatrak, a human meter works just as well and the test strips are FAR less expensive. Also, you can run to the store and pick up test strips at any time if you run out or have an emergency (like low numbers) where you need to test more than planned. It's more important that you are able to afford to test your cat as frequently as needed rather than use the meter your vet is recommending (remember that they make money selling you the test strips). The dosing protocol for Lantus is written for both Human or Pet meters, so you have the option of using either. Walmart's Relion Confirm or Micro are both inexpensive, reliable meters that many people use here. The same meter is also sold on the American Diabetes Wholesale website as the Arkray Glucocard Sensor, so you can get test strips online at for much less.
 
is there any reason why you are only giving insulin once a day instead of twice a day? due to the high metabolism of cats we recommend giving insulin every 12 hours. would you be willing to do this? to read more about using lantus please check out the stickies on the lantus forum that explains everything better than I can.
 
Thanks for your response Hilary and Maui.

Well, it's a long story. I should probably start a new post for this. But Buddy had been well regulated on Humulin 70-30 for a couple of years. He was on 5.5 units twice a day. Then, out of the blue, 2 weeks ago, he had a hypoglycemic episode (Blood Glucose down to 20). He was hospitalized and they never could figure out what caused the severe drop. They tried reducing the Humlin 70-30 to 3 units, but he had another low reading (38). They have ruled out Cushings Disease and insulin resistance by doing an ACTH-stim test I think it's called. Also did an ultra sound and could find no tumors although they did discover he has Hypertrophic Cardiomyopathy (mild). So we're starting over from ground zero again this time with Lantus. They are being overly cautious since he had the hypo episode. I feel certain we will increase his dose as he is still in the 400's. This is agonizing.....

Thanks for your response!

Susan & Buddy
 
If you have syringes with half unit markings, you could do 0.5 units every 12 hours - 12 hours on & 12 hours off is putting him on a roller coaster of glucose levels.
 
I agree--dosing Lantus once a day makes it not very effective. The whole reason why Lantus works well in cats is that each shot lasts 12 hours, meaning it lowers glucose for a full 24 hours when shot twice a day. When shot once a day, you're lowering glucose for half the day, and then allowing BG to remain high the other half. This is not good for the cat, and you won't be able to get BG under control that way. I agree that it's much better to shoot .5u twice a day if you want to be cautious. If 1u is too much insulin, then your cat will still hypo even if you're only shooting once a day.
 
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