METER ACCURACY CONCERNS - what I've learned so far...

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Grayson & Lu

Grayson & Lu

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For my PZI friends who've worried about my sanity, and others who've ever questioned the accuracy of their meter, I learned a few things today (that I probably SHOULD HAVE realized, but apparently hadn't).

Over the past 3 months I've been testing Grayson w/ my ReliOn Ultima (RU) meter. He's not much of a bleeder, so a meter that requires .6 of blood may not have been the best choice, but it was economical (about $9) and the test strips were some of the least expensive (100/$36). Early on, I compared it with Kim's meter and it appeared to be pretty close, so I've continued to use it.

Every once in a while, I'd get a number that was really off from any pattern that Grayson had followed. Since he's known to stay flat as a pancake ("at the IHOP") in the pinks, seeing a 150 or 90 was even startling - welcome, but startling. Initially I accepted it as a gift and went on w/ life. Every other once in a while, I'd get a number that was really high. I started to re-test when that happened, and eventually I saw some readings that were WAY off - not 20%... but higher. I picked up a ReliOn Confirm (RC) and started to run tests with both (as well as a Nova Max (NM) - which all but once tended to be lower - sometimes by as much as 119 points. So now I'm staying w/ the two Relions...

On March 31, RU = 357, while RC registered a LO and NM a 256! Earlier that morning I had a 455/447 with RU; and a HI (>599) w/ RC.

Today I spoke w/ customer service representative for the ReliOn Confirm - which BTW is made by a different manufacturer than the Relion Ultima. After describing what I've been experiencing, the rep explained some reasons for different (and in some cases, extreme) variations. The usual stuff we should all be doing, but I have to admit sometimes I don't... like:

Wash your hands before testing - especially after handling his food.
Wash (and dry) his ear - with either water or alcohol.
Use the 1st drop of blood (not like at a blood drive where they use the 2nd when testing iron or hemoglobin).
Use a fresh drop of blood for each test. There's an enzyme on the test strips. Some of that enzyme from the first strip, could be left in the blood and affect the reading on the 2nd strip.
Run the test within 20 seconds of getting the blood; as time passes, the blood is oxygenated, which can skew the numbers.
Use a different lancet each time. Old blood can skew the reading as well.
Lastly, I kept getting E-7 messages. She asked if the strip was sipping up from the blood droplet, or if it was on his ear - which I KNOW I've done. It needs to NOT touch the ear, as it may "read" that it has adequate blood, when in fact it doesn't.

So, several things I knew, but others that hadn't been on my radar. Will try to be more consistent in my technique and we'll see if I see a difference in my readings. If anyone else is having readings that don't seem quite right, you may wish to do the same. I'm anxiously looking forward to going back to one meter/one reading thing... as long as I can feel confident that it's accurate... before they send the men in the white coats for me! :o
 
oh thanks for sharing this!
Sam bleeds a lot and I know I have retested him with the same blood instead of poking to get a new one!

I've been also guilty of using the same lancet if I see the number is strange I use the same lancet instead of a new one..!!
 
Wow, what fantastic information to have. Somebody sticky this!
I was guilty of every one of those at some time during Bob's dance.
Thank you Lu, for taking the initiative and investigating this.
Finally some explanations for "wonky" numbers...
Carl
 
Hi Lu,
Great information, thank you. I would not use alcohol on my kitty's ears mostly because it dries the skin and can irritate it. At least, that's what a respected dermatologist told me. It's especially important not to use it in areas where pokes are administered since we want those to heal as soon as possible. Any irritation delays the healing process. Probably, plain warm water on a washcloth will do the best job. I imagine there must be exceptions to what I'm saying, but overall I've been advised not to use alcohol.
 
Thanks - I personally don't, but likewise, I haven't been washing his ears either. The rep may have just been reading from their protocol, but was very kind and didn't seem startled when I told her that there were many of us testing our cats regularly w/ their meter!
 
My approx. total testing so far is over 16 years. I have never washed an ear yet, alcohol will dry the skin, and if blood doesn't come right up, I do use the lancing device again without changing the lancet. As for clean hands, I always am washing my hands, especially after food handling so hands are always clean and minus hand cream. I also have never put an ointment on an ear and have never had an infection either.
 
Lu, thank you so much for this information! It is extremely helpful information that should be used by newbies & oldies. ;-)


I'll call off the men in the white coats. :lol:
 
All meters and strips have some inaccuracy. Ours is accurate to within 0.5 (apx 10 US) 19 times out of 20. Just as an example.
 
Just by paying a little closer attention to the absorption of the blood onto the strip this morning, I got AMPS readings of 380 (RU) and 369 (RC). Personally, I think that was the biggest reason for my inconsistent readings! I'll give it a few more days, then return to one meter (which really WAS the plan from the start!).

Jenn & Baxter said:
I'll call off the men in the white coats. :lol:
Click to expand...

I know some people will be relieved to hear that! :lol:
 
One more warning to add: make sure the strips are stored in their original container with the cap tightly closed. I had accidentally spilled some. I gathered them up quickly and out them back in the bottle and they were all fine. However, I found one on the counter a day or two later and decided to use it since the things are so stinking expensive. I almost panicked because I got a reading of 32! Luckily I remembered it was the strip that had been on the counter and retested twice with fresh strips and got readings in the 90 range both times. So now I'm careful to only use strips that haven't been out of the bottle for any longer than it takes to get the test, and to make sure the bottle is always tightly closed.

It also bears remembering that the 20% variance that meters can have can produce quite a swing at high numbers. For example, for a BG of 300, a reading of anywhere between 240 and 360 would be within that variance and considered accurate. The 357 and 256 do fall within that range.

If you're comparing meters with the vet, make sure you use a fresh drop of blood, not blood from a vial. In several tests at my vet's, the blood from the vial read significantly lower than fresh blood on both meters, but worse on my human meter. When measured on fresh blood, both were within a few points (vet's Alpha Trak was, as is normal, higher) of both each other and the reading I'd gotten at home just before the visit. We tried it a few times and on different cats and every time, the blood in the vial tested lower by a lot...my vet thinks it's because of the anticoagulant in the vials.
 
MikeysMom said:
If you're comparing meters with the vet, make sure you use a fresh drop of blood, not blood from a vial. In several tests at my vet's, the blood from the vial read significantly lower than fresh blood on both meters, but worse on my human meter. When measured on fresh blood, both were within a few points (vet's Alpha Trak was, as is normal, higher) of both each other and the reading I'd gotten at home just before the visit. We tried it a few times and on different cats and every time, the blood in the vial tested lower by a lot...my vet thinks it's because of the anticoagulant in the vials.
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WOW, I had never thought about there being something in a vial... that's interesting. When I initially tested at my vets, we did his Alpha Trak and my Relion. Unfortunately, I didn't record the readings and don't remember what they were - DUH! But because they were drawing blood, we used blood from the vial. Not to mention, at that time, I had such a difficult time getting blood from "my little turnip", that I didn't want to show the vet just how bad I was! Now I know he doesn't bleed well and I'd be like, "Whatever!" :lol:

I never cease to be amazed about the things I learn here. Thank you all!!!
 
This is great info! Thank you! I'm also concerned about the accuracy of the ReliOn. I've been assuming it reads low compared to the AlphaTrak at the vet, but on Tuesday, at the vet's office, the ReliOn said 306 and the AlphaTrak said 290! Who knows why. My vet didn't seem to be too bothered by the difference and encourages me to keep testing at home, which I really appreciate.
 
grapey said:
This is great info! Thank you! I'm also concerned about the accuracy of the ReliOn. I've been assuming it reads low compared to the AlphaTrak at the vet, but on Tuesday, at the vet's office, the ReliOn said 306 and the AlphaTrak said 290! Who knows why. My vet didn't seem to be too bothered by the difference and encourages me to keep testing at home, which I really appreciate.
Click to expand...

A 16 point difference from 306 is negligible - most here would say that's the same number. I know there's supposed to be the 20% meter variance, but I have a hard time accepting a 100 point spread - especially if it's between 300 and high.

I ran a couple tests today and on the +4 my Ultima gave me 326 and 320... basically the same number. Meanwhile, the Relion Confirm gave me 278 followed by a 507... that's what I'm talking about - Based on the +2 (RU 348; RC 342)and +6 (RU 348; RC 345) from BOTH meters, I'm convinced the Ultima numbers were correct for +4. The Confirm... I have NO idea! I've been paying closer attention to my technique, so I'd like to think they're more accurate, but decide for yourself! Crazy!
 
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