Meter problems again?

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owlgal

owlgal

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WHen i first started home testing, i was using the freestyle meter. We all know what was wrong with that. I tested with the freestyle, alpha and relion and the alpha and relion within 30pts of each other. The alpha being the higher number than the relion. So stayed with the relion because of costs and felt very confident about it until i test compared today with alpha track. I've tested twice today on same blood drop and the relion came in about 30pts higher than the alpha track. Now i'm a little concerned because i have been confident with the readings of relion and thinking when he got low i had a 30pt window difference because running a little lower than the true number of alpha track. Now when i get low, i really am 30pts lower based on what i got with alpha track numbers today. I started to question the meter today because my fructo bg range (avg. 270). I've been showing him higher all along. This is a good thing, but not confident of my meter or the alpha now.

I wanted to test the control sol'n but can't find it for neither meters. Must of gotten tossed by mistake. Any other suggestions about this differenece in numbers? Now i'm wondering if i should go down instead of up. He has been pretty leveled in the high 200-300's throughout the day today. Wondering if i should do a 1uskinny or maybe a .8u. What do you all think i should do for the dosing if my numbers are really 30pts lower?

Thanks for your thoughts!

Lori

p.s.
Gave 1u-Pmps 301 +3.5 305 (alpha meter @3.5 on sameblooddrop-273)
 
I know this probably won't help much,but I tend to forget this too.....

Meters can vary 20% by law and be deemed accurate. 300 on one meter could easily be 240-360 on another, or even the same one when tested with the same blood.

I'd look more at the trend than individual numbers. :smile:
 
My Relion can test anywhere from 70 pts to 30 pts lower than my Alpha. On the higher end the Relion tested 318 and the Alpha 381. On the lower end of the scale, the Relion came in 214 and the Alpha 246.

I mapped them on a line graph and the curve of each line is close to identical.
 
Good info. So which one do i trust? I'm kinda worried about if he goes too low now what is true number is. This morning I tested twice. First, was a huge blood drop, tested relion and came in at 274. Tested alpha on another drop because copper didn't cooperate- it came it @ 241. Did another test and used same blood drop. The alpha was @ 262 and relion @244. So interesting. So i went with the 244 since i'm trying to stick with same meter.

I think i will make sure that he doesn't go below 70 no matter what. Now i'm worried.

Maybe this is good cause to keep doing the fructo test every month to make sure meters are working right.

Lori
 
My vet uses an Alpha so that's the one I go by. I just have it in my mind that I won't start freaking out until she hits 70 or lower.
 
Lori,

In my opinion, you don't need to worry about a 30 point difference when it comes to his numbers being too high. Why? Well, as Theresa pointed out, meters have a 20% variance. If I recall correctly, anything over 250 is bad, because that's in the renal failure threshold zone. 250 +/- 20% is 200-300. That's more than 30 points either way. Anything over 250 doesn't matter in my mind. It's all too much. Clearly, 400 is worse than 250, but 400 is not within 30 points of 250, either.

Where 30 points makes a big difference is at the low end of the spectrum. If the meter shows 70, and the meter is within its 20% variance threshold, then the real number could be as low as 56. This 14-point difference is concerning, but not life-threatening. However, If your meter is 30 points off at 70, then that could be a life-threatening situation. At 43% variance, your meter needs to be repaired, replaced, or refunded.

So, I guess this is my long-winded way to ask a very simple question: are you seeing that 30 points across the board? If so, and especially if you're seeing it for anything *under* 150, then there's a problem. If you're seeing 30 points variance *over* 150, though, that's within 20%.

eric
 
THanks! I did the +4 on same blood drop: Relion@ 300 AT @ 274

So that is a 30pt difference and within the 20%variance. Again, surprised that the AT lower-but again the 20%variance rule- So i guess the number is about the same? High and flat. At least that is how i would interpret it. Since he is high and flat, and then drops down for PS- does that mean too much insulin or not enough?

Lori
 
Ok I will throw the monkey wrench in here, sorry!
this moring I teted first onthe RElion(which I really dont like)
and I got a 543!!! WHAT@!$&&#($&#$&(&^*(%^
so I grabbeed the alpha track and I got a 381,
So I think I will bite the bulltet and stick with the alph track as that is what my vet uses
 
Actually, Denise, that sounds like a bad strip. I get them ocassionally with the relion, so if I see a weird number like that I retest.
 
Hmmmmm! How often have you compared the alpha track with relion? Just curious. I did his +6 on same drop: Relion@ 239 AT@250. So not off too much. This is the way i thought it was. The AT about 30pts higher than the relion. Now this is only 11pts higher. At +4 the AT was lower reading than Relion.

I guess i just need to be looking at trends instead of the real number, although i like numbers. The fructo that i got back said he was running around 240-270avg BG. My meter(relion) was showing a lot higher. I need to go over my SS and add up all the numbers and get the avg and see what if comparable with fructo.

Anyhoo! I know i need to go up a tad on the insulin. Just would like a reliable meter. The strips for the alpha are so expensive.

lori
 
Nice chart. In light of that, I retract my previous post. :) Looks like there is a definite difference all across the board.

Can you remind us again how your meters tested against the vet's?
 
Love the graph. That is what i expected about 30pt difference with AT being the higher BG. For some reason it is the opposite on my relion. I know back in November when i was first having problems with the freestyle, i compared side by sid with relion and alpha. The AT always coming in 30pts higher than the relion and the freestyle always 100 pts lower. Now the AT is coming in lower than the relion. Not sure what to do now. Maybe another relion meter? That would be cheaper than buying the AT strips. WHere do you get your alpha strips from? Do you get a discounted place?

My amps: Relion: 303 Alpha: 277
Fed
Shot 1u

Thanks!

Lori
 
Ok, i added all the numbers up for the last two weeks and avg the avg bg was 207. This is with the relion meter. I only counted it once, so not sure that is 100%. Did i do this right? Am i getting too technical about the numbers? I mean, if the At can go either 30pts higher or lower each blood drop and so could the relion, then how do you know what his real BG is, especially when he is getting real low? This bugs me!!!!! I don't know what to do now. UGH!

lori
 
Lori,
Yes, you're probably getting a little bit too technical with the numbers. Me, I love numbers and math and formulas and statistics, so I understand what you are doing. But...

When I see numbers on a SS, I never, or rarely, consider the meter variance at the same time. Occasionally, I will look at a flat curve, for instance. And it may look a bit "inverse" to some, but then I'll think "well, fine line between flat and inverse, and those "high" numbers could just as well be the same as the others....so I will evaluate the curve as "flat". If one or two of them stick out, like way higher than the others, then yes, I have to consider the curve inverse, which would indicate a reduction is needed. But the cure for an inverse is "reduce", while the cure for a "flat" is "increase", right? Two different directions that are not going to cause the same effects. Anyway....

I totally understand with the recent FreeStyle fiasco, why you and Denise and Donna (and others) have had such a hard time. But you could go crazy trying to figure out the difference between the Relion and the AT it looks like. Here's what I would do.

I would put away the AT and forget you own it. I would put faith in the Relion, and keep in mind that it can be off by 20%, and if I understand what lots of others have said on the board, keep in mind that the higher the BG, the more likely it is that the Relion will read "off", and will read lower than "reality".
Then, pick a number, any number, that you feel is the absolute lowest number you are comfortable seeing on that Relion meter. If it is 40, 50, 75, whatever. And going forward, think "OK, I am not going to sweat a hypo unless I see 50 on the meter. Above that, he's good, below that, I'm getting out the gravy." As far as the higher numbers go, just take them at face value, and pop them in the SS. Try to forget about 20% variance unless that variance is going to be critical to a decision you need to make, like "do I increase on this flat looking curve, or not?" All the numbers are just numbers. Pay attention to the colors on the spreadsheet, and look for color patterns. A curve that goes from Red to Green is probably too steep, and indicates a dose that is probably too high. But a curve that goes from Pink to Yellow is probably indicative that an increase is needed.
When I look at PS readings and nadir readings, I look at "percentages". No matter what the numbers or colors are, I think "is it a 20% drop, a 50% drop, a 70% drop, etc?" If the percentage is low, then I think "increase". If the percentage is high, I think "probably too much, but what is the low number? Is it yellow, blue, green?" If it's yellow, then it doesn't concern me. If it's green, I pay more attention. I think the goal is to make kitty stay under 250 for as long and as often as possible. To get below the "renal threshold" and "glucose toxicity" numbers. The more time a cat stays out of those ranges, the better chance that some pancreatic healing can take place.
Does that all make sense?
Carl
 
Carl,

You explain it so good. I never really thought about just looking at colors or % of drop. So is that the drop from PS to nadir that i need to look at? What about if amps is lesser than the pmps or vica versa? I've always wondered this.

I've always thought that i had that 30pt safety zone or so when he got low. Now i'm thinking that since the AT is reading lower than the relion that i should not go below 80 on the relion. His normal glucose reading a year ago and 2yrs ago was 110 and this was at the vet visit.

I'm trying to get below that 250 range. Feel like i'm getting closer and then seems to back step some. What do you see when you look at copper's SS? The vet said, based on the fructo reading, that i should try 1.2 or 1.4 and hold. His amps keeps changing from high to low so i'm afraid to go up in the mornings. Also, i've been so busy this past week that i really haven't been home enough to monitor too much. So tried to stay stable at 1u. What do you all think?

THanks for all your support.

Lori
 
Yes, I look at the percentage drop from AMPS to nadir, or from PMPS to nadir. In general, I think of a 50% drop as a decent drop, but less than that, it indicates, to me, that you could increase dose to try to get at least 50% drop. So on a 300 PS, I'd try for a nadir of 150 or lower. As far as the difference between AMPS and PMPS goes, I try to look for a good reason why that is happening. It could be due to activity level being different night and day. Or it could have something to do with the timing of meals and the quantity of food if it is different night and day. Then I would try to find a balance by changing food timing or quantity so that the amps and pmps were closer to each other. If those numbers are pretty similar, then the dose can be similar and you can "expect" a certain result.

I've always thought that i had that 30pt safety zone or so when he got low. Now i'm thinking that since the AT is reading lower than the relion that i should not go below 80 on the relion. His normal glucose reading a year ago and 2yrs ago was 110 and this was at the vet visit.
Click to expand...

Different with me, but I understand your logic. My relion was tested at the vet against their AT twice, side by side, same sample of blood. Mine was 25-30 points lower each time. So I always had in the back of my head that the Relion reading of 50 was "really an 80". The problem with that was that the readings at the vet were in the red range. So mine might have been off by 30 points on a reading of 450, but looking back on it now, I have no idea what the difference would have been if Bob's BG had been 100 for those tests. I can't say for sure that the relion would have been 30 lower in the "normal" range. But when Bob gave me a 42, in my head I was thinking "okay, that's a 70 or so, he's good". I don't think that thinking that way was really a good thing looking back on it now. What if he really was at 42, or even lower? So that's why I try to forget that little voice in the back of my mind that says "ok, then that number is really a ___". I don't know that the little voice was really right.

Now I'll take another look at the SS and see if I can figure anything out...
Carl
 
ericbakes said:
Nice chart. In light of that, I retract my previous post. :) Looks like there is a definite difference all across the board.

Can you remind us again how your meters tested against the vet's?
Click to expand...

I wouldn't completely retract it Eric. Yes, there are definite diffrences, but the lines aren't parallel.
At times the difference is 30 points while at others it's 70 points. That just confuses things worse! We can't say the relion is always X points off at all. Does anyone know what the % meter variance is on the AT? Is it 20% like human meters? My vet seemed to think her meter was "right", so I don't know if it has any variance, but if the AT is off by 20% too, then nothing is conclusive.
 
Carl,

Not sure if AT has a variance, but i'm sure it does. I know i've tested several times in a row with AT and relion and they both gave high and low numbers each time. So like you said, i'm not really sure what to think. I know that i have to relie on something and will keep the relion and test from time to time with AT. I go back in 2wks to the vet to check him again. I might make that 4wks. Too far away and stressful for all involved.

I think i will definelty not go below the 70 mark on the relion. It seems that the 1u at first worked good on him and then stopped working as well. If i went to .8u he would stay in the low yellow's all day. I like that better than the low 300's all day. No blue's-so i know not good. I think the last couple of days he hasn't been feeling all that well. He is eating fine, but his eyes were very weepy and not as active as usual. Today they have been good, but the weather has gotten cold again. So maybe it is allergies. Who knows.

Anyhoo....I've got to get to bed.... Got church early in the am.

If and when you have time, take a look at his SS and tell me what you see.

THANKS!

Take a pic of sunrise and post. Would love to see another sunrise beach pic. Keeps me calm.

lori
 
Lori,
I'll have to take the look at the SS tomorrow....I'm pretty crispy and need some beauty sleep. Sunrise pictures will come next week when I have to work the 6am till 2pm shift again! Don't like the hours, but the sunrise makes it worth getting up for. Look for one Wednesday, clouds permitting...
I'll find something to take a pic of tomorrow I'm sure. Today was lighthouse picture day... I had to take some pics of the lighthouse for a vendor who is putting it on a new line of t-shirts. It's supposed to be in the picture, but not the focus of the picture, pretty tough because it was about 1/3 mile away from where I was...here is my favorite from today:



Carl
 

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