Meter Variance (and question for Relion Prime users)

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Melissa and P

Melissa and P

Member Since 2014
Meter variance drives me crazy. I don't know why, but lately, I've really been getting hung up on it.

Last night, I tested P at pm+6, and got a reading of 552. He had just been at 294 at pm+5 but on one occasion, he has bounced that high, that fast before. Still, it's one of those numbers I like to recheck, so I did, and the second time, the reading was 333. That seems outside of meter variance to me. When I get a number like that that I want to recheck, I test again immediately and then do a little math. I take the first number, 552, then multiply by 20%, which equaled 110. Then I subtract the 20% from the original number, so 552-110, and got 412. So the meter variance for the 552 should have only been as low as 412. So what's up with that 333? Am I approaching this correctly? I have seen a couple times on here about meter variance where there is usually a scale but have never seen mention of meter variance over 500 (the scales I've seen on here usually stop at 400 and say "etc"). I just want to be sure, but I think last night was a fluke.

It very well could be these darn strips though. Have any of you Relion Prime meter users ever had any trouble with getting consistent looking test strips? Sometimes I'll buy a box and the part that you stick into the meter will have a hole, sometimes it won't have a hole, and like this current box, half a hole. I'm pretty darn sure that isn't normal.
 
An important note about glucometers: The FDA allows glucometers to be sold which read within 20% of what a lab test might get. This means that any test represents a range of possible values.
For any 2 tests, they may be considered equal if they overlap, ie.
1.2 * low value is greater than 0.8 times the high value.

In general, a pet-specific glucometer will read higher than a human glucometer. At the low end of values, that difference is approximately 30 points. At the high end of the scale, it doesn't matter. If the test is high, its high and you take the appropriate action based on the insulin you are using.

TestValue Ranges
Graph
 
Hey Melissa!!

One big thing you're not taking into consideration. At those higher numbers, the meters (all of them) seem to be off even more than the 20%

Quit looking at the numbers so closely. What you want to look for are "patterns"...are they generally staying pink or red? Are you seeing drops into the yellows, blues or greens?

Now I'm not a ProZinc user, so I'm limited at what I can recommend, but a few things I think I see on your spreadsheet.

Looks like at least for the last several days, there have been "stressers" on P, like a drive in the car, and a new cat in the house. These kinds of things can wreak havoc with their numbers.

It also looks like P might have an early nadir. You might want to ask the ProZinc board if it looks to them like he's got an early nadir. If they say it too, it's possible he just needs more, or that he may do better with a different insulin, like Lantus or Levemir. He's still pretty new to ProZinc, so it's also possible he just needs more time.

As for the Prime strips..yes, you're right! Some seem to have holes, and some don't, and some packages seem to have a mix of them.(I thought I was going crazy too!) It doesn't seem to matter on China's numbers, and we've used the Prime for quite some time. If you're concerned about it, you can always buy a 2nd meter to compare to, like the Confirm. It reads very similar to the Prime, the strips are a little higher, but it may give you some peace of mind.
 
Never had any Prime strips without holes but I did have a couple of boxes of Prime strips where some were put in upside-down and some rightside-up, which I'd never seen before.

And yes, you can drive yourself crazy by trying to figure out how accurate the glucometer is. For me, anything over 200 is basically the "same" number: too high. Anything under 200, I've been using the Prime for long enough that I've grown to trust its results. Yes, there is the occasion where I'll test a second time because I don't believe it (i.e. if I think he's low but he gives a high number or I can't believe how much he dropped in a short period of time). If there's a huge discrepancy (like you saw with the 552 and the 333), then I'll test a third time and toss out whichever number is farthest off. I add the two closest numbers and then divide by two and use that as my test result.
 
At the end of the day I wouldn't get stressed about it- essentially he is pink and yellow which is too high. But he is on a higher dose so I wonder

- Is there any underlying conditions i.e. is he on steroids? any infection? Hows his teeth
- does he get any dry food at all? treats?

Wendy
 
Thanks everyone! Sorry for the long delay in replying. Had a lot going on lately.

Wendy, he's not on steroids, just got bloodwork done again a few weeks ago-no infections, he's got some plaque buildup on his teeth but the vet said he wouldn't need a cleaning for 6 months. He doesn't get any dry food, and the only treats he gets are Simply Nourish freeze dried shrimp.
 
Ok so you are at 4.5 units. I think you really need to start shooting at lower numbers . The few times you do get a lower pre shot number you only give a partial dose...but the mantra is shoot low to stay low! So I would start shooting the full dose of 4.5 units as long as he is over 200. Especially since you seem to be home a lot of the time to test anyway.

Shooting at lower numbers may help bring him down. And after shooting at 200, if nothing scary happens then I would reduce to as low as 150. And if that doesn't bring him into better numbers we need to start considering a high dose condition.


Wendy
 
I'm nervous to shoot a full 4.5 on my longer school days. Two days out of the week I'm not home until +7.5, with no monitoring in between.
 
You have some room to tweak the dose slightly and possibly develop a sliding scale - compare the nadirs with the ranges below.
[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
I would ask on the pzi board but I don't think you need to be nervous, his numbers are high and as BJ said you have a lot of wiggle room.., ie a lot of way to go before you need to worry. You haven't even seen a green yet. I would also ask there about increasing the dose.

Wendy
 
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