Question about new low end for Alpha Trak?

[lovey11]

Hi everyone.

I now the Romp protocol ( I am not sure if I am remembering the name correctly) change the low end parameter for alpha trak users from 80 to 68. Does anyone know the reasoning behind it? Did the low end change for human meters?

I was always told the normal range for the alpha trak was 80-150. Is this range only to be used for people who test intensively or is 68 the new 80? I am happy to have more of a safety net when I am at work or a little more room for

increases, but I am having trouble putting my faith in it it is only one study.

Lovey tested 3+ on her urinalysis. Does that signify too high numbers for one day or for a period? How much glucose is that in the urine?

 

[Sienne and Gabby (GA)]

The article (Roomp & Rand, 2013) that Jill noted, doesn't describe a research study. Rather, it is a summary, the authors of which are the same people who developed the TR protocol. I suspect that the rationale is that there has been a change in the method by which the strips measure BG (plasma equivalent vs. whole blood). In addition, the way the article reads, the authors are attempting to get BG measurements using human meters to be closer to the results from a serum chemistry analyzer (i.e., the equipment which cranks out those long lists of blood tests) or an AT which has always used the same technology as the serum chemistry analyzer. The difference now is not just related to the use of plasma equivalent readings. Rather, the difference between a human meter and a meter developed for cats is just that -- the difference is due to the differences between the two species (or at least that's my read).

If a serum chemistry analyzer or plasma-equivalent meter calibrated for feline blood is used (eg, AlphaTRAK, Abbott Animal Health, Abbott Laboratories, Abbott Park, Illinois), the measurements at the low end of the range need to be adjusted and are 30% to 40% higher than for a whole-blood meter calibrated for human blood. The doses, when using such measuring devices, should be changed as follows: the lower limit of the range should be adjusted accordingly by adding approximately 18 mg/dL (1 mmol/L) to the value listed in the protocol in Table 2. For example, a target value of more than 54 mg/dL (>3 mmol/L) becomes more than 72 mg/dL (>4 mmol/L) when using a serum chemistry analyzer or a meter calibrated for feline use. Alternatively, use the normal range for feline blood glucose concentrations as a target when using a meter calibrated for feline blood. Most of the major human brands of glucometers now report plasma-equivalent values and these are intermediate between those measured by whole-blood meters calibrated for human blood and plasma equivalent meters calibrated for feline blood. Be aware that test strips sold by the major human companies now provide plasma-equivalent readings, even when used in older whole-blood meters, although their accuracy and precision are not as good in the whole-blood meters.

The value of "68" is not a hard and fast number. If you note, Roomp and Rand give a range (30 - 40%).

The other thing I would point out is that for quite some time, people were concerned about how certain meters were giving "bad" numbers especially at lower ranges. At least in part, this may have been due to the changes in the strips from whole blood to plasma equivalent technology.

Essentially, what the article is suggesting is that 68 (plus or minus) is the approximate number for a dose reduction if you're using an AT meter.

 

[lovey11]

Thank you very much for your sharing your understandings of the Roomp study. I wasn't familiar with the term serum chemistry analyzer. I guess we are always talking in ranges with all our measurements.

I appreciate it! Have a good night!