Question about reliability of test strips

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Cindy & T

Cindy & T

Member Since 2013
Hi -- I am pretty new to testing my cat's BG before shots (although he has had diabetes the entire 6 years I've had him). I have a quick question for people who have lots of experience with this: T has been going along relatively stable... the last few days, not so much (you can look at his chart in the signature link and see). He has hit under 100 levels 2x in the past week, and both times, I have held the shot. The first time, he came back up to normal pretty quickly. This time, it seems really out of whack!

I did do one thing different: I had been testing with Bayer Contour but I ran out of test strips... I had a TrueTrack here and I had acquired some test strips for it... so, I made the switch right before his readings sky-rocketed.

Could this be a test strip issue? He seems fine -- nothing out of the norm. Eating well, not drinking excessive water or urinating more than usual... still, he has a black and a red on his chart, and I am baffled (and concerned).

Thanks!
Cindy
 
Thanks, Larry! It just seems like such an odd coincidence that when I switched, his numbers skyrocketed so drastically! And I really want accurate readings now.

For those who have used TT and who have had issues: is the BG reading within a correct 'general' range? (i.e., perhaps his blood readings are a little high, but not that high? And, if I get a reading of around 150, perhaps I should perhaps suspect it is much lower? Trying to figure out how to manage this until I can get some more BC strips...)
 
Cindy & T said:
Thanks, Larry! It just seems like such an odd coincidence that when I switched, his numbers skyrocketed so drastically! And I really want accurate readings now.

For those who have used TT and who have had issues: is the BG reading within a correct 'general' range? (i.e., perhaps his blood readings are a little high, but not that high? And, if I get a reading of around 150, perhaps I should perhaps suspect it is much lower? Trying to figure out how to manage this until I can get some more BC strips...)
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In my experience, those kind of meters are fairly accurate at lower numbers (around 130), but there's no rhyme or reason at higher numbers.
 
Could be the meter. Could also be he is dropping low overnight and bouncing. I can't imagine he only shows those greens during the day and as many cats go even lower at night.. if he sneaks under 50 he might bounce to red or black during the day. For safeties sake i would start getting some pm tests.
 
Wendy, is the "bouncing" you are referring to "rebound hyperglecimia?" I'm trying to understand what is going on... this cat has been absolutely stable for 6 years until May, when he had his first hypo on my birthday, and then not again until last month (that I know of). I'm trying to figure out what is going on.
 
Cindy & T said:
Wendy, is the "bouncing" you are referring to "rebound hyperglecimia?" I'm trying to understand what is going on... this cat has been absolutely stable for 6 years until May, when he had his first hypo on my birthday, and then not again until last month (that I know of). I'm trying to figure out what is going on.
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Since had a hypo, too, it sounds a lot like a reduced need for insulin to me - his BG is getting low enough for his body to 'panic' and throw out glucose, hence the high numbers following low numbers. He missed a shot last night, correct? How do you feel about giving him a reduced dose today?
 
Yes, Becky, thanks! I wrote to his vet last night and that is what she said! She said he may be having a Somogyii reaction and suggested I drop from 1.5 units to 1 unit. Unfortunately, I already gave him 1.5 this morning before I got her email b/c his BG had spiked again overnight, but I will reduce it starting this evening. She also suggested testing him 5-6 hours post shot for a while to see where he is... I can't do that all of the time (due to work), but I will be able to do it for the next couple of weeks fairly often.
 
Cindy & T said:
Yes, Becky, thanks! I wrote to his vet last night and that is what she said! She said he may be having a Somogyii reaction and suggested I drop from 1.5 units to 1 unit. Unfortunately, I already gave him 1.5 this morning before I got her email b/c his BG had spiked again overnight, but I will reduce it starting this evening. She also suggested testing him 5-6 hours post shot for a while to see where he is... I can't do that all of the time (due to work), but I will be able to do it for the next couple of weeks fairly often.
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Most people will suggest drops of .25 on here, but that is usually more of a preemptive thing when numbers are a little low at nadir, and it seems that it's a little more drastic than that for T. It's something to think about, but for what it's worth I'd probably be dropping to by .5, too.

Either way, I hope he's showing you some better numbers real soon :-D
 
Cindy & T said:
HIs reading at +7 hours is 'Hi,' which the TrueTrack manual says is over 600.... :/
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He is terribly confusing right now, isn't he? :? Do you have an idea when the other testing supplies will arrive?
 
Pretty much somogyi with those blacks. If he is dropping under 50 at night he could shoot up in the morning... and a bounce can last up to 72 hours after that happens.

Heres what a bounce is
When a cat isnt regulated, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce

Anyway I would start getting a before bed test (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle. Means you don't need to always get up at night if the before test bed is higher than pre shot!.


Wendy
 
@ Becky -- yes, terribly confusing! He's drinking a lot of water tonight so I know those high numbers are for real (but perhaps not as accurate as they could be with the other meter). The other strips are due to arrive tomorrow.

@ Wendy -- thanks for that explanation! It is beginning to make sense to me. I will get in the habit of checking his PM BG for a while to see what's up at night.

I am worried with the 'over 600' readings. I tested his urine a little while ago -- no signs of ketones. I am planning to give him his PM shot at 10 hours intstead of 12...
 
That's fine but remember than means tomorrows shot needs to be two hours early too. And get a before bed test in case he drops suddenly.
 
Okay, I will move the shot time back tomorrow, too. I need to move his 'shot schedule' back a bit anyway, since I will be starting a new job in a couple of weeks and he and I will have to adjust to my new schedule.
 
I got T's Bayer Contour test strips today (THANK YOU DCIN!!!)

Wow, there is a SIGNIFICANT difference in readings! I did 4 tests (2 drops of blood and I tested each once with the Bayer Contour and then the Truetrack).

Results =
First test: 311 TT/185 BC.
Second test: 336 TT/182 BC.
 
Yes with the freestyle ones. Not got any experience with the true ones. Can you test yourself with both? I expect both meters will get closer at lower numbers.
 
Hmmm. Bayer says I am 61 and TrueTrack says I am 98. I'm not quite sure what to think of that. :?
(I'm not fasting -- I ate within the last hour!)
(and now, with that lancet pricking... I feel T's pain)
 
Since you are home testing, you may find the following helpful.

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as mid-cycle data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
Thanks, BJM -- this helps a lot! I am going to print it out until I memorize it.

I just realized today (reading some other threads) that I shouldn't give him a shot if the pre-shot level is <200 (since it is Lantus). I erroneously thought it was <100. I'm glad I figured that out!
 
Well ... not exacty.

The 200 mg/dL limit is where we start for beginners who don't know how the cat is going to respond to the insulin because there isn't test data. Its a reasonably safe number.

As you get data, specifically in the +5 to +7 hours after the Lantus to see how low it takes the cat, you can start to lower your no shot limit of 200 down to 150 mg/dL, so long as the cat remains above 50 mg/dL at the nadir/low point.

And if you follow the Tight Regulation protocol, and get enough test data, you can learn to shoot low to stay low wth Lantus or Levemir, below 100 mg/dL, even, so long as the cat remains above 50 mg/dL
 
As BJ said, the 200 number is just for newbies. As you gather data it becomes safer to shoot low and its important to learn how to do so to ensure your kitty stays in normal numbers longer. The mantra is shoot low to stay low. Maybe read this http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

Give your current data, and if you are able to test, I would be ok with shooting as low as 150 for now. but read the primer above..
 
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