Relion vs. AlphaTrak

[arozeboom]

I've been using a Relion Micro since Ruby was diagnosed at Christmas. On the recommendation of my vet, I did order an AlphaTrak, which came today. I definitely like the size and shape of the Relion better and I also like that the sample goes into the end of the strip. The Alpha is bigger and rounder and the sample goes into the side of the strip. Its just more awkward for me.

I've done 3 tests tonight comparing them, all three done on the same drop of blood with the Relion first and the Alpha second. The Relion is so far consistently lower by 20 - 60 pionts (336/353, 317/356 and 228/283). Between the first and second tests, the Relion shows she went down, but the Alpha went up a point. That was about +1 after the shot.

I've seen pros and cons on both. Is one really more reliable or accurate than the other?

 

[BJM]

Yes, we know they read differently. One is normed on human blood; the other is normed on cat (& dog) blood.

The stickies for Lantus will tell you that the reference levels we use for dose adjustments are different for human glucometers vs pet specific glucometers. Basically, human glucometers may read an average of 30 points lower than the pet specific ones.

ex: Low on ReliOn is 40-50 vs low on AlphaTrack of 70-80

Per FDA, both read within 20% of the 'true' lab value.

 

[Melanie and Smokey]

The numbers and ranges talked about on the site are for human meters. When you post numbers while using the AT, you would want to mention that.

Any meter calibrated for animals will generally read higher. We aren't usually really concerned about one test as it stands by itself - 32X, 38X you will respond to in the exact same manner. Once you start getting into the lower numbers is the only time it is going to matter and just knowing the kind of meter you have, you respond accordingly. What we are really looking at here is patterns and trends in the numbers - are they dropping, is there a curve... . "Accuracy" is not really an issue because you would be judging the number you are reading based on a different scale.

The biggest difference you will see in the meters is the cost of using them. The AlphaTrack will be astranomically higher cost than the ReliOn because the strips are the most expensive strips you can possibly use.

 

[arozeboom]

I bought the Relion originally because of the price. The Alpha was 3 times more. For the Relion micro, 100 strips and 100 lancets I paid $56. For the same set up with the Alpha, it was $225.
I did it because If I take Ruby to the vet for a curve, it rings in around $140 and she pulls numbers in the high 400s. She's never gone anywhere near that at home. The Alpha saves the curves at the vet and Ruby the stress. And honestly, the money doesn't matter to me right now. What matters is making sure I'm doing the very best I can to get her and keep her well.

The other night when Ruby had her hypo episode, it seems possible that it was really only a hypo because I was using the Relion. If I had the Alpha then, her lowest number probably wouldn't have been below 100. That's where my confusion comes in. How do I know which is closer to correct? If I had been using the Alpha that night, I wouldn't have panicked. I would have been thrilled because her BG numbers would have been within the target range. She wouldn't have had her ears poked a billion times and I would have gotten some sleep! ;-) Also, the vet says to not give her the insulin if she falls under 200, just to be safe. I tested her just now and on the Relion she was 189 and the Alpha was 255. If it had been time for her insulin (which its not), should I give it to her or not? Or do I just take an average of the two and base it on that. Does all of that make sense? If it isn't obvious, when it comes to this situation I'm not liking the whole grey area I seem to find myself in.

 

[Melanie and Smokey]

Why can't you do a curve at home with the ReliOn? I have NEVER taken my cat to the vet for a curve. I don't use the ReliOn I use the Accu-chek Aviva, but it is still a human meter. There is no reason a vet can't interpret a human meter curve done at home, a curve done in their office isn't any less "inaccurate" because it is affected by stress on the cat which gives the innacurate readings instread of real BG reading done on a human calibrated meter instead of a pet meter.

I personally don't call a low number with no hypo symptoms a hypo episode. Even if you have a Alpha meter, you would have seen low numbers and would have taken precautions. With an AT, you will be taking precautions at higher numbers so in reality the change in meters really shouldn't change anything in that situation, kwim? A 40 on the ReliOn is a time when you take precautions, that might read a 60 on the AT - but that is the time you take precautions on that meter, you don't wait until the 40 on the AT, the 40/50 is the human meter watch number, not the pet meter watch number. I don't think you would have over 100 on a AT and 40s on a ReliOn, the variance is usually a %, and narrows as you get in the lower digits.

eta: It is never a good idea to try to use 2 meters and try make sense of it. 2 meters, whether both human or both pet are rarely going to read the same, heck the same meter is rarely going to read the same with 2 pokes at the same time. It is the nature of blood glucose meters, they have a variance of + or - 20% at any given time. You want to just pick one and put the other one away or you will drive yourself crazy seeing the differences. If you go with the AT, just make sure to note that when you post numbers here so people can adjust their thinking and advice accordingy.

 

[MikeysMom]

I don't use the AT (too expensive and not more reliable), but I believe the rule of thumb is that you treat for hypo for any number below 80 on the AT, and below 50 on a human meter. If a cat is at 50 on the Relion, it's extremely likely that they will be below 80 on the AT. As long as you know this rule, I don't think it matters. The lower the numbers are, the closer the two meters will be, so it's unlikely if you have a 50 on a human meter it will be over 100 on the AT, and even so, do you want to take that chance?

Remember that meters can have a 20% variance, regardless of brand. So if the meter reads 100, the actual BG is between 80 and 120. That doesn't mean you should always assume the low end of the spectrum, but it partly accounts for the variance. The "normal" range is also adjusted. 70-120 is normal range on a human meter. 70 on the AT is a hypo situation, but 150 would be a normal reading.

At higher numbers, that variance is greater...a 250 reading can be between 200 and 300; 350 is between 280 and 420. So 336 and 353 are well withing that and probably not that different. Most AT users actually note that it's an AT because it will read higher. The Lantus protocol actually has separate instructions for the AT to account for the difference.

I do weekly curves with the Relion and send them to the vet. She knows there might be a slight difference, esp. at higher numbers, but that they will be within the variance allwed by law for the meters.

If you remember that 80=possible hypo on the AT and 50=possible hypo on the Relion, you should be fine as far as knowing when to treat for it.

 

[arozeboom]

We had her at the vet for a curve on Tuesday because Ruby was diagnosed less than a month ago and we're still pretty clueless. We also had to have a urinalysis done to verify that her bladder infection was cleared up so decided it was a good opportunity to get it all done. When we picked Ruby up that evening, Dr K and I agreed that its best to do a couple of curves here at home. She's totally on board with home testing.

Thank you for that hypo rule of thumb. I hadn't run across it before and its really good to know. I'm new at the board here and haven't figured out all of the ins and outs of it. At the time it happened I only had the Relion. Before she ate that night she was at 328. A couple of hours later she was down to 91 and then went 46 in less than an hour and I freaked out. It was the first time she had tested below 100 at all and we had just upped the dose of PZI that evening. The plan was to up her dosage because her numbers were consistently high. I ordered the AT and we were going to give it some time and I was going to do a curve on the 21st and fax it in.

Based on all of this I will probably stop using the Relion and stick with the AT now. Last night was the first time I've used it and wanted to see how they compared. Now I have a pretty good idea of that.

Thanks for all of the info! It really does help.

 

[MikeysMom]

Some cats just dive. I don't think the meter made a difference to your situation.

My Mikey can do that-he went from a preshot of 263 to 74 in two hours and by +3 was at 44. And he's only on .1U. The key is knowing how your cat reacts to his insulin and when his nadir is. That makes the low swings a lot less scary because you know if it's normal, if it's going to slow down (MIkey almost always slows dramatically after the first two hours) or continue to drop if you don't intervene, and when his BG will start coming up because you've passed nadir.

If you decide to keep using the AT (too expensive for my wallet, personally, as the strips cost a small fortune and you go through them like water if you hit a dive/hypo situation), make sure you note in your posts on the board that you are using it, as people can help you better knowing that you're using a meter known for reading high.