Relion vs OTU - Huge Diff in #'s

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Gail & Houdini (GA)

Gail & Houdini (GA)

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Due to the alarming rate that Reagan is using test strips I decided to try the WalMart Relion meter…strips are half the price of OTU…..

Set meter up…naturally had to compare with OTU…85 pts lower ??? Got out spare OTU and compared…. Relion 45 pts lower. Figured new meter was bad so I called the company & went through the explanation & they sent me a new meter & test strips. BTW they are really nice people…..

Set up new meter used control solution & all is normal….compared with OTU ….Relion 97 pts diff!!! WTH??? :shock: Did another test with spare OTU….86 pts lower.

BTW – no cats were used in these comparison tests….. DH made the sacrifice :lol:

What are the odds that both of my OTU meters are wrong? In all tests they were only a few points different from each other. But what are the odd that both Relion meters are wrong….

I know there is always a difference between meters but this is too big a spread to ignore.

Thoughts anyone?
 
Hi, Gail ~

I know how frustrating that meter difference can be. We use a Relion Confirm with a One Touch Ultra 2 as our backup meter. What we've found with our two meters is that the variance/difference in bg readings is much higher at the higher bg ranges and narrows as the bg range comes down. I can give you some examples of our readings:

8/11/11 - One Touch: 423; Relion Confirm: 384
8/27/11 - One Touch: 143; Relion Confirm: 116
8/29/11 - One Touch: 325; Relion Confirm: 296
9/13/11 - One Touch: 282; Relion Confirm: 250
9/14/11 - One Touch: 136; Relion Confirm: 117
10/30/11 - One Touch: 181; Relion Confirm: 167
11/5/11 - One Touch: 68; Relion Confirm 59

Next time we take Butters in to our vet's, I want to compare our two meters' results with the lab blood draw done at the same time. I happen to believe our One Touch is more accurate, but we'll see. We don't really care about a comparison with our vet's meter because we're making our own dosing decisions for Butters.

Will let you know how it turns out.

Eva

P.S. We're not doing many comparisons now, because our reason for using the Relion is to cut down on test strip expense. :-D
 
FDA allows meters to be within 20% of the 'true' value.

All things considered, I'd use the meter that reads low, because hypoglycemia will kill quickly and a hyperglycemia will kill slowly.

Makes me much more comfortable with Spitzer's 52 on the ReliOn confirm this morning! And a lot less comfortable with the HI he posted last week!
 
Gail, I'm a confirmed OTU user but I also know that it will read higher than some meters once you get in the hi 300 and up range. When it comes to lo numbers I swear by the OTU. I am also talking about the regular OTU...not the OTU2 or the Mini, which I don't like to begin with.

If you want to compare a meter with a lab reading like from IDEXX or ANTECH then you should test your cat at the vet right before blood is drawn by the vet and then immediately get a reading after the blood draw and wait to compare with a labs value. My OTU was off by only 8 points.
 
BJ - you are so talented! :-D

I guess I'll just stick with the OTU... Reagan has some pretty steep highs and lows so I would always be wondering what his "real" #'s were.....

I did check at the vets once after their blood draw and my meter was 40 pts higher but that wasn't immediately after the draw so I'll try it again next time.
 
Hi, Everyone ~

BJ, that's so cool! Really does show that either meter is likely fine to use if you go with the overall trend. Thanks for taking the time to graph the results for the two meters, BJ. I wish the FDA would tighten the requirements for meter accuracy though. Heck, we pay so much for test strips that it seems reasonable to expect greater accuracy and less variance between meters.

"If you want to compare a meter with a lab reading like from IDEXX or ANTECH then you should test your cat at the vet right before blood is drawn by the vet and then immediately get a reading after the blood draw and wait to compare with a labs value. My OTU was off by only 8 points." -- Hope, thanks for explaining how to do the comparison. I wasn't sure whether we should use some of the blood drawn by the vet or from an ear prick. Guess there's a difference in bg readings between capillary and venous blood?

Gail, if you do a comparison with your Relion and OTU and your vet's lab test, please let us know how it goes.

Enjoy the day,
Eva
 
Keep in mind that a meter uses whole blood whereas the send-out lab uses serum (more concentrated with glucose since there are no red blood cells present) so the values should NOT be the same.

The send-out lab value should be higher....literature states by at least ~20% if I remember correctly. When I compared my Dad's OTU with serum measured at the lab, the lab test was much higher...can't remember exactly but it was even higher than a 20% difference.

The difference depends on the PCV (HCT) value which reflects the concentration of red blood cells in the serum.

If a meter matched serum, I would consider the meter to be testing too high and not necessarily be using that as a sign of meter accuracy.
 
Thanks for that information, Dr. Lisa. You reminded me to check to see if my meters are plasma or whole blood-calibrated. On the Lifescan web site, I see that the One Touch Ultra 2 is plasma-calibrated, but I don't know about the Relion Confirm. I'll need to check on that.

From the Lifescan web site:
http://www.lifescan.com/company/contact ... s#accurate
www.lifescan.com/company/contact/faq/products#accurate (full link...don't know why my urls are being truncated?)

My meter readings do not match the laboratory's results. Is my meter accurate?

Comparing meter and laboratory results.
For many people blood glucose meter accuracy becomes a concern when they purchase a new meter and compare it with their old one, or go to the doctor to have a laboratory test. They may notice a seemingly large difference between the two test results.

At first glance, you would expect all blood glucose meters and laboratory equipment to give the same result. After all, they're measuring the same thing-the amount of glucose in a specific blood sample. But meters and lab equipment may be calibrated, or set, to measure blood glucose in different ways and will give different results.

Accuracy
How is accuracy defined? Before deciding if your meter is accurate, it's important to understand how accuracy is defined. In the medical community a home blood glucose meter's test result is considered clinically accurate if it falls within + 20%* of an accepted reference result, usually a lab test. Comparing a meter's test result with a lab test is the only valid method of determining its accuracy.

Plasma-calibrated meters
While all home blood glucose meters use whole blood to measure glucose, lab equipment uses only the plasma portion of blood, meaning the red blood cells are removed before glucose is measured. Because of this difference in sample types, whole blood test results are approximately 12 percent lower than plasma test results. Some blood glucose meters are already calibrated, or set, to give a "plasma" test result, making this conversion unnecessary. For an accurate comparison of your blood glucose meter to a laboratory result, you must first know how your meter is calibrated.

Whole blood-calibrated meters
Whole blood-calibrated meters require a simple mathematical conversion to compare their test results with laboratory test results. Plasma-calibrated meters do not require a conversion and their results may be compared directly with laboratory test results. Whether you use one meter type or the other, it is important to note that both are accurate and neither is superior to the other. Just as with the Celsius and Fahrenheit scales measuring temperature or miles and kilometers measuring distance, both meter types measure the same thing-your blood glucose level.

Before you go to the lab:
• Perform a control solution test to make sure the meter is working properly.
• It is best to fast for at least four hours before doing comparison tests.
• Take your meter with you to the lab.

While at the lab:
• Make sure that the samples for both tests (the meter test and the lab test) are taken and tested within 30 minutes of each other.
• Wash your hands before obtaining a blood sample.
• Never use your meter with blood that has been collected in a gray-top test tube.
• Use fresh capillary blood only.

You may still have a variation from the result because blood glucose levels can change significantly over short periods, especially if you have recently eaten, exercised, taken medication, or experienced stress.1 In addition, if you have eaten recently, the blood glucose level from a fingerstick can be up to 70 mg/dL higher than blood drawn from a vein (venous sample) used for a lab test.2 Therefore, it is best to fast for four hours before doing comparison tests. Factors such as the amount of red blood cells in the blood (a high or low hematocrit) or the loss of body fluid (severe dehydration) may also cause a meter result to be different from a laboratory result.

Comparing the results
OneTouch® II, OneTouch® Basic®, and OneTouch® Profile® Meters are whole blood-calibrated meters. To compare a lab result with a whole blood-calibrated meter, you must first convert the lab result into its whole blood equivalent by dividing the result by 1.12. If your lab result is 112, you divide 112 by 1.12 which equals 100. In this example, the number 100 represents the "whole blood" equivalent of the lab's "plasma" glucose value. You would then compare your meter's whole blood result to 100. If your meter's result fell between 80 and 120 (+ 20%), it would be considered accurate. Try our Test Result Converter for an easy conversion between "plasma" and "whole blood" results.

OneTouch® Ultra®2, OneTouch® UltraSmart®, OneTouch® UltraMini™, OneTouch® Ultra®, OneTouch® FastTake®, and OneTouch® SureStep® Meters are plasma-calibrated meters. To compare a lab result with a plasma-calibrated meter, no conversion is necessary. However, the +20% range still applies. If your lab or "plasma" result is 100, your plasma-calibrated meter would be accurate if it gave you a result anywhere between 80 and 120.
 
Found this in the Relion Confirm manual:

Thank you for choosing the ReliOn® Confirm Blood Glucose Monitoring System. This system measures blood glucose in fresh capillary whole blood. Results are shown as plasma values. This makes it easy to compare the ReliOn® Confirm blood glucose meter and lab results.

So looks like my two meters, the OTU2 and the Relion Confirm are both plasma-calibrated. Of course, there's still that plus or minus 20% in comparing them to lab results.

Eva
 
When the 'Relion' brand of meters is being discussed, we need to be aware that there are several 'Relion' meters.

My first meter was the Relion Contour meter. It takes very little blood and I truly have very few errors with it. We really like it the best. The strips seem to be about the most inexpensive out there right now which is another plus.

I'm current TRYING to use the Relion Ultima meter. The Contour strips do NOT fit this meter and are more expensive. The Ultima takes a lot of blood, the strips don't draw well or quickly. It also reads typically at least 20 points higher than the Contour meter almost every time. We do NOT recommend this meter. We'll use it until the strips are gone but won't buy more.

We also tried the Wavesense Pronto meter. It reads basically the same as the Relion contour with each of my comparisons. The strips do draw fairly well with very few errors also. I consider this one comparable to the Relion Contour altho' the strips are more expensive.

Just our two cents worth....
 
Good information from all...thanks for posting.

OneTouch® Ultra®2, OneTouch® UltraSmart®, OneTouch® UltraMini™, OneTouch® Ultra®, OneTouch® FastTake®, and OneTouch® SureStep® Meters are plasma-calibrated meters. To compare a lab result with a plasma-calibrated meter, no conversion is necessary.
Click to expand...

Hmmmm......I really wonder about the "plasma-calibrated" issue. My dad uses a OTU Mini that, according to the above, is plasma-calibrated.

I drew blood from my cat and spun it down for the lab to test the serum. Serum and plasma are not technically the same and I assuming that the lab runs the sample on the serum, not the plasma but in any case, the values were:

OTU Mini on whole blood = 81

OTU Mini on the serum (red top tube spun down and separated) = 198 and 218

Lab (I assume on serum not plasma ..but need to confirm) = 126

So the comparison should be the 81 with the 126. If this truly is an accurately plasma-calibrated meter, I would have expected closer values.

The OTU Mini is not designed for use with serum so who knows what was going on with the 198 and 218 values.

~~~~~~~~~~~~~

Rite Aid True Result on whole blood = 62

TR on serum = 122

Lab = 126

I don't know if the RATR meter is calibrated for whole blood or plasma so that is not helping us much here. It is interesting to note that the RATR serum and lab values matched.

It would be interesting to find out from other people how their meters have compared with a send-out lab result but we would also have to know how their meters are calibrated to make any sense of this issue.
 
Larry and Kitties said:
Also, the hand-held meters are calibrated for capillary blood which is different from that of venous blood. See:
http://www.ncbi.nlm.nih.gov/pmc/article ... p00177.pdf
Click to expand...

Thanks for posting the link to this article.

In a quick skim of the article, it did not show that the difference was clinically significant. Also, the study only used normal patients and the number of patients was small. As with many studies, it is a good start but not conclusive - especially as it pertains to diabetics.

Here are a few excerpts that I found noteworthy on a very quick skim:

A statistically significant difference did occur between the capillary and venous bedside blood glucose estimates, but such a difference (0.33 mmol/l) may not be clinically significant in routine practice. This supports the view that venous derived bedside glucometer blood glucose measure- ments may be used in place of capillary derived specimens in the management of non-critically ill patients......


There are a number of limitations to the study. The number of patients included in the study was comparatively small, but was guided by a power study. In this study, no patient had an abnormal capillary glucometer result with a normal range laboratory glucose result. The study was not engineered to have sufficient power to determine this, but rather, was designed to detect a 1 mmol/l difference, which may or may not be clinically truly relevant. The study was limited to non- critically ill patients and included no hypoglycaemic patients. Only three mild cases of hyperglycaemia were included. The narrow range of blood glucose levels present in the subjects enrolled in the study and the wide range of presenting conditions meant that subgroup analysis could not be performed meaningfully. It is therefore not possible to make conclusions about the accuracy of venous derived blood glucometer estimates in the presence of severe illness or blood glucose levels outside the normal range. Further study will be required to determine the accuracy of blood glucometer analysis in these situations.

CONCLUSION
Venous bedside glucose estimation can be used with some degree of confidence in the mid ranges of blood glucose measurements as it correlates well with both capillary derived blood glucometer estimations and laboratory blood glucose estimations.

However, significant outlying results can and do occur, although their true clinical relevance is as yet undetermined. It is recommended that a laboratory blood glucose should still be performed if the venous bedside estimation is at the extremes of the glucose range or the results are likely to significantly influence clinical management.

End excerpt.

Here is my bottom line. Meters frustrate the heck out of me...quite frequently. This group is so smart and so analytical (I am constantly learning from the FDMB) but even with all of our smart and analytical minds....we often are left scratching our heads wondering why the heck our meters come up with the values that they do.

And...when comparing meters....that is when I start to go bald from ripping my hair out and want to run screaming into the night....
 
A lot of meters give 14 and 30 day averages. A fructosamine also gives approx. 2 week average. On my old Elite XL that average I was dosing by gave me a fair fruct. report. Went back to OTU for both Hope and Mishka, bided my time, dosed according to those numbers, and in a few months ran another fruct. test and both came back Excellent.
 
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