Variation in glucometers?

Status
Not open for further replies.
S

sapling

Member
I recently started hometesting my cat - she had a crisis after refusing to eat after dental surgery and my OneTouch Ultra just required too much blood (1 microliter is way more than I thought!). The vet rented me the AlphaTrak which only requires .3 microliters.

Over the weekend I did some research and decided to pick up a Relion Confirm, rather than paying my vet $170 to order an AlphaTrak for me (!) - it also requires .3 mL of blood and had good reviews.

Before I took the loaner AlphaTrak back to my vet, I tested both on my cat at about the same time (I couldn't get enough blood from one prick.. sigh.. so I pricked her again about 5 minutes later). The Relion Confirm showed 220, but the AlphaTrak showed 291.

Now I don't know what to think - are either of them accurate? I know there's supposed to be up to ~20% variation but this is closer to 30% and just seems like too much. Could her glucose have changed that much in the 5 minutes I spent petting her and massaging her ear?

Should I ask my vet to use the Relion and compare it to her results the next time I take my cat in for a blood curve? Should I test the Relion multiple times in a row to make sure its at least consistent with itself? Should I test it on myself to avoid traumatizing my cat?
 
Many of us use the Relion mico. We know it's not perfect, but perfect isn't necessary. Consistency in whatever meter you decide to use-pick one and stay with it. There have been lots of discussions here and in think tank and I believe at the top information topics on the various meters and comparisons. IMHO- I would not even pay that price spread for one more accurate for me, I consider it a ridiculous mark-up that should be boycotted. If I recall correctly, a number of studies show the Relion to closely match a venous blood draw which is more accurate.
My Maisey has not been to the Vet since our diagnosis, and the miserable instruction I got from the vet tech which was also astronomically priced - and they wanted to sell the Alphatrak to me for $240. I believe I heard somewhere that the test strips were also quite expensive, for that price - I'd want them free for at least a year.
 
the "allowable" variation is +/- 20%

So the "true" BG is probably where the two meters' ranges overlap.
220 +20% = 264

291 -20% = 233

when it comes down to making a shoot or no shoot decision -- these meters' results do give you the same answer -- which is "Yes, it is safe to give the injection"
 
In the time I've been on the boards here, it has seemed to me like the ReliOns have been ones to run a little lower numbers than others. As long as you aren't jumping back and forth between meters it really shouldn't matter because the number isn't varying enough to make a diabetic cat look non-diabetic and home testing isn't about one number. It's about patterns and trends. The ReliOn is going to show a decreasing BG just a well as an AlphaTrak. It will show a cat in rebound or an inverted curve just as well too. The single number's are close enough to give you the same answer to the question can I shoot? And when you see lower numbers, you will usually hold and test again, if you see the number coming up you will usually be safe to shoot.

The ReliOn is probably one of the most used meters on here. If you are concerned there are other options out there, just be sure to look at strip pricing rather than meter pricing when you are determining cost. I use the Accuchek Avia and it seemed to run pretty close to my vet's (54 on mine 61 on their's when we compared them), but the strips are very expensive unless you get the online from eBay or somewhere like that. Probably the only reason I went with that meter is because our state is weird about pharmacies and there aren't many in big box stores like Walmart (not even in many of our Walgreens!) so I bought mine at my pharmacy and it is the one they recommended.
 
Hi

The BG measurements obtained with the AlphaTrak meter are ~30% higher than the results obtained with human meters; however, since the AlphaTrak is validated for measuring BG in cats, the AlphaTrak number is the "correct" one.

This AlphaTrak website (http://www.abbottanimalhealth.com/veter ... uracy.html) shows a comparison of results using AlphaTrak and two human BG meters (Bayer Ascensia Contour and Roche Accu-Chek Advantage) against the 'gold standard' of sending the sample out to a veterinary testing lab. These results showed that the measurements obtained using the human meters were biased low by 21-39%. More anecdotally, I tested my own blood with the AlphaTrak and it was ~30% higher than normal (here's hoping I don't have undiagnosed diabetes).

The relationship is probably consistent for a given meter, so that if you are using a human meter, you could multiply your results by ~21-39% to get the 'cat equivalent'. The test strips are soooooo much cheaper for a human meter...
 
Hi -

After I posted, I remembered that there is a good discussion on this topic on the "Think Tank" section of this message board. Look for the link on "Meter Comparison: AlphaTrak and ReliOn Micro" moderated by Lynn & Bear.
 
there is no need to multiply by some whacky factor -- the whole point is to track your kitty's blood sugar consistently over time. Not to try and fudge numbers and second or third guess what is right. That is just a waste of energy

pick one meter that you like and can afford and stick with it.
 
My concern over the number is because for the weekend, my vet told me to give her 1 unit if she went over 300. Since she just had dental surgery done and isn't eating as much as she should, she's worried about her becoming hypoglycemic - the morning of the dental work after fasting and no insulin, she was at 40 BG. :(

I took the Relion in to the appt this morning and the vet did a blood draw - we compared the AlphaTrak to the ReliOn and this time the ReliOn was only 6 points lower (252 vs 246), from blood from the same needle.

I'm going to stick with the Relion for now - the vet was very happy with the results and is actually recommending it to her other clients now, so I hope it wasn't a complete fluke.


I'm still checking her.. for now, the directive is still only to give her insulin if she goes over 300. Is that too high? She's on Lantus and was on 2.5 units twice a day until last Thursday night, the evening before her dental surgery.
 
you can always drop the dose down to 1u BID to play it safe and then do a curve on your day off. better too high than low. we suggest for newbies no shot under 200 until you can gather more info by testing more.
 
The dental surgery might reduce her need for insulin, so I would definitely start out low if she does need insulin and stick to that dose for a bit. After Bandit's dental surgery, he became very well regulated on a consistent dose of 1u. If you're not comfortable giving 1u while you're not there because she's not eating quite right because of the dental, then don't shoot and wait until you can monitor her. As Diane said, it's better that the BG is a little too high than low.

I very much recommend setting up a spreadsheet and heading over the the Lantus forum for advice--her dose may need some fine tuning after she recovers from the dental.
 
I plan to post on the Lantus forum tonight when I'm at home with her numbers written down, but I'm curious - why would the dental surgery impact her insulin need? I expected it might in the short-term with the fasting, but it surprises me longer term it would have an impact.

She had 3 teeth that were pulled - they were being resorbed. :shock: She's had the problem for a while but it wasn't deemed "critical" and we've been trying to get her diabetes regulated before she had any surgery.
 
sapling said:
I plan to post on the Lantus forum tonight when I'm at home with her numbers written down, but I'm curious - why would the dental surgery impact her insulin need? I expected it might in the short-term with the fasting, but it surprises me longer term it would have an impact.
Click to expand...

Any infection can cause BG to remain high and/or unstable. Now that you've taken care of the mouth problems, her BG will gradually (or sometimes even suddenly) drop. If you look at Bandit's spreadsheet, you can see his numbers dropped significantly after his dental (in Dec. '09). He also had resorbed teeth. I decided to wait until after his dental to raise his insulin above 1u and my current vet agreed. I'm glad I did because he never needed more than that.

It's impossible to regulate a cat with a secondary infection. My old vet told me she wanted to regulate Bandit *before* the dental. When I did some research and realized this was pretty much impossible, I changed vets to one that knew about the effects of infection on BG and had his dental done there. Best decision I could have made for Bandit!
 
Status
Not open for further replies.
Back
Top