? 21 Dec | Girlie AMPS 311; +4=76; PMPS 185 Human vs Pet: really different numbers?

[Girlie's mom]

Condo: http://www.felinediabetes.com/FDMB/...-3-194-5-112-6-103-8-115.188285/#post-2091699

Well, I was going to go up to 0.5 last night as @Marje and Gracie suggested, but I decided to sleep all night instead and increase in the AM. I left 12%, 8% and 6% food out, and she gave me a 95 at +7: some 8% food leftover. So I thought I'd give her the 0.25 this AM and see how she went.

She dropped quickly, of course, from +2 to +3:30, but this time I thought I'd try her 6% food with some drops of glucose syrup to see if I can give her that rather than the MC or HC food as I think that the affect of the MC food lasts longer than that of the glucose syrup, and I want just enough to stall her a little bit but not stop her duration. I might be nuts, but this was my thinking...

So we'll see how she goes!

 

[Girlie's mom]

Bayer (now Ascensia) is relatively new to Australia for BG meters so they're sending me the Contour Next for free (yay!). And I thought I'd try the Freestyle Lite. Does anyone have any thoughts on these human meters: Bayer Contour Next vs. Freestyle Lite vs. Freestyle Freedom Lite? Any thoughts would be great!

I'd prefer a meter that only requires 0.3 ul of blood (vs. the Contour's 0.6 ul), but there don't seem to be that many human meters that only require that tiny amount of blood...?

 

[Wendy&Neko]

I tried both the Freestyle Lite and the Bayer Contour, before the time the Next came out. I too preferred the smaller blood drop requirement and had a hard time using the Contour for that reason. At the time, the downside of the Freestyle was that it was misleading on the high end numbers. Check out Neko's 2012 beginning SS. The main issue for me was that I though she was lower than she was so didn't increase in large enough amounts. I believe the strip technology has changed since then. We have a few people here using the Freestyle. Might want to put "Freestyle vs. Bayer Next" in the subject tomget more eyes.

Nice diving today Girlie. Way to say no to an increase.

 

[Girlie's mom]

At the time, the downside of the Freestyle was that it was misleading on the high end numbers.

It's interesting that you say that, Wendy, as @Christie & Maverick mentioned that she was having that problem with her Freestyle Lite - that it was reading yellow numbers on the FSL but pink on the AT2. I'll see if others find that's the case as well.

Nice diving today Girlie. Way to say no to an increase.

Isn't it? The question is the duration after the deep dive. Here's just hoping I'll have a nicer PMPS so that she won't do the dives again.

 

[Wendy&Neko]

It's interesting that you say that, Wendy, as @Christie & Maverick mentioned that she was having that problem with her Freestyle Lite - that it was reading yellow numbers on the FSL but pink on the AT2.

That part isn't surprising. Almost any human meter will show lower than the AT in higher numbers. The old problem was that the Freestyle barely registered pink, when other human meters did red, or worse.

 

[Marje and Gracie]

Looks like the old dose increase threat worked!

Great job watching the numbers and making a good decision!

I hope you got some sleep last night.

 

[Girlie's mom]

Looks like the old dose increase threat worked!

Great job watching the numbers and making a good decision!

I hope you got some sleep last night.

Thanks, Marje, I did! I'm hoping for another good sleep tonight. Yawn!

It was pure laziness rather than an informed decision. Of course, she's now up to 112 at +8:30, which means that she'll go up again by pre-shot. It seems to be hard for me to slow her down from those deep dives after the shot when she starts in anything yellow and above. Either I slow her down so much that she just stays in blue, and then loses duration, or she'll try to dive later anyway. I'm wondering if there's anything I can do that can stop her from those dives that - I assume - are getting her into those AM/PMPS bounces. The other night - when she was at 205@ PM+11 - I actually thought, "what if I just shoot an hour early when she's close to blue?" But I know that that's a bad idea...

Are there cats who are just determined to dive no matter what, and you just have to wait them out? Such a pity that the vet won't give me the short-acting insulin so I could fine tune things...sigh...

I guess I might continue to try fiddling with the glucose syrup plus LC food and see if I can figure out what number of drops will stall her without bouncing her up. Or I can just watch her bounce and bounce and stick with the lower carb food and hope that she'll even out with the AM/PM pre-shot numbers and get some more duration. What do you think?

 

[Girlie's mom]

That part isn't surprising. Almost any human meter will show lower than the AT in higher numbers. The old problem was that the Freestyle barely registered pink, when other human meters did red, or worse.

But does it do that on lower numbers? Yikes!

This is utterly confounding! I got the Freestyle Lite as I already had the test strips and I thought I'd give it a try. And first reading:
Alpha Trak: 6.2 (112)
FSL: 3.9 (70)

So on one she's blue and on the other she's green! That can't be right, can it?

And I did download the SS for World for Human Meter and put the FSL reading in that SS and not the pet meter SS.

Has anyone else seen such a disparity in readings when switching from a pet meter to a human meter? Yikes...

 

[Stacy & Asia]

But does it do that on lower numbers? Yikes!

This is utterly confounding! I got the Freestyle Lite as I already had the test strips and I thought I'd give it a try. And first reading:
Alpha Trak: 6.2 (112)
FSL: 3.9 (70)

So on one she's blue and on the other she's green! That can't be right, can it?

And I did download the SS for World for Human Meter and put the FSL reading in that SS and not the pet meter SS.

Has anyone else seen such a disparity in readings when switching from a pet meter to a human meter? Yikes...

Yes, they can be quite different and it's mind boggling to attempt to compare them. I've done a couple, they are on my SS But just to give you an idea, first number is human meter, second is AT:

73/141, 54/107, 236/321, 60/112

If it's true they are close at lower numbers, that 54 should meet with something like a 72, if there is any rhyme or reason there, it's beyond me. Best to stick with one and not look back.

 

[Wendy&Neko]

Take a look at Gracie's SS on Marje's post. She did quite a bit of human/AT testing. The numbers are much closer when you get lower. It's the higher numbers where they are out more. Stacy's advice is good - pick one and stick to it!

 

[Marje and Gracie]

But does it do that on lower numbers? Yikes!

This is utterly confounding! I got the Freestyle Lite as I already had the test strips and I thought I'd give it a try. And first reading:
Alpha Trak: 6.2 (112)
FSL: 3.9 (70)

So on one she's blue and on the other she's green! That can't be right, can it?

And I did download the SS for World for Human Meter and put the FSL reading in that SS and not the pet meter SS.

Has anyone else seen such a disparity in readings when switching from a pet meter to a human meter? Yikes...

Absolutely you can see that kind of variance. It’s actually common. I have a ton of comparison tests between the AT and a human meter on a tab on Gracie’s SS.

If you switch, I can reformat the SS so you keep the same one. It helps us continue to track what she’s doing instead of going back and forth between two SSs.

Thanks, Marje, I did! I'm hoping for another good sleep tonight. Yawn!

It was pure laziness rather than an informed decision. Of course, she's now up to 112 at +8:30, which means that she'll go up again by pre-shot. It seems to be hard for me to slow her down from those deep dives after the shot when she starts in anything yellow and above. Either I slow her down so much that she just stays in blue, and then loses duration, or she'll try to dive later anyway. I'm wondering if there's anything I can do that can stop her from those dives that - I assume - are getting her into those AM/PMPS bounces. The other night - when she was at 205@ PM+11 - I actually thought, "what if I just shoot an hour early when she's close to blue?" But I know that that's a bad idea...

Are there cats who are just determined to dive no matter what, and you just have to wait them out? Such a pity that the vet won't give me the short-acting insulin so I could fine tune things...sigh...

I guess I might continue to try fiddling with the glucose syrup plus LC food and see if I can figure out what number of drops will stall her without bouncing her up. Or I can just watch her bounce and bounce and stick with the lower carb food and hope that she'll even out with the AM/PM pre-shot numbers and get some more duration. What do you think?

If it’s possible, you might want to get the +1 tests and determine if she needs more carbs at that point.

 

[Girlie's mom]

If it’s possible, you might want to get the +1 tests and determine if she needs more carbs at that point.

She's always going up at +1, unfortunately, so that won't give me an idea. What I get with her is a sudden dive between +2 and +3/3:30 - such a dilemma!

 

[Girlie's mom]

Take a look at Gracie's SS on Marje's post. She did quite a bit of human/AT testing. The numbers are much closer when you get lower. It's the higher numbers where they are out more. Stacy's advice is good - pick one and stick to it!

But I'm looking now at lower numbers, aren't I - with 70 for the human and 112 with the AT2?

 

[Girlie's mom]

Yes, they can be quite different and it's mind boggling to attempt to compare them. I've done a couple, they are on my SS But just to give you an idea, first number is human meter, second is AT:

73/141, 54/107, 236/321, 60/112

If it's true they are close at lower numbers, that 54 should meet with something like a 72, if there is any rhyme or reason there, it's beyond me. Best to stick with one and not look back.

Oh boy, oh boy - I can see myself heading for a nervous breakfast (i.e. breakdown ) now trying to make this decision... For some reason, I thought that the difference would be more along the lines of the 18 point variance (e.g. at lower numbers, 50 is the take action number for human meters and 68 for AT2; Roomp and Rand go into this in their tables and their paper at some length). I never expected it to be this big a difference...

On the other hand, all of you have done the switch, so...well...my Visa card says "switch!" - I'll do side-by-side comparisons as I did with the FSL test strips in the AT2 (and I know I will go straight to the naughty corner for saying this, but the difference of the FSL strips in the AT2 meter were minimal compared to this variance).

I'm sure there must be both rhyme and reason to this! My inquiring little mind wants to know why... of course it's probably just simply that human blood and cat blood are different, so there.

 

[Marje and Gracie]

Here is some info I wrote for another member a while back.

Here are some of the past discussions:

Pet Meter to Human Meter SS and if you look at post 65, you’ll see some comparisons between the AT2 and FSL.

Calling all Alpha Trak Users

I ran comparisons so people should see we shouldn’t be running comparisons because there’s is no consistency. There was not a consistency between the meters I always used and there is not consistency between my AT2 and yours much less my AT2 and anither’s Human meter. There are too many variables which I discuss in post 54 of the latter link I provided above.

Every couple of years, we get new members in who are using the AT2 and we go through the same conversations. What is not understood is that you don’t need to compare them and the numbers on the SS don’t need to be adjusted. Roomp and Rand found that the safe end of the AT2 meter is 68; on a human meter, the safe end is 50. It doesn’t mean there is always going to be an 18 mg/dL spread. It means if kitty goes below 68 on an AT2, it’s a situation that requires your attention. If a kitty goes below 50 on a human meter, it requires attention. Don’t equate the two in an effort to extrapolate the numbers.

The AT2 is the most accurate meter for use in cats. I stand by that and those are the numbers I trust the most. I would have loved to use the AT2 all the time. Having said that, I used a ReliOn Micro because the AT2 strips are too expensive for the amount of testing I did. And I followed the TR guidelines, taking the reductions or doing increases based on the readings on my ReliOn.

Comparing the two is an exercise in futility. There’s no sense in reinventing the wheel. There is nothing that allows for a standard comparison between the two. All you need to know is the research says to reduce the dose at 68 on an AT2 and 50 on a human meter if you are using TR. For anything else with the TR protocol, use the same number. In other words, if the kitty is consistently having nadirs above 200 on either meter, the dose needs to be increased.

Does that help any

 

[Stacy & Asia]

Oh boy, oh boy - I can see myself heading for a nervous breakfast (i.e. breakdown ) now trying to make this decision... For some reason, I thought that the difference would be more along the lines of the 18 point variance (e.g. at lower numbers, 50 is the take action number for human meters and 68 for AT2; Roomp and Rand go into this in their tables and their paper at some length). I never expected it to be this big a difference...

On the other hand, all of you have done the switch, so...well...my Visa card says "switch!" - I'll do side-by-side comparisons as I did with the FSL test strips in the AT2 (and I know I will go straight to the naughty corner for saying this, but the difference of the FSL strips in the AT2 meter were minimal compared to this variance).

I'm sure there must be both rhyme and reason to this! My inquiring little mind wants to know why... of course it's probably just simply that human blood and cat blood are different, so there.

Yes, it's a lot to accept, that's why I say pick one and stick with it, this is a scenario it's best to not think too much about because it will drive you crazy!

So all the meters are allowed to have a 20% variance from a lab number, right? That's for the US anyway, I think the variance may be less in other countries, but I digress. So say the lab number is 80, that means your meter can measure anywhere in the 20% range on either side of that number: 64-96, doesn't sound too bad, right? But if the number is 200, that range is now 160-240, if it's 300: 240-360. Add to that one AT meter compared to another AT meter are going to read differently, but as long as they are in the 20% variance, they can still be considered accurate. So pretend we have the 200 number from the lab, AT meter 1 could read 160, AT meter 2 could read 240, that is a most extreme example, of course, and I would hope the same brand meters would read more consistently with each other, but it would be allowed and considered properly functioning.

Then you throw in the mix AT is calibrated for a cat's blood, so the readings are going to be higher than on a human meter, and both can still vary 20%, do that math! No fun. But the reason AT and human meters are closer at lower numbers is because all meters are closer at lower numbers, the range of the 20% gets tighter as the numbers get smaller. This is all, of course, assuming you do everything perfectly, get the right amount of blood and wick it properly on a good strip that is at the ideal temperature and hasn't been contaminated by anything on your hands or your cats ears...none of that stuff is accounted for in the 20% variance, so it could be further from 20% of the lab number when you factor that in. It's maddening.

I have to just be happy that whatever comes up on a lab is reasonably close to the number I got. Some meters have been known to have issues reading high or whatever, but outside of that, you are looking for trends and any meter can do that well enough as long as you are using the same one every time.

 

[Girlie's mom]

Here is some info I wrote for another member a while back.

Here are some of the past discussions:

Pet Meter to Human Meter SS and if you look at post 65, you’ll see some comparisons between the AT2 and FSL.

Calling all Alpha Trak Users

I ran comparisons so people should see we shouldn’t be running comparisons because there’s is no consistency. There was not a consistency between the meters I always used and there is not consistency between my AT2 and yours much less my AT2 and anither’s Human meter. There are too many variables which I discuss in post 54 of the latter link I provided above.

Every couple of years, we get new members in who are using the AT2 and we go through the same conversations. What is not understood is that you don’t need to compare them and the numbers on the SS don’t need to be adjusted. Roomp and Rand found that the safe end of the AT2 meter is 68; on a human meter, the safe end is 50. It doesn’t mean there is always going to be an 18 mg/dL spread. It means if kitty goes below 68 on an AT2, it’s a situation that requires your attention. If a kitty goes below 50 on a human meter, it requires attention. Don’t equate the two in an effort to extrapolate the numbers.

The AT2 is the most accurate meter for use in cats. I stand by that and those are the numbers I trust the most. I would have loved to use the AT2 all the time. Having said that, I used a ReliOn Micro because the AT2 strips are too expensive for the amount of testing I did. And I followed the TR guidelines, taking the reductions or doing increases based on the readings on my ReliOn.

Comparing the two is an exercise in futility. There’s no sense in reinventing the wheel. There is nothing that allows for a standard comparison between the two. All you need to know is the research says to reduce the dose at 68 on an AT2 and 50 on a human meter if you are using TR. For anything else with the TR protocol, use the same number. In other words, if the kitty is consistently having nadirs above 200 on either meter, the dose needs to be increased.

Does that help any

Marje, I shower you with gold stars! That helps tremendously - it really does. I haven't read the links yet, but - once again - I so appreciate your hearing my concerns and taking so much time to address them - and in such a kind and thorough and reasoned way. Thank you, thank you!

Just practically, I think it says a lot about all of you really experienced members that all of us newbies who pepper you with the same questions over and over again don't drive you nuts! It's tremendously kind of you to help us all this way. Do you have a secret "Well of Patience" that you draw from? If so, I'd like to drink from it on occasion for real-life dramas...

 

[Girlie's mom]

Yes, it's a lot to accept, that's why I say pick one and stick with it, this is a scenario it's best to not think too much about because it will drive you crazy!

So all the meters are allowed to have a 20% variance from a lab number, right? That's for the US anyway, I think the variance may be less in other countries, but I digress. So say the lab number is 80, that means your meter can measure anywhere in the 20% range on either side of that number: 64-96, doesn't sound too bad, right? But if the number is 200, that range is now 160-240, if it's 300: 240-360. Add to that one AT meter compared to another AT meter are going to read differently, but as long as they are in the 20% variance, they can still be considered accurate. So pretend we have the 200 number from the lab, AT meter 1 could read 160, AT meter 2 could read 240, that is a most extreme example, of course, and I would hope the same brand meters would read more consistently with each other, but it would be allowed and considered properly functioning.

Then you throw in the mix AT is calibrated for a cat's blood, so the readings are going to be higher than on a human meter, and both can still vary 20%, do that math! No fun. But the reason AT and human meters are closer at lower numbers is because all meters are closer at lower numbers, the range of the 20% gets tighter as the numbers get smaller. This is all, of course, assuming you do everything perfectly, get the right amount of blood and wick it properly on a good strip that is at the ideal temperature and hasn't been contaminated by anything on your hands or your cats ears...none of that stuff is accounted for in the 20% variance, so it could be further from 20% of the lab number when you factor that in. It's maddening.

I have to just be happy that whatever comes up on a lab is reasonably close to the number I got. Some meters have been known to have issues reading high or whatever, but outside of that, you are looking for trends and any meter can do that well enough as long as you are using the same one every time.

I'll tell you what, Stacy: I refuse to do the math! LOL Math is NOT my friend and never will be...

But I get the gist of what you and Marje are trying to get me to understand: there is no perfect meter; there is no perfect reading; and I hadn't even thought of all of the variables that you threw in there! I don't know whether I should thank you for that or not...

The biggest fear (at the low end) is a hypo, and the FDMB protocols and SS have built in the protections for that. What makes me feel wobbly is that the human FSL is reading so much lower than the AT2: it makes Girlie look "better" than the AT2 does.

And I know that no one here on FDMB would do or recommend anything that would put any beloved cat in jeopardy. And so many cats have gone OTJ using human meters. So I need to take a chill pill, bite the bullet, and not look back.

But I'll wait to make a final decision until I get the Contour Next (which they're sending me for free as it's fairly new in the Australian market).

Thank you, Stacy. I shower you with gold stars as well!

 

[Girlie's mom]

PMPS 185 - blue! Doing a happy dance for a somewhat decent PMPS number - yay!

I gave her SEB with AVJ earlier - I don't know why, but I suspect that the AVJ might have something to do with the blue. I'll be very, very curious to see where she goes tonight...

 

[Girlie's mom]

@Marje and Gracie : Wow! That was one heck of a discussion, but thank you for giving me the AT discussion link and the Pet meter to human meter link: they both really, really clarified things for me.

I think it's an absolute shame - and very, very unfair - for the AT2 strips to be priced so high. When you look at them - vs. the Freestyle Lite strips which look exactly the same and cost so much less - it's hard to believe that something absolutely extraordinary is done in the manufacturing to justify the cost for the AT2 ones. It seems more like the manufacturers of the AT2 strips are motivated by more than a little bit of greed, to be honest. I can't believe that they are that much more expensive to produce than human meter strips. It's a true shame.

 

[Marje and Gracie]

Marje, I shower you with gold stars! That helps tremendously - it really does. I haven't read the links yet, but - once again - I so appreciate your hearing my concerns and taking so much time to address them - and in such a kind and thorough and reasoned way. Thank you, thank you!

I’m glad it helps you. As you can see, there have been many, many discussions over the years regarding this subject. I also wish the AT strips were not so pricey. I really liked using the AT2 meter.

practically, I think it says a lot about all of you really experienced members that all of us newbies who pepper you with the same questions over and over again don't drive you nuts! It's tremendously kind of you to help us all this way Do you have a secret "Well of Patience" that you draw from? If so, I'd like to drink from it on occasion for real-life dramas..

It has been done through time for all new members by the more experienced ones. Gracie, Mike, and I benefited more than I can ever say from the knowledge of people like Jill, Libby, Sienne, and many others who no longer post but taught us so much. And believe me, I was not an easy “newbie”. My scientific mind always wanted a scientific answer and I had lots of questions and long condos. I know I wore them ragged but they were always so incredibly patient. Gracie taught me patience

@Marje and Gracie : Wow! That was one heck of a discussion, but thank you for giving me the AT discussion link and the Pet meter to human meter link: they both really, really clarified things for me.

I think it's an absolute shame - and very, very unfair - for the AT2 strips to be priced so high. When you look at them - vs. the Freestyle Lite strips which look exactly the same and cost so much less - it's hard to believe that something absolutely extraordinary is done in the manufacturing to justify the cost for the AT2 ones. It seems more like the manufacturers of the AT2 strips are motivated by more than a little bit of greed, to be honest. I can't believe that they are that much more expensive to produce than human meter strips. It's a true shame.

Yes, discussions in the Think Tank tend to get quite detailed. What members lose sight of is the FSL strips are made for human meters and the AT strips are made for a pet meter which uses different assay methods. It’s not like there are 25 different kinds of pet meters are on the market. I don’t know what goes into the technology but I think is is quite different enough on the methodology that it is the reason I’d never use a FSL strip in an AT for my kitty. Plus....they do have the market somewhat cornered and a captive audience with the veterinary community which is going to encourage clients to buy it.