5/12 MAX AMPS 104+2.5/163+6/83 PMPS 106+3/78+4.5/63+6/70

YESTERDAY:http://www.felinediabetes.com/FDMB/...-25-106-3-104pmps-170-3-104-5-75-6-74.137663/

I definitely need to get another meter. I thought all was well with the battery change but last night at +6 it was registering 104 and my Arkray 74 and 78. I don't know if I should get another Relion Micro or the Comfirm. I need to see what the difference is.

Max was meowing this morning and ate his baby food but then left the ff. He has since gone back to finish it. Prayers and vines to all in need this morning with extras for Tricia's 4, Amy's DF, and all others in need.

 

Nice amps to start the day! Now just surf safe Max! Strange on the meter variances. Ive only ever used the Confirm, so not sure which is better? Thats a little worrisome that your different meters were off by so much

 

Great way to start the day Max! I want to know what you find with the meters. I use the Micro, now I may pick up a second meter for comparison.

 

I use the relion prime. I have heard others say not to but I have never had a problem with it and it gives big numbers for those of us with "i can't find my glasses" issues.
Nice start to the day Max! Surf safely!

 

Thanks. This meter variance is driving me crazy. Sometimes the Arkray and Relion match perfectly and most of the time within the 20% variance. What is scaring me is times like last night when I get two tests with the same drop of blood and they read 104 twice with the Relion and and the Arkray reads 70. The higher number would make me think he might need more insulin. Sometimes I will get even bigger differences. I think I will call and order the solution to check the monitor. I've gotten a 140 followed by a 74 as well. I thought the battery change fixed it but now I'm more confused. The other day when I got the 38 they both read it the same.

 

Sorry your meter issues are so frustrating! I think the only real difference between the Confirm and Micro is the size of the meter and screen, possibly with how they store old data, too? I don't use those features, though. I use a Confirm and have a Micro for a backup since the strips are the same.

 

Thanks Patricia. I think I'll get another Relion as my back-up uses Relion strips as well. I don't care at this point to get exact numbers. My worry is overdosing Max

 

There is nothing to be had but frustration when attempting to compare meter readings. The variance allowed at the lower readings (under 70) is less than the 20% usually stated so a hypo (or an earned reduction) should be caught the same with any meter. I just purchased a 3rd Aviva off of eBay since it looks like they may be being replaced by the nano. That way I have a backup for my backup

 

The thing is I am getting readings of 143 and 70's on the same drop of blood and same meter. That is why I am double checking with my back-up. If I get 2 readings that are similar I am going with that. I've been testing since January 2014 and never had this happen before. If I get a 99 and 114 I'm not worried.

 

In the last several years manufacturers of human BG meters have changed methods used to measure glucose in blood. They no longer use the same methods. Some use one method. Others use another method. Trying to compare meters can become a frustrating experience. There are several methods used, including, but not limited to:

GO = glucose oxidase
GDH-PQQ = glucose dehydrogenase with pyrroloquinolinequinone
GDH-FAD = glucose dehydrogenase with flavin-adenine dinucleotide
GDH-FAD = glucose dehydrogenase flavin adenine dinucleotide

This minor change can result in differences in results from one meter to the next. It's something we're beginning to see here on the board.

Based on what I've read and the results in this study on dogs: ISO-Based Assessment of Accuracy and Precision of Glucose Meters in Dogs, one may want to re-think human meter options when dealing with our diabetic cats. This particular study concluded: "Although none of the PBGM fulfills the ISO requirements for whole venous blood, overall, AccuChek Aviva Nano is the best option among those evaluated, given its accuracy, precision, and lack of interference by hematocrit." The study is a dry read, but may be worth your time. It does mention several other brands of meters. Granted the study was done on dogs, but I think some of this could easily be applied to cats.

Marje/Gracie and I were discussing meters recently. She asked me what I would do today. If the AlphaTrak2 or i-Pet meter strips were made affordable it would be my first choice. For years the AccuChek brand has been known to be the closest to lab results and the results from the study on dogs is enough for me to give it a whirl. I'd probably opt for the AccuChek Aviva Nano as a second option unless the cost of the strips became unmanageable because of how often I was testing. If the only affordable option was to use an inexpensive meter such as a ReliOn or Arkray... I would seriously consider having fructosamines done once or twice a year depending on how things were going with kitty... just to get a better picture of how well kitty's blood sugar was being controlled. This is a complete flip-flop from how I used to feel about having fructosamines done, but over the last nine years I've learned it's sometimes necessary to do that because of changes/advancements in the world of feline diabetes.

As far as relating BG readings to protocol guidelines when using a human meter... I would stick with one meter and use those values to make dose adjustments. I would consider that practice to be safe because we already know readings from human meters are *usually* lower than those from pet-specific meters and lab results.

FWIW, just some food for thought mixed in with a little opinion...

 

Wow, Jill has certainly given us a lot to chew on! I use the Bayer Contour and have always been happy with it, but now I'm starting to wonder. Of course I just ordered and received 600 test strips!!! Maybe, once I make a dent in those, I'll think about a new meter.

Meanwhile, Elise, I can certainly understand your frustration. I hope you arrive at a solution you can work with and that Max cooperates, too. Cinco would like his company in the lagoon today!

 

I don't want to give anyone the wrong impression. There are plenty of good meters out there!!! Personally, I consider the Bayer Contour to be one of them. I simply relayed "my" choice to Marje when asked as if I were starting anew. I just think we have to realize that using the combination of human meters and fructosamines is probably the best way to go. We've poo-pooed fructosamines for so long. Today there might be a place for them.



Edited to clarify...
The points I was trying to make:

• Today meters use different methods for testing blood. Trying to compare results from one meter to the next especially when they may be employing different methods to test blood may/will probably result in a lot of head-banging.
  
• Using some brands of human meters on felines may provide results that are closer to lab results than others.
• Pet-specific meters are supposed to be closer to feline lab results than human meters.
• Because there is such a wide variety of human meters being used on our cats... meters using different methods for testing human blood... having a fructosamine done periodically or when in doubt may be a good idea.

 

Thanks, Jill. Obviously, my kitty is doing very well right now, so the meter has to be doing it's job. Like everyone else here, I just want the best I can get of everything for my babies. If there is a better meter to use, I'm willing to change, but for right now, I'm just going to keep the info you've given us as a reference and appreciate it so much! I hope Elise feels better, having read what you've shared.

 

I'm using the Relion Micro and I know it runs lower than my beloved One Touch Ultra Mini which was always very close to the lab. But the OT requires a huge drop of blood. The Micro requires a 0.3 microliter blood sample. I was seriously considering switching to the AccuChek Aviva Nano but it requires a 0.6 microliter blood sample. Because Gracie was young at dx and is a long-term diabetic, I want to use the smallest gauge lancet for the smallest sample I can to be sure her ears stay in good shape. Roomp/Rands Management of Feline Diabetes discusses sample size and states the 0.3 microliter sample size is a good one for cats.

I've also found the Micro seems to be a bit more reliable since I've been using the new strips. I get a lot less errors...in fact, I've gotten none and the strips draw much better.

I've found, in doing meter comparisons, that at numbers below 40 mg/dL, the meters get much closer to the point that I'd reduce her no matter which meter I used. I've also found that, even though the spread may be a lot more, when she's in normal numbers above 40 on the Micro, she's been in normal numbers on the comparison meters although the Micro is lower. I've only gotten one questionable test where I would have reduced her on the Micro but not the comparison meter. I went with my gut and knowledge of the meters as well as Gracie. But this takes time and experience and I strongly encourage all new members without much data to be conservative and reduce based on the meter you are primarily using when the protocol calls for a reduction.

I look at trends in Gracie's numbers. If she's running in low blue all the time on the Micro, I know I need to tweak the dose up. If she's in yellow with blue nadirs, I increase the dose.

I do agree with Jill's comments and especially on the pet meters and this has been a huge sea change for me as well. If I could afford to use the AT2 all the time, I absolutely would. But for the amount we test, it's really cost prohibitive. Next time I have Gracie in for a check, I plan to have a fruc test done.

 

It's interesting that what Marje is saying about different human meters is so similar to what Dr. Nelson told me about comparing human and vet meters - the difference is negligible at lower numbers and increases as the numbers do. I agree that knowing one's cat is a huge factor in the whole process. As Dr. Nelson told me, we need to be careful not to become too number obsessed and always look at the whole cat.

 

After the numbers I was getting the last few days I had been tempted to ditch the meter and start using the back up. I was once told right at the beginning of our Sugar Dance, when I purchase 5 different meters to see which one I like best, not to try to compare readings, because I would go insane. So I want to pass that along to you now. If you think the old meter is just not doing the job, then ditch it and use a new meter, but don't try to compare results. What I did was I test myself and if I get a number that I am expecting then I assume that the meter is fine. If I get a reading that seems really out of whack then I assume the meter needs to go. Hope that helps.

 

Yes, we've known vet and human meter results have been closer at lower numbers for years. I remember borrowing the original AT meter from my vet to compare Freestyle results many years ago. Readings in the low 50s were sometimes the same or at most a point or two in either direction.

However, things have changed. The government has been putting a lot of pressure on meter manufacturers to become more accurate than they've previously required. What Marje found with her meter may not apply to each and every meter out there. We can no longer make assumptions across the board... and my guess is we can expect more changes to occur in the years ahead.

 

Elise, I hope you can find one meter that works for Max. I would caution you against comparing numbers with different meters. When I switched meters, I compared the results from the new meter with the old meter from the same drop of blood and got different results most of the time. I realized I was driving myself crazy and just switched to the new meter.

 

My vet uses a One Touch Mini- and that was what I thought I would be getting too until I realized how expensive the strips are plus it requires way more blood than the Relion Micro! It has been intersting to read Jill's thoughts, thank you! I'm not sure I will look forward to all the upcoming changes in meters though...

 

I agree with Carla about comparing meters. It definitely can drive you crazy!! Jill has definitely brought up some interesting thoughts. I have always vetoed the fructosomine tests even though my vet thinks they are very important. I don't think I will subject Simon to the test again (he hated the only one he had when he was first diagnosed) because he is so old at this point, but if I had a younger cat, I may consider doing the tests once in awhile. Food for thought.

 

interesting...
i have the bayer contour and the accu-chek.... and yep, about 26 cents a strip.

 

I have the accu-chek, but was thinking of getting the bayer because the it allows a second attempt on the same strip. I waste a LOT of strips. But after reading what Jill wrote about the accuracy of the accu-chek, I`ll stay with it and try not to cry when I waste a strip.

 

Thanks Jill for taking the time to address my concerns. I never compared the meters until I started to get numbers that weren't making sense, either higher or lower during a cycle. My micro has been pretty consistent until recently. So I changed the battery and thought the problem was solved. Then last night I got wacky numbers and repeated the tests. I was finding that the Arkray would match up with one of my two very different Relion tests. I'll get a fructosamine next month when I bring Max in for a 4 month recheck. I refused it the end of January because I'd been reading here that it's a waste of money. We did do a urinalysis and he wasn't spilling any glucose into his urine but I know that can quickly change from day to day. Since I have over 900 Relion strips and 200 Arkray, I won't change meters at this point.

Thanks everyone else for chiming in on this subject. I wish I was rich so I could use a pet meter. I'm not feeling good about my meters right now.

One more question. Wouldn't the Arkray and the Relion be the same since they are made by the same manufacturer? That is why I bought the Arkray as my back-up.

 

Not necessarily. Remember the 20% variance is not between meters even of the same type. It's for the meter you are using. I have two Micros and while they usually read fairly close together, they don't always. Because I've found that using a meter immediately to do a recheck results in a skewed number so that's why I have a backup. If I get an unexpected high or low number, I use the backup for a recheck. Even at lower numbers, it has been 10-15 mg/dL different, on occasion, to my primary meter. Not always...but occasionally.

I spoke with Arkray recently about comparing the Arkray Gluocard 01 mini meter and the Relion Micro and they told me the Arkray strips should only be used in the Arkray meter and Relion strips in the Relion meter. I told her many of our members use the Arkray strips in the Relion meter and get similar test results but she said there is a slight design difference. When I look at the new strips for the Arkray and the new strips for the Relion, they are identical down to both having "Arkray" on them. But she said there is a slight difference.

Thank you for mentioning this, Jill. I knew I was forgetting something but I was posting while waiting to board an airplane and what you posted is what I forgot to mention. In looking at what other members have gotten in numbers when they compare their AT2 to a Relion, a see a great variation from what I get. The take home is to look at your data and not someone else's. Don't base your decision on what you see other members get when they compare meters. Pick your meter, know your cat, make your decision.

 

I don't know.

I've listed some country-specific Glucose Monitor Lists in the "New to the Group" sticky. The USA list is a non-comprehensive list, current as of February, 2013. Check your particular models of the ReliOn and Arkray meters against the list to see if the same methodologies to determine blood glucose are found in each.

Having said that, I don't *know* that using the same glucose reading technology matters. After all, one can take 2 meters of the same brand and model and get two different results from the same droplet of blood. Heck, we can test the same droplet of blood with a single meter and get different results!

I know this entire subject can be very, very frustrating. My comfort level with human meter use for felines increased tremendously once I reconciled myself to the fact a human meter would give me enough information to treat Alex, but I could not expect accuracy like one would expect using a pet-specific meter.

LOL! I see Marje posted while I was typing! GMTA!
Good info from Arkray. I suspected as much...


I think it's important to remember human meters will give us the information we need to treat, but we should not expect anywhere near the accuracy we'd find from lab results.

 

Thank you Jill and Marje. Just when I feel I'm feeling sort of comfortable about all this I get thrown a curveball and start doubting everything and myself as well. I have to keep reminding myself there is no such thing as a perfect straight forward way to deal with FD and just let the occasional odd tests go.

My original Relion gave me crazy numbers and I sent it back for a replacement. This one has been consistent until now. Who knows? It could also be a few bad strips. I'll take my advice that I've given to others and just relax.