Alpha Trak vs Freestyle Lite

My cat was tested at the vet's last week on her Alpha Trak and he was 19.2mmol. At home, a half hour later, he was at 15.2mmol on my Freestyle Lite. The vet told me that human meters aren't properly calibrated for feline blood, so I bought an Alpha Trak.

Since then, he has been testing higher than what I am used to.

I am concerened for two reasons - one, he might have been having gotten less lantus than he actually needed (for the past 2 yrs, he has always been between 7.5mmol - 16mmol; now he is reading 12.2-21mmol)

And two, what if the Alpha Trak is actually higher and I give him too much insulin as a result.

there is this document which talks about this sort of thing, and how it relates to proper Lantus protocol, but am afraid its miles over my head. Could anyone explain to me what they mean by this:

"NB. It is very important to note that blood glucoseconcentrations measured using a whole blood
glucose meter calibrated for human blood may measure 30-40% lower in the low end of the range than
glucose concentrations measured using a serum chemistry analyser or a plasma-equivalent meter calibrated
for feline use. Therefore, if using a meter calibrated for feline use (eg. AlphaTRAK, Abbott
Laboratories, CA, USA), or a serum chemistry analyzer, add approximately 30 mg/dL (1.7 mmol/L)
to the target glucose concentrations (see Table 3B). For example, a target > 50 mg/dL (2.8
mmol/L) becomes > 80 mg/dL (4.4 mmo/L) when using a meter calibrated for feline use. Instead of
aiming for 50-100mg/dL (2.8-5.6 mmol/L) , aim for 80-130 mg/dL (4.4-7.2 mmol/L [round numbers
4.5-7.0 mmol/L). Meters calibrated for feline use may read higher or lower than the actual value, in
contrast to consistently lower readings for meters validated for human blood. "

It seems that they are suggesting that not only could a feline meter (eg Alpha Trak) be higher, it could also give a lower reading as well?! Does anyone get what they are saying in the last sentence?

 

I can't explain what all the technical jargon says but I did use an Alpha for most of the time that Ruby was on insulin.

If you follow the link in my signature, there are tabs on the spreadsheet marked "AlphaTrak" and "Relion Equiv". From April thru May of this year, I used both an Alpha and a Relion Micro. My Alpha always tested higher. Sometimes it was only 10 points or so (when Ruby was testing in low numbers), other times it was upwards of 80 points (when she would test in the 200s and 300s). In the end, the average came out to about 40 points difference between the Alpha and Relion. (these are all US numbers. I'm not sure what the conversion is for international numbers). I actually have 2 Alphas and they both tested pretty much the same when compared to each other. From what I can tell, this is pretty normal.

That said, not all Alphas will test higher than a human meter. I can't remember who it is, but I know there is someone here who used/uses an Alpha that tests lower than a human meter.

 

That's the scary part - that this one person had an Alpha that tested lower than a human meter.

I wonder if the biggest cause of hypo cats are maybe inaccuracies with glucose meters?

 

Were you using the Freestyle Freedom Lite with the butterfly strips? Some members, myself included, have found that that make of meter registers lower numbers than other meters for cats, especially at the higher numbers. If you look at Neko's SS, it's like there are two different cats before and after March 13th when I switched meters. I now have a Relion (I live close to the US border and have a friend who also gets me strips) and also a Contour. I loved the small drop needed and the ease of use of the Freedom Lite but the data was just too far off. The one comparison I did with the Freestyle showed 16.2 and the Relion showed 24.6! The Bayer and Contour tend to be close. I've seen someone say that the meters only have to be guaranteed within 20% so some variation is expected.

 

yes, I've always used those butterfly strips.

What I've been reading is that there is a sort of logarithmic difference with these strips and other meters (particularly Alpha Trak): at lower doses, there isn't that much of a discrepancy - maybe 10-30 points (.5-2.5mmol), but this becomes more skewed with higher numbers.

(I'm dealing with this, and at the same time looking at tapering him off of a low ROD dose of prednisolone, which he's been on for the past 2 yrs to stave off IBD and pancreatitis flare-ups. But I think it's making managing his diabetes much worse...)

 

It's probably an issue with the Freestyle, we have had many instances here where the meter would simply not read anything over 300 (16.6), leading people to believe their cats numbers were good while their symptoms just kept getting worse.

You will drive yourself crazy if you keep trying to compare meters though. Pick a good meter that you can afford and stick with it. If that's the AlphaTrak by all means go ahead, but I personally couldn't afford it! We pay attention to number ranges more than exact numbers, and meters are legally allowed to have a 20% number variance either way, so for example, a 300 could actually be anywhere from 240 to 360. I use a Bayer Contour myself.

 

Does anyone know if there is another strip option for the Freestyle Lite than the butterfly strips? IIRC, the problem with Freestyle was the strips, not necessarily the meter itself? I'm not sure, I never used one, but I know a couple of people in PZI both found the problem with their meters consistently reading low, for months, while their cat's were in higher numbers than they thought.

What I don't understand is that the just released consumer reports rankings of BG meters lists the Freestyle Lite at #4 , ahead of every other company except Accu-Check with the highest rating (excellent) they give with respect to "accuracy" and "repeatability".
http://felinediabetes.com/glucometersNov12.pdf
Ranked higher than any meter made by Relion, Bayer, or OneTouch, which are all meters used by many people here. There are only 4 meters that get "excellent" for those two features -

FreeStyle Freedom Lite
FreeStyle Lite
Accu-Check Compact Plus
and
OneTouch UltraSmart.

So, is the "issue" with the strips fixed? If not, how does Consumer Reports get it "wrong"? Last year, the Freestyle Freedom Lite was #5 on the CR list, and the Freestyle Lite ranked #11. So, this year, they moved up the list. So maybe they have been improved?

Carl

 

I looked at the owner's manual for my Freestyle Lite and it says that it should only be used with Freestyle Lite test strips. Those are the butterfly strips. I had my problems with the meter this year as did someone else on the Lantus forum during the summer. I just wonder whether there is something different about cat blood that makes the Freestyle Lite not work as well for higher numbers. Other than the numbers, I really liked how it worked, so I could see how it could get rated highly.

My vet asked me if I wanted to buy an AlphaTrak, but she uses the OneTouch herself and said she always found it compared very well with lab results. I went with the Relion/Contour combo because I like the smaller drop of blood needed.