Control solution- Alpha Trak + Freestyle Lite

Discussion in 'Feline Health - (Welcome & Main Forum)' started by PiePie, Dec 13, 2018.

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  1. PiePie

    PiePie Member

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    Mar 11, 2018
    Just started a new box of strips and the readings seem low. Should I use Alphatrak control solution or Freestyle or does it not matter? Thanks.
     
  2. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    Not sure is there is any difference between the control solutions for the AT2 and the Freestyle meter so I'd use the AT2 solution but that will only tell you if the meter is registering in range which is quite large......it won't tell you how accurate the readings might be. What code do you have your AT2 meter set to? You have to use a known cat code to get a ballpark reading with the FS strips and since there are 7 known codes, one may give you a more accurate reading than another. Known codes are 07, 08, 22, 37, 38, 92, 93.
     
  3. PiePie

    PiePie Member

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    Mar 11, 2018
    Mine is set to code 07 and it seemed like the numbers were fine until I opened a new box of Freestyle strips.
     
  4. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    While the Freestyle strips are the same strips packaged for the AT2 meter, the AT2 strips have been batch tested to determine which cat meter code will produce the most lab accurate readings. You could experiment with the different codes from the list in post #2 to see if that gets you closer to expectations or just take make note of the degree of difference you are seeing. All meters have a variance allowance and on the AT2 I believe it's 20% so it could just be that one strip or it could be the whole vial that will read lower. There is no way to know. Your meter is a rough estimate of BG not an exact reading. Next time you get a lower reading than expected, test again immediately preferably with the same drop of blood with a new strip and see how close those readings are. They should be close but may not be identical.
     
  5. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Jul 6, 2017
    I have not seen this anywhere in the AT documentation. The AT strip documentation says accurate within 5%. I read the results of a study that found that the AT meter w/AT strips was within 1% of lab glucose tests.

    Does anyone have something showing the 20%? I see that mentioned a lot here, and I am just curious as to where that is officially documented.
     
  6. majandra

    majandra Well-Known Member

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    Oct 11, 2018
    I don't have access to my bookmarks with studies right now, but iirc, one did x amount of tests, looking at how accurate the strips were to actual values, and like 95% had high accuracy. The strips would have to be wothin allowable margins to be on the market. Hopefully me or someone else can find the study.
    There is a margin of error with every scientific test, even if small.
     
  7. majandra

    majandra Well-Known Member

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  8. FurBabiesMama

    FurBabiesMama Well-Known Member

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    That article was about the draft that came out in 2014. This one is about the final FDA recommendations that came out in 2016: https://diatribe.org/fda-publishes-final-recommendations-blood-glucose-meter-accuracy (has link to actual FDA doc). It says it did not apply to meters already on the market at the time it was finalized, but for meters (for home use) coming to market from that point forward:
    • 95% of all measured blood glucose meter values must be within 15% of the true value (a lab measurement); and

    • 99% of meter values must be within 20% of the true value
    "...this means that people with diabetes can feel confident that a blood glucose meter measurement is accurate (within 15%) at least 19 times out of 20, and within 20% of the true value 99 out of 100 times. If the true (lab-measured) glucose value is 100 mg/dl, that means the meter has to be within 15 mg/dl (85-115 mg/dl) in 95% of cases, and within 20 mg/dl (80-120 mg/dl) in 99% of cases."

    It also says the package insert for the test strips and the user manual for the device should have their accuracy information placed prominently.
     
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  9. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Health Canada does not test pet meters for variances and plays no role in assuring their accuracy and I seriously doubt the FDA does either. Admittedly the 20% variance is an assumption but I think it's a reasonable one. I'm sure the veterinarian community would demand standards that meet human standards.

    They are still trying to get human meters to read more accurately and here in Canada the variance allowed is 15% and I believe the US is heading toward that goal too. My assumption is that the AT2 meter regardless of marketing material provided, would read within 20% overall for all BG ranges. The standards set out for human meters requires the accuracy of the meters be less variable in very low or very high BG ranges. That means a certain % of readings in high or low ranges have to have better accuracy while the rest can be out as much as 15% or 20%.

    Bottom line....if it were possible to make a glucometer that was accurate 100% of the time to within 5% of lab results, Health Canada, the FDA and the entire human medical profession, would be jumping all over it. There are more accurate glucometers (10% variance allowance) used in hospital settings but the cost of them is prohibitive for general population use. If pet meters were that accurate, it seems logical to assume the costs of using one would also be far more cost prohibitive than it already is.

    I'd love to see that study to know how many tests they did and who did it. The strip documentation indicates they took 50 readings on BG samples between 82 and 497mg/dL and came up with a variation coefficient of 5.3% which is a probability figure not an absolute. I have to wonder what the variability would have shown on readings below 82 where it really matters and question why lower readings were not included in the figures presented.

    The AT2 meter is the same meter as the old version of the FreeStyle Freedom Lite with a different colour case and different algorithms. It uses the same strips as the Freestyle Freedom Lite so there is nothing special about the meter or the strips (other than the batch testing) that would make it capable of being more accurate than the human meter. That means the only difference that could possibly affect accuracy would be in the algorithms so it seems to me if it were that simple to make a meter accurate to within 5% with the algorithms alone, that accuracy would also be available in human meters.
     
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  10. FurBabiesMama

    FurBabiesMama Well-Known Member

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    I was just looking for documentation specific to the AT accuracy. I see people say all meters are 20% but have not found actual accuracy documentation on the device. Looks like that 20% is coming from FDA guidelines for what is required. I still wish actual accuracy info was documented for the individual devices. Those 2016 guidelines say the info should now be in the user's manuals. I imagine you are correct that the FDA probably does not approve pet meter's so that requirement would not apply.
     
  11. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    I called Health Canada to ask what controls/regulations are in place to differentiate glucometer strips since the AT2 and Freestyle strips are visually identical and if there was in fact any difference in the strips themselves, the fact that they are identical in appearance could pose a health risk to diabetic humans who happened to have the pet meter and strips in their possession. That's how I found out that they do not regulate pet glucometers. It's also how I confirmed that the strips had to be the same as the human strips because ABBOTT wouldn't admit they were the same (this was before Zoetis bought back the marketing rights for the AT2) but did tell me the strips are batch tested to determine the code that would produce the most accurate lab equivalent reading. If the strips were in fact different posing any human risk, I'm sure ABBOTT would have done something to visually differentiate them given their glucometer market share and the potential for devastating law suits. If you check the patent numbers on the insert from a vial of AT2 strips against one for a vial of Freestyle strips, most of the patents are identical and both are manufactured in Ireland. The AT2 strips do have one extra patent which would make sense since they would want to protect them from anyone producing counterfeit AT2 strips.

    The only place I've seen a list of human devices with an accuracy overview that I would consider credible is Consumer Reports. I've never seen any comparison testing on pet meters. I got hold of a FastaCare pet meter (Everpaw in the US) and was disappointed to find it read low at high readings and high at low readings when compared to the AT2....the exact opposite of what I want my meter to do but overall my comparison showed essentially the same accuracy with a variability of 5-10% between the meter readings on average.
     
  12. Debra and Yoyo

    Debra and Yoyo Well-Known Member

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    Nov 10, 2018
    Hi, Can you please tell me which test strips can be used with the Alphatrak2 pet meter. I have tried using the Freestyle InsulinX test strips with the Alphatrak2 meter. Readings are closer when numbers are lower, and readings are far apart when the numbers are higher. Is this correct or should I be using the Freestyle Freedom Lite test strips?
     
  13. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    If you want the most accurate readings your AT2 is able to provide you should be using AT2 strips.

    The Insulinx and Freestyle strips are one and the same. In Canada, there are no specific Insulinx strips now....don't know if they ever were packaged differently. The Freestyle Lite strip box here indicates they are for use with the Freestyle meters and Insulinx is one of them. I believe they have always been the same strips simply branded/marketed under the meter name for whatever reason or it could be that they are packaged differently for different markets (US vs. Canada). A lot of people in the US seem to picking up the Insulinx strips at a considerably lesser cost than the Freestyle strips recently which makes me wonder if they are not just trying to clear out the stock of Insulinx branded strips.

    The AT2 strips come with a code that has been determined through batch testing to give you the most accurate lab equivalent readings. When using either the Freestyle Lite or Insulinx branded strips, although they are the same strips, you don't know what code on your AT2 meter will give you the most accurate lab equivalent readings. There are 7 known cat codes (see reply #2 in this thread) but there could be more we just haven't seen mentioned here. So you stand roughly 14% chance of getting the most accurate reading possible with any of those 7 codes. I don't think the difference from one code to another would be that significant but there is no way to know what that difference is.

    When comparing human meter to pet meter readings, the numbers are generally be closer at low readings and farther apart at higher readings. It's possible you might see the same trend if the code on your AT2 meter is not the one most accurate for that batch of strips.

    If using either Insulinx or Freestyle strips in the AT2 meter, I would recommend doing at least one comparison test with a properly coded AT2 strip for each new vial to get an idea of the level of variation you can expect to see.

    In the big scheme of things, a high number is high so the difference isn't as critical. If I saw a big difference at low BG range and the Insulinx strips were reading higher, I would definitely be concerned about accuracy for safety reasons.
     
  14. Hogan

    Hogan Member

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    Dec 5, 2018
    I have both the AT2 strips and the InsulinX strips. As my starter AT2 strips got low, I started testing concurrently with the InsulinX strips. I'm currently at high BG numbers, so the difference between the AT2 and the InsulinX has been 20 - 40, with the InsulinX being higher. But as Linda points out, the difference of 415 and 455 is not important, they are both high. I ordered more AT2 strips so I will continue doing concurrent testing if I'm lucky enough to get Hogan's numbers down. My AT2 code was 37 and I kept the same for the InsulinX strips.
     
  15. Debra and Yoyo

    Debra and Yoyo Well-Known Member

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    Nov 10, 2018
    Comparing both the Alphatrak2 test strips and the Freestyle InsulinX test strips, I have found that the Alphatrak2 tests higher in high numbers and higher in low numbers. Example: 97 for Alphatrak2 and 90 for Freestyle InsulinX from the same blood sample. I use code 38. Best of luck!
     
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