Three readings in low "blue" area despite no insulin??

I have two dilemmas here, and as a newbie I'm not sure how to handle them. I've updated the spreadsheet so you can see the pattern. Shaikha was getting wild swings after we put her on insulin originally. She was getting 2 units per day, then we doubled it to 4 units, and over the holiday weekend I dropped it to 3 units because she got a couple of readings in the hypo area. Since we dropped the dose, she's been much more even, with readings finally dropping into the 200s and even 100s.

Last night when I tested I got two different readings -- 100 on the new Relion meter I'd bought, and 144 on the Alphatrac I'd been using. I wasn't sure if I should give her insulin and didn't get a response here, so I put it off but even several hours after the +12 (when she'd get insulin originally), she was still at only 154 on the Alphatrac (I didn't use the Relion because there wasn't enough blood).

This AM her BG was 173 on the Alphatrac and 133 on the Relion. I will give her insulin shortly, but am trying to figure out what it all means? Is she getting regulated or does she need a smaller dose now? She also started leukeran about 10 days ago. Though it caused anemia, I do think it was helping to resolve inflammation in her pancreas (she has pancreatitis and IBD) but now we have to stop that drug. Is it possible that her diabetes is resolving since we stopped her on steroids?

I will take her to the vet this AM, but am not sure how to interpret the changes (especially since she hasn't had insulin in 24 hours) or the huge differences in the meter readings. Alphatrac was 44% and 30% higher than the Relion, so which should I believe? I don't have a control solution, but will order some this AM.

 

Update: My vet wants me to reduce her insulin to 2 units per day and to test her BG at regular intervals over the next few days to ensure it stays steady. He feels she is getting more regulated and possibly that the impact from the steroids is waning, though the leukeran could have helped too in making her pancreas work better.

I'd still like feedback though about what to do about the meter reading differences. I just want to ensure my meter is working correctly or that the strips don't have a problem.

 

Frequently, steroid induced diabetes IS temporary.

I would stop insulin until Blood sugar is over 200.

Blood sugar below 200 is NOT damaging kidneys, etc, so it should be OK.


RE: meter readings

The accuracy of the meters is +/- 20%

So -- readings 100 & 144
If "true" BG is 120, the meter can read anywhere between 96 and 144 and still be "ACCURATE". So -- these two readings are FINE.

readings 173 & 133
If "true" BG is 150, the meter can read anywhere between 120 and 180, and still be "ACCURATE" --- again, these readings are FINE.


SO.... final recommendation --- choose the meter that you like better, and don't bother using the other one.

And regarding CONTROL SOLUTION ---- if YOU are not diabetic, your own blood makes a FINE, easy and inexpensive control solution. The control solution is merely guaranteed to give a reading in the "normal" range.

Since meters are generally used by diabetic humans, they can't use their own blood for the "control".

 

About the meters. Usually the idea is that there is a 20% variance between meters, especially at the higher numbers. Yours seems to be a little more than that and at the lower numbers. I am not familiar with the AlphaTrak so don't know if it is different. The usual advice is to pick a meter and stick with it. And that would have worked in your case - either number you got each time is a no shoot number.

Getting the control solution is a good idea. You could also test yourself, but unless you have 2 people meters to compare, you aren't going to be able to tell much.

Sorry. Wish I had better ideas. Maybe someone else will be along.

 

How do I know when to "shoot" and when not to? Maybe I missed it in the literature you have, but I wasn't sure whether there was a cutoff number below which insulin is not advised???

 

There is NOT a 20% variance between METERS.

There is a +/- 20% ACCURACY for pretty much any meter.

SO.... if you used the SAME meter twice in a row on the SAME drop of blood, you may see the big difference.



Don't shoot if BG is below 200.

 

this 2 units twice a day IS 1 unit every 12 hours and not just one shot of 2 units once a day, is it??
insulin usually does not last for 24 hours. 12 hours is the max UNLESS a vat IS getting some pancreatic action and ONLY needs a touch of insulin every now and again to help it out. because , MUCH CHEAPER on strips and easier to run to store and pick up more if by chance some night you need to test MUCH MORE frequently

 

We started out with 1 unit once per day, but that didn't work so we changed it to one unit BID, then 2 units BID, before dropping to 1.5 units BID.