1/15 Sami - AMPS 217 - Must read about meters

Good Morning All!

Yesterday's Condo

Yesteday, Sami did see some higher 200's, at least higher than she has seen in a few days, but we did increase her dose slightly, and she was also at the office with me yesterday afternoon. We had the security alarm people there switching out are equipment and she could have been a little freaked out over the alarms going off, but she was purring a lot of the time and laying openly in my office, not really hiding or anything.

She is now on 1 unit + the line, so I am marking that as 1.1 on the spreadsheet, but it might even be more like 1.15. Those micro dose are so hard to be exact. I wonder if weighing the syringe would be more accurate.

I was so tired last night after getting up several times a night over the last few weeks, that I decided I would just skip testing overnight, so I didn't get a reading at +6. How do you all do it?

Anyway, I am hoping her body has been able to adjust to the new dose and we will see some lower numbers today. We can only wait and see.

Sami will be going to the office with me again today. If you can believe it the boss would rather I bring her to the office than to run home twice a day to do her test her. I only live 3 miles from work so I can get home test and get back within 20-25 minutes. But for most of the day I am there alone and he doesn't want the office unattended during business hours. The first few days she went with me to the office she was a little scared, but now it is like a second home. She has all the comforts of home, except her toys, and she has something better me. We work well together, she lays on my papers while I am trying to work. Typical cat.

Hope everyone has a great day.

 

Re: 1/15 Sami - AMPS 217

Lucky you that your boss lets you take Sami into work with you!

 

Re: 1/15 Sami - AMPS 217

Yes, he has been an angel. When Sami first got diagnosed I was totally freaked out and so nervous she would drop too low. That was in September and I didn't know everything I know know, and I wasn't home testing then. She came to work with me for two full weeks. This was when she was very tired and didn't feel like doing much so it was very easy.

Now that she is feeling better it is a little more difficult because she gets restless sometimes. She wants to explore the whole office, but I don't really let her do that when everyone is there. By noon everyone is out on the road so I let her explore all afternoon. But yesterday, like I mentioned, we had the alarm company changing out our equipment so she was stuck in my office until they left.

Today, will be more quiet, but the guys do come back to the office in the afternoon. Everyone is starting to get use to seeing her there and they even come in to check on her too.

I work with some really great people.

 

Re: 1/15 Sami - AMPS 217

Glad Sami is feeling better--Great that you can bring her to work with you--Saw you posted to someone in trouble this am..We have experiened folks here who give dosing opinions , even I dont do it & I've been here a long time..Your input is welcomed, and some ideas were good, but the situation was a little too critical for even me to advise.
Hope Sami has a great day...

 

Re: 1/15 Sami - AMPS 217

Hi Tina: Welcome to LL. Hope to see you post often.

I was looking at your spreadsheet. You have changed doses quite a bit in 1u increments. Lantus likes consistency. Usually the doses are changed in .25 increments and are held for at least 6 cycles. Perhaps re-reading the sticky New to Lantus & Levemir will provide you with more information about how it works and the protocol used here. Also, visit condos and look at spreadsheets and you will learn a lot about the “tight regulation”.

Some kitties take a while to adjust to the insulin. Here it is called Liver Training School. When they first get low numbers they visit RBC or bounce.

We have many experienced people on the forum and their opinions are very good. I do not offer dosing opinions even though I have been here for a year, because I am not comfortable with possibly providing an incorrect suggestion and jeopardizing someone’s sugarbaby. We can offer support and encouragement and leave the rest to our experienced individuals.

My kitty has made great progress here in LL by following our experienced individuals. I am wishing you the same success.

 

Re: 1/15 Sami - AMPS 217

Yes, I do realize now that consistency is key. I have really just been on this board for about a week, and that is when I started dosing more consistently and started to see some stabilization in Sami's numbers. I am so thankful that I found this board because since changing my practices based on recommendations on this board Sami is starting to see some better numbers. I am looking forward to some greens in our future.

 

Re: 1/15 Sami - AMPS 217

Sami is surfing the BLUES right now. She was 158 at +4 and 145 at +5.5, and she ate an entire can of Fancy Feast just before the +4 test.

She seems to be really tired right now. Is that normal? I know cats like to sleep, and having her at the office is a little more excitement than she gets at home all day, but it seems like the lower her BG goes the more she wants to sleep. Am I just freaking out? Probably! I will probably test her again shortly to see where she is. I know unless she drops more than 100 points she is in no health danger, but I guess I am going based on her activity level right now. The past few days she has been rather spunky and has been following me everywhere.

 

Re: 1/15 Sami - AMPS 217

Yes, they react to the lower numbers in more ways than one. They are used to high numbers and think that is normal. They get lower numbers and they either bounce, some are more tired, some eat more, some don't eat as much. Be patient. If you get a number you are not sure about post and someone will walk you through the process. Tuffy loves to throw 20s. Now, it is old hat for her and me. She is fine, I don't like the number but she has no symptoms. I have also learned to be very cautious in reducing her dose. I have had to go back up several times. You are in good hands here.

When I first joined, Tuffy was on 10 u. prescribed by my vet. I shot an 80 (3u) under the direction of the vet and I had no idea how dangerous that was. My DSIL is a vet and he totally approves of this board and the suggestions offered here.

Keep up the good work. Ask questions, post, read condos and spreadsheets and you will become used to all the data you are collecting. The data benefits everyone including all the sugarkitties.

Have a good day.

 

Re: 1/15 Sami - AMPS 217

Thanks, Sami is sleeping now, and snoring. I feel like I need to shake her to make sure she is in fact okay. I guess I will wait until she gets up from her nap to test her again.

 

Re: 1/15 Sami - AMPS 217

Hi Tina
Glad to see you had a nice day at work with Sami.
You mentioned you are only here for a week and look how well you are doing.
Take it from somoeone who is also relatively new that this is the best place to be.
I have to say that at the begining of this journey I thought that I was nuts to be getting
"advice" from a board on the internet and not listening to my vet.
Who are these people, right?
Boy am I happy that was excatly what I did and still do.
Of course I do my own research and I know my Max so whatever direction I decide to go on based on recommendations here, I am very comfortable.
I have not been steered wrong yet and I have a bunch of new friends.
One memeber (okay Ronnie & Luna) took care of my condo and had all of Max's numbers
updated for me while I was on a cruise. She even saw some dosing input and called my DPS for me. No vet is doing that.
Read and trust and follow protocol. I know it will make a difference.
And just think how many new friends you are making. We are family here too!

 

Re: 1/15 Sami - AMPS 217 - NEED Everyone's Advice

I need everyone's opinion on this. I don't care how NEW you are. If you have a cat with FD and you are home testing I want your opinion. In will understand it is your opinion and take it with a grain of salt, I just want to know what everyone would do if they were in my situation.

As I have mentioned before, last weekend I bought a second meter to verify accuracy. I found that the second meter was reading more than 100 points higher than the meter I have been using. I used the testing solution and got a good reading with the meter I had been using and tested again with the same results. I couldn't use testing solution for the new meter because I didn't have any.

Anyway, since then I have purchased two more meters, and tonight I tested with all of them. Here are the results:

TrueResults (CVS): 169
Relion Micro (Walmart): 340
Relion Ultima (Walmart): 322
One Touch Ultra Mini: 379 (this one could be slightly elevated because it was the last one tested

As you can see the CVS meter reads the lowest and this is the meter I have been basing my dosing on. All the other meters are showing readings into the 300's, not exactly where I would like the number to be, but if they are more accurate then I will have to deal with that.

My question to you is what would you do? Would you continue using a meter just because you have been using it all this time or would you switch meters? And if you choose to switch meter how would you deicide which meter to go with?

At this point I mostly want to have accurate readings, but after this experiment I don't know if I am getting that with the CVS meter.

 

Re: 1/15 Sami - AMPS 217 - NEED Everyone's Advice

Tina


my advise: and it's worth .25cents!
stick with one meter, put away the rest, you are going to drive yourself crazy.
And this advise I have received and seen many times to others.

 

Re: 1/15 Sami - AMPS 217 - NEED Everyone's Advice

I get that, but which meter should I stick with. One that appears to be wrong or start using a different meter?

 

Re: 1/15 Sami - AMPS 217 - NEED Everyone's Advice

I started with the AlphaTrak specifically designed for cats. I switched to the ReliOn Ultima. There is a 10-20% variance between the two. ReliOn Ultima has a very high Consumer Protection rating. That is the only one I use. I purchased another ReliOn Ultima as a back up to avoid any conflicting numbers. That is my opinion.

 

Re: 1/15 Sami - AMPS 217 - NEED Everyone's Advice

Tina
I know we had some discussions on meters in pm.
I had been using the OTU and went cold turkey last week on it due to cost of the strips.I switched to the Relion Ultima and have not looked back. The first reading I did was a huge difference, I did a few comparisons and was "advised" to just stick to one.
I recall reading somewhere that the CVS one was not good but for sure
could be mistaken. If 3 out of 4 are showing numebrs in the 300's I would say the 4th
is not accurate.
But, I don't have as much experience as many others here with regards to the meters.
Others will help.

I just read Ronnies's reply. That's what she told me, and I listened.
I am enjoying the Relion too.

 

Re: 1/15 Sami - AMPS 217 - NEED Everyone's Advice

[/quote]

I get that, but which meter should I stick with. One that appears to be wrong or start using a different meter?[/quote]




One Touch is an excellent meter, with expensive strips, if u can afford it
Relion, an excellent meter, with inexpensive strips

Both are good, so I guess - how much do u wanna pay for strips?
DO keep one handy, hidden, forget about it, you may need it one day - but DO put one away.
Pick one and go be test happy :lol:

 

Re: 1/15 Sami - AMPS 217 - NEED Everyone's Advice

There can be about 20% variance between meters and between tests done on the same meter. (The between tests on the same meter is error variance and is a form of normal measurement error.) Looking at your numbers on the different meters, the TrueResults meter is the outlier -- all of the other meters are giving you essentially the same number. The Relion meters and the OTU all have a good track record. The strips for the Relion are among the least expensive available. I'd not put a great deal of faith in the numbers your getting from the TrueResults meter.

 

Re: 1/15 Sami - AMPS 217 - NEED Everyone's Advice

Meters are no different than any other tool you are using for measuring.
You use the meter to get snapshot of the BG number at a single point in time.
You then want to track the BG in a timely and consistent way. You want a reliable monitor.

Here's a better example: You want to lose 30lbs

Weigh yourself on one scale and from that number you want badly to go down 30lbs.
If you lined up 12 different body weight scales, how do you think they would fare in results?
I bet you would get varied numbers, but who's to say this one is wrong or that one is wrong.
If you stepped on the 12 scales and recorded the numbers, repeating to see if each scale was consistent.
I can weigh myself at home then go to the gym and weigh myself there and get two different numbers.
Which is just crazy talk, so that is why people say pick one and only one.

Select the meter which suits your needs and budget, then stick with it.
I use the one touch mini and it's working just fine for me and our needs.

 

Re: 1/15 Sami - AMPS 217 - NEED Everyone's Advice

I've done a lot of "thinking" on this subject and here is my 25 cents worth. Numbers are numbers and all they do is tell a story. We have to know what the numbers mean to be able to read that story. So, once you determine what a number of 340 means for you, then you can base decisions on a comparative number of 240. In a nutshell, what I am trying to say is that once you choose a meter, stick with it so you know that the results you are getting from one test to another are comparable.

Having said that, each meter is different and the test strips are different. Therefore, you should expect to get slight variations in the numbers. I use a One Touch Ultra and the test strips say on the bottle that the "control range" is 107 to 142. (Interesting thing I discovered is these numbers are slightly different on each new vial I have used.) What that means is that you have a margin of error and anything within that range is really considered the same number. So the same meter can test the same sample of blood with 2 different test strips and one could read 107 and the next could read 142. There can be up to a 20% variance in the same meter. I think this is a VERY extreem example, but the point is that there is a margin of error. So, in your example, I would say that the 340 and 322 from the 2 Relion meters are essentially the same number and the 340 and the 379 between the Relion Micro and the OTU are essentially the same. My personal experience is that I got one test of 110, which seemed weird so I retested immediately and got an 82.

If I were you, I'd choose one of the Relion meters (because the strips are cheaper), start using it and don't look back.

I'm no expert, but I wouldn't think that the change in numbers (100s to 300s) would change the dose you are giving right now since we start out at 1.0 regardless. Just might take a little longer to get to those pretty green numbers. Someone with more dosing experience might want to comment on that one though.

 

I thank you very much for sharing your opinion and I totally agree. Right now the numbers I have gotten with the TrueResults meter have been consistent, and even though the Micro Meter reads 340 and the TrueResults meter reads 169 that shouldn't change how we go about increasing the dose. But I can tell you that I only increased her dose by 0.1 unit because I thought she was more in line with getting closer to normal and I didn't want to miss the window. So I wanted to make micro increases so I didn't allow Sami to go too low.

Now, let me tell you what happened tonight, after I posted my plea for help. I just couldn't take it and I rushed over to the vet's office to have Sami and all the meters tested. And we found that in fact the TrueResults meter was reading much lower than actual. Now again, that might not have made too much of a difference at this point in the game, but had I continued to use this meter and Sami started to get down under 100 I might have capped off her dose and even started to decrease depending on protocol.

Here are the results of the testing at the vet's office

TrueResults: 225
Relion Micro: 393
Relion Ultima: 377
OTUM: 416
Lab equipment: 401

So in fact Sami was much higher than the numbers I have been getting the last few day. Sure she has come down quite a bit since last week and the week before, but still not out of danger just yet. Had I known yesterday that she was actually much higher than I thought I might have gone ahead and increased by .25 or .5, which is what the vet has recommended. So, starting tomorrow I will be increasing to 1.5 units, I think! I actually have to sleep on it because I might feel more comfortable only increasing to 1.25, at least until I can get some data with the new meter.


I am so glad I am anal when it comes to stuff like this because now I know that the TrueResults meter is not as accurate as it could be. I highly recommend you take your meter with you the next time you take your cat in for blood work just to see how close it reads to the results with high tech equipment. I do understand that there is still a possibility that the numbers will be different or have a variance, but like Jamy said, you can base your information on what you know. I now know that the Micro Meter is the closes to actual and I can work with that number. I would also feel comfortable using the Ultima and the OTUM because I can see those too are close although still slight high or low. I have pretty much determined that I will never be using the TrueResults meter again. I haven't actually pitched it yet, but probably will by the end of the weekend.

Hope this helps everyone, and I hope I don't freak everyone out thinking that their meter might be off.

 

I believe I stated the variance in my post regarding meters. Vet us the AlphaTrak. I have an AlphaTrak and you need to rob a bank to use it. THe strips are 50 for $80.00. There is a 10-20% variance in the reading between the Abbott AlphaTrak for dogs and cats and the human meters. Guess you did not understand my post.

 

Nope, I totally got what you said. And I understand that meters have variances. I too didn't want to purchase the AlphaTrak for the pure fact that the meter as well as the strips are very expensive. What I did want to know is which human meter falls more in line with the AlphaTrak or the equipment used at the vets office. That way I can have accurate information when decided to increase/decrease the dose. I still know that there will be some variance with one meter, but it shouldn't be 200+ points different. I am okay with a variance I just want to know what I am dealing with and 10% or even 20% variance is acceptable but a 100% variance from meter to meter is not acceptable and I needed to make sure that I was working with numbers that were as accurate as possible.

 

Good choice...the ReliOn Micro. That's the one I use and have been very happy except for a box of bad strips last week. I compared the readings with another meter I have, the Bayer Contour, and there was only something like 9 points difference. The Contour is a good meter too but the strips are 2-1/2 times the price of the ReliOn ones.

 

TrueResults (CVS): 169 <----- known to run low

Relion Micro (Walmart): 340
Relion Ultima (Walmart): 322
One Touch Ultra Mini: 379

the last 3 meters are all within an acceptable range. nothing to worry about. :smile:
like someone already mentioned. pick a meter and stick with it or you'll drive yourself crazy!

what a nice blue day for sami...

 

I switched about a month and a half ago from a One Touch ultra to a Wavesense Presto. The Presto is less than half the cost for strips. Also, it uses half the amount of blood. We had one OTU strip left when the new meter arrived. So, we tested with both meters and the OTU was about 60 points higher (in the 300-350 range) than the Presto. (That's another thing--the difference between the two meters could vary in different BG ranges.)

But in any event, a 10 to 20% variance is a lot of points (30 to 60) in the 300 range. Presumably, the range in points would be smaller at the low levels (20% of 50 is 10).

 

Actually, there's about an $8 difference between the Relion strips ($20 for 50 strips) and the Contour strips on Amazon.

 

You've asked the question many of us have asked at one time or another and gotten the usual answer--pick one and stick with it. This is a good idea. Otherwise you will go crazy trying to figure which one is "right." Yes, weighing yourself on the same scale is the best way to track your progress. But the rest of the question comes along as the BGs get lower. As you strive to reach blue and then green numbers, those numbers really do mean more than relative progress. Dosing decisions are made based on specific numbers and ranges, so your 95 on one meter might get you very different dosing suggestions than say 120 on another meter, even when measuring the same drop of blood.

We use the AlphaTrak, and yes the strips are stupidly expensive. Fortunately we're OTJ now and use very few strips any more. We started with that because our vet recommended it and because it would align closely with numbers from the vet. However, we ended up doing all our own testing and there was ultimately no need to even think about what numbers Beethoven might get there. We stayed with it only because we had started with it, and it was not a terrible hardship for us to pay the cost. The main thing was to get him OTJ, and now we're saving money like crazy.

Dr. Rand suggests two separate BG target ranges depending on whether you are using AlphaTrak or a human-calibrated meter as the AlphaTrak will align more closely with actual lab tests. I don't have the protocol here in front of me, but I think I recall her writing that in the lower range, you should add 30 mg/dL to a human meter number to get the "equivalent" on the AlphaTrak. So instead of trying for say 60-90, we aim for 90-120. That doesn't mean the AlphaTrak is any better--just that you may need to adjust for the difference.

 

Ruth, you have brought up a good point here. Usually, the vet will get a higher number because they draw the blood from a vein instead of the ear and they are using a meter that is specifically calibrated for animals, not humans. I actually took my meter with me to the vet and had them test the same sample of blood with their meter and mine. Vet was 392 my One Touch Ultra was 375. This should be kept in mind when sharing your spreadsheet with the vet. I remember talking to my vet when Indy was on .5 U and running in the 80 -100 range. She nearly had a heart attack and said "that is way too low, he needs to be higher, that is hypo range." They go by anything under 80 as hypo. So, like I said before, you just have to understand what the numbers mean. To her hypo is under 80, but to us it is under 50.

 

392 - 375. at that range, these are virtually the same number if you consider an accepted meter variance of plus or minus 20%.

just a clarification...
we consider anything under 50 as indicating the need for a dose adjustment in newly diagnosed cats.
vets are not used to seeing 80s in the office because *usually* kitties are so stressed their numbers run higher in a vet's office. in the comfort of their home, my diet controlled diabetic usually runs in the 50s and 60s... my three non-diabetics kitties run in the 40s and 50s.

the published study by rand and roomp addresses the difference in human meters vs meters calibrated for animals as far as numbers in the low end of the range when using this protocol.

Dosing protocol for cats on glargine or detemir using daily home monitoring of blood glucose concentrations to adjust insulin dose:

"It is very important to note that blood glucose concentrations 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."


hope this helps...

 

It would have been nice to know that TrueResults meters ran low last week, before I purchased two more meters.

Technically, she didn't have a BLUE day, because the meter was off.

 

Yes, you are correct, there is a difference between a human glucose meter and AlphaTrak, but the AlphaTrak is typically higher than the human meter, not lower. Please re-read the protocol just to be sure you are using the correct one. By the way, I hope you don't get called out by the Forum Police! I know everyone here is just trying to help and sometimes information gets misinterpreted. Thank you for sharing what you know.

In my case, the Relion Micro was within 10 points of the lab equipment so I will be using it as if it were calibrated for feline. With this in mind everyone might want to get their meter checked to see if it is higher or lower than the equipment at their vet's office, because some of these 40's people are getting might in fact be too low. It has been recommended by my vet that below 70 is starting to get into the danger zone, so if your meter runs high to begin with and you re dipping down below 70 you could be causing undue trauma to you cat. Just a thought.

 

"In my case, the Relion Micro was within 10 points of the lab equipment so I will be using it as if it were calibrated for feline. With this in mind everyone might want to get their meter checked to see if it is higher or lower than the equipment at their vet's office, because some of these 40's people are getting might in fact be too low. It has been recommended by my vet that below 70 is starting to get into the danger zone, so if your meter runs high to begin with and you re dipping down below 70 you could be causing undue trauma to you cat. Just a thought."

Personally, I don't get my Morris' blood checked at the vet unless he is sick and needs bloodwork for something else. You are in a very small group that relies on their vet for assistance in regulation...the rest of us use this board as a tool for regulation because it has been proven time and time again that the "board" knows FD better than most vets. :thumbup

When your vet says below 70 is the danger zone, they are probably talking about below 70 on the feline calibrated meter, which equates to 40 on the human meter, which is not exactly a danger zone might need to be fed to be brought up a few points, depending where in the individual cat's cycle you are. I have also found that a reading of 40 while using Lantus/Levemir is quite different from a 40 on other insulin.

And that statement that you could be causing undue trauma to your cat by dipping below 70 :-Q smacks very much of the vets who tell the owner that home testing does injury or causes trauma to the cat....and we all know that ain't so. :mrgreen: I am one of the ones reporting 40s and believe me Morris is nowhere near hypo. If you read my profile you will see that he has been clinically hypo more than one time, once in a coma and on a feeding tube. There is no way I would allow him to be that low if I felt he could be hypo! (FWIW those hypos were while using Humulin N without regular testing after he was regulated on N.)

I also use the ReliOn Micro and recommend it highly. Good choice!

 

Hmm, thanks for this discussion... I've been using the True2Go meter (same company that makes the True Results) and my guy has been in the blues most of the time. Hate to think that he's really been in the yellows and I'm happily thinking he's doing pretty well after a dx well in the red zone. Time to go get the ReliOn... Worst case is that they test comparably and I have a backup meter. :smile:

 

Re: 1/15 Sami - AMPS 217 - NEED Everyone's Advice

My advice is dump the trueresults meter and stick with the relions or the otu mini. All meters have a range of inaccuracy acceptable in treatment of human diabetes. They could be off up to 20%. The trueresults either is off and needs calibration or you got a bad test with it. The OTUs are known for their accuracy and so are the relions. OTUs are notoriously very accurate at low numbers, and sometimes go a little higher at high numbers. Don't drive yourself crazy with trying to find meters that will read exactly like the others. A recent consumer reports study showed that the OTUs are top ranked and the relions were a best buy. I have used all of them and refuse to use any of the "true" generation such as truetrak, trueresult or other similar names with "true" in them. These are all the same meters rebranded for drug stores and they are notoriously flaky.

 

I didn't say that below 70 was the danger zone, I said below 70 was starting to get into the danger zone. The vet has told me that 70 is fine, but when the cat starts to drop below 70 that is when we really want to watch more closely. If the cat drops below 60 then we really need to be concerned and we should begin trying to raise the BG back into the 70s. At no point did I say that below 70 was hypo, I just said that it isn't the best place for the cat to be.

If anyone of you has ever had low blood sugar you would realized what it actually does to you. I myself have had low blood sugar and it really messes with your brain. You get to the point where you can't function. When it has happened to me I have know I need to eat something, but I just couldn't get myself to get something. It is like being in a dream and not knowing how you got there or what you are doing there. It is a very scary situation and not one I would want to put on my cat if it can be prevented. I now know the signs when I am started to get low and I immediately eat something while I can still function. I almost always have some sort of a bar in my purse for just this occasion.

Everyone, please stop taking what I say out of context. I am, like the rest of you, just sharing my opinion and experiences and it is important for everyone to know each situation. Not everyone wants to be stressed over the possibility of their cat going into hypo so they need to know the alternatives and they need to know solid information from the veterinary world. Just because there are a handful of people on this board that preach a certain protocol it doesn't mean that everyone will follow it exactly, and they shouldn't be bashed if the do something, and believe something, a little different.

 

I agree with Caroyln, lose the TrueResults meter! I have seen here many times people that had problems with the "True" something meters, I have never had one myself but it seems they are quite imperfect.

It's not a bad idea to have a back up meter, but don't make yourself crazy with comparing results or defining accuracy. These meters are classified for home use / personal use and do not quilify as diagnostic equiptment. They are not extremely accurate, but they are for the most part precise. Those are 2 different things.
The accuracy of a measurement system is the degree of closeness of measurements of a quantity to its actual (true) value. The precision of a measurement system, also called reproducibility or repeatability, is the degree to which repeated measurements under unchanged conditions show the same results. We want to be as precise as possible so it is important to keep as many variables as possible unchanged. Use just 1 glucometer all the time. It's not about the individual numbers you have at any point, but the overall trends over a period of time (days, weeks). Is the number rising or falling, is it over 200 or under 100? I usually say we are looking for Zip codes and not actual street numbers.

Precision is sometimes divided into:
* Repeatability — the variation arising when all efforts are made to keep conditions constant by using the same instrument and operator, and repeating during a short time period; and
* Reproducibility — the variation arising using the same measurement process among different instruments and operators, and over longer time periods.

What is important for us the first defintion the repeatability.

The same is true for the given dose of insulin. Without a device which can measure extreme minute amounts with high accuracy it is impossible to know if YOUR 1U is really infact 1U. And your 1U may be different from mine. If I could measure that accurately maybe yours is really 1.1287U and mine is .0.9812U but we both are calling it 1U. Is that important...no, what is important is that I try to be consistant (precise) with my dose always using about the same amount no matter what I call it. It is not possible to reliably achieve accuracy in individual measurements without precision. The more precise something is over a longer duration the more likely it is that it is also more accurate.

 

Tina, I think what you're saying is offbase. Let me explain why, all right?

"I didn't say that below 70 was the danger zone, I said below 70 was starting to get into the danger zone. The vet has told me that 70 is fine, but when the cat starts to drop below 70 that is when we really want to watch more closely. If the cat drops below 60 then we really need to be concerned and we should begin trying to raise the BG back into the 70s. At no point did I say that below 70 was hypo, I just said that it isn't the best place for the cat to be. "
I think you're not realizing that the work that's been done over many years with human meters has already been accommodated in the protocol. In your experience, and according to your post, the Alpha Track runs higher than the human meter, right? So, if you're using an Alpha Track, the number that is important is something different, and higher, than the numbers the human meters use.

Another factor you're not considering is that when blood value ranges were established in the veterinary world, the numbers were taken while at the vet's office. Few animals I know ever enjoy going to the vet; and their bs are often elevated simply because of being put into a carrier, hauled through city streets in a moving vehicle, and have someone shove something up their bottoms or taken away from Mom/Dad and into the back room for blood. That alone will raise the sugar level. Any numbers the vets base decisions on will automatically be higher than what the cat normally runs, as we see in home testing.

Those two factors alone would indicate that a sugar of 70 without symptoms is not something to be considered dangerous. Those are just the numbers that the vets use to determine what sort of treatment a cat would need - a different meter (which runs higher) as well as the stress of vet visits. If the value of 70 was seen in the vets office, and one figures into the equation that the bs is elevated from stress as well as the use of a meter which measures higher...well, yeah, at 70, it's a problem in the vets office. It's NOT a problem at home.

Does that help explain it?

"If anyone of you has ever had low blood sugar you would realized what it actually does to you. I myself have had low blood sugar and it really messes with your brain. You get to the point where you can't function. When it has happened to me I have know I need to eat something, but I just couldn't get myself to get something. It is like being in a dream and not knowing how you got there or what you are doing there. It is a very scary situation and not one I would want to put on my cat if it can be prevented. I now know the signs when I am started to get low and I immediately eat something while I can still function. I almost always have some sort of a bar in my purse for just this occasion."
You're talking about symptoms. A symtomatic episode is something quite different than just low sugar numbers. Let me give you an example...we're taught in nursing school to look at the patient...not rely on machines. One day, an alarm beeped, and I looked in on my patient. His blood pressure was 63/37. According to the book (and the Drs), he should've been dying - cold, lethargic, non-responsive, slow/non-existant heart rate. OTOH, when I looked at him, I saw a patient reading the morning paper, sitting up in bed, drinking a glass of water. When I asked him how he felt, he said "fine, what're you worried about?" I stuck my stethescope on his chest, and his heart was sounding fine. I left him be - yes, I called the Dr., but my patient was not experiencing any symptoms of a low blood pressure event, let alone a life threatening crisis (which the numbers said he should be having).

Another story: I tend to run low on my blood pressure. 100-105/58-62. That's just how my body works. So one day, I had a bad, bad headache, and felt really strange. I had the CNA run a blood pressure on me - and it was 130/72. Very, very high according to how my body works ("the baseline"), but still, on the books, a nomal reading (albeit a tad high). I immediately called my doctor, he saw me, and sure enough, I had an infection (in my sinuses...), and dealt with it. Shortly after starting treatment, I took my BP again...and was fine.

Both of those stories are to illustrate the point that while there are hard and fast rules about numbers in medicine, someone can indeed be, according to the books, fine and have a problem, or dying and not show any evidence of impairment whatsoever. Monitors are simply tools - look to the patient to see what's actually happening. In your example I highlighted, you were experiencing symptoms of a hypo event. If a patient is not symptomatic, no treatment is necessary (most of the time), but it does bear watching. "What is the patient experiencing" is what I run my life by - if they have no symptoms, then I'm probably not going to run and get the crash cart. If they tell me "wow, that's higher than usual for me" and the numbers are "normal", I'm going to listen to the patient.

I've had Esse go as low as 39 without any symptoms. I went by the book, and panicked. She just looked at me. LOL.

More in the next post...

Best-
Michele

 

I was using the True2Go Meter for a short time. If you look at Magnolia's SS, that big chunk of blues in November, were all from that time. I support the switch to a better meter. It's nice for the bean's peace of mind to have low numbers, but if they aren't real, it's not helpful.

 

"If anyone of you has ever had low blood sugar you would realized what it actually does to you. I myself have had low blood sugar and it really messes with your brain. You get to the point where you can't function. When it has happened to me I have know I need to eat something, but I just couldn't get myself to get something. It is like being in a dream and not knowing how you got there or what you are doing there. It is a very scary situation and not one I would want to put on my cat if it can be prevented. I now know the signs when I am started to get low and I immediately eat something while I can still function. I almost always have some sort of a bar in my purse for just this occasion."

Yes, I know exactly what it feels like...I get low blood sugar as well...symptomatically that is. If I test myself during one of my episodes, my readings are fine, usually between 100-110, which is actually a bit high but I was diagnosed as pre-diabetic so I DO run a bit high. I have been this way all my life...protein is the answer though, a sugary bar just sets you up for rebound.

Just my opinion...YMMV.

 

Good morning to you Tina & furbaby Sami too!! I use the ReliOn Micro, I am a newbie & this is the only meter I have used - I love it. Consistency is key - so using the same meter will let you know the #s for that meter & your kitty - I cannot even begin to imagine using multiple meters, I don't feel I would ever really know the true # :?

I am sooooo jealous of you getting to take your furbaby to work & living so close to work! That was my biggest concern initially - not being here if she went hypo - now two weeks into it, I don't worry so much - I see where leaving food out is working & that Lantus does not cause the #s to bounce around so much.. very slow & steady, plus we are on such a small dose. The next month will be cRaZy busy at work & I am worried about being able to run home & give her shots.. I will be working a lot - living close would help out so much!! ;-)

Happy Caturday to you both & have a fabulous day with beautiful #s!!

 

Tina said: "Everyone, please stop taking what I say out of context. I am, like the rest of you, just sharing my opinion and experiences and it is important for everyone to know each situation. Not everyone wants to be stressed over the possibility of their cat going into hypo so they need to know the alternatives and they need to know solid information from the veterinary world. Just because there are a handful of people on this board that preach a certain protocol it doesn't mean that everyone will follow it exactly, and they shouldn't be bashed if the do something, and believe something, a little different."
No, no-one should be bashed if they believe something different. But reliance on a vet, when they don't know something, or are not specialists, without questioning it and finding out what works for the cat...well...that's blind and can kill. Most diabetic cats' owners don't home test. They're scared of it. Vets have recommended to pts cats simply because of diabetes.

My first vet nearly killed Esse - and would have, if I didn't have medical experience and didn't know how to think independently. Another vet thought that I was testing far too often, and basically accused me of torturing/abusing my cat. And a third vet wanted me to start at 4U bid of Lantus..., but never shoot anything under 300. I finally found a vet who not only respects the fact that I am "unusual" in that I test often, but is willing to work with me, and understand that I have certain medical knowledge already and can deal with things as they arise. She is willing to learn, and knows of/approves the Rand/Roop protocol...and encourages me to use it.

No, not everyone wants "the stress" of a hypo event. But we also want our cats to be healthy, or as best they can be given the diagnosis. The problem that arises is what is a hypo event? Is it by the numbers? Or is it by the patient? And if by the numbers, according to the vets venous puncture data (with it's inherent elevation), or by our meters we use at home? That's the question...

And I've found that for me, the answer is that if Esse is sypmtomatic, she's hypo, no matter what the meter says. I do have difficulty when I see numbers in the 60s, but don't start treating until I see the number at 50 or below. And even then, I let Esse "tell me" what she needs.

And I have to say the comment upthread about the "forum police" bugged me. You're very new, and I appreciate that. But to call people "forum police" because they're trying their best to teach you - and prevent you from inadvertantly harming others - is distasteful to me. I am sorry to say that, I truly am. But I also think it needs to be said: please stop giving advice. I'm sorry if that bothers you - I really don't mean it to. I just want you to learn how to do the protocol, and get your cat under control...that is enough for now, don't you think?

And I really am sorry if that last comment hurt you. I really don't mean to hurt your feelings...

Best-
Michele

 

some comments on this thread have certainly provoked lively discussion! many points to ponder. there are many discussions similar to this on the "old" board. the search function on the old board isn't the best, but there's a whole lot to be learned from prior threads. anyone/everyone is welcome to start meter discussion on Think Tank... if you'd like.

this also might be a good time to review Suggestions for Advice Givers

i'm going to close this thread. it's a new day and time for tina to set up a new thread for sami.
have a good day...