Compared results between AlphaTrak, ReliOn and Tru2Go meters

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d0zivyhoo

d0zivyhoo

Member Since 2012
I just returned from the vet's office for my kitty's official BG curve, and they were nice enough to use my two meters, comparing the results with their feline calibrated Alphtrak. The vet is a large speciality hospital, and I have faith that they keep up their meter calibrations.

In full disclosure, they used a leg vein to get the results, not capilaries from the ear. Can anyone tell me if that makes a difference?

Anyway, the differences between the meter readings are quite vast, I'm afraid. Here they are.

The first set is the Alphtrak result divided by the other meter (so, you would need to multiply the human meter reading by the meter's number below to reach the feline calibrated result:

Tru2Go (Walgreen's - highly rated by last year's Consumer Reports, but not this year): 2.046511628; 2.256410256; 2.020408163; 2.341772152; 1.876404494
ReliOn Micro (Walmart - highly rated by this year's Consumer Reports): 2.588235294; 2.2; 1.571428571; 1.439688716; 2.226666667

The next set is the meter subtracted from the Alphtrak results in actual points:

Tru2Go (Walgreen's): diff. 45; 49; 100; 212; 156
ReliOn Micro (Walmart): diff. 54; 48; 72; 113; 184

I've been told by several people in this group to just add 30 to the human meter results. However, that's even worse to come up with some sort of calculation to receive the correct results:

Tru2Go (Walgreen's): 1.205479452; 1.275362319; 1.546875; 1.968085106; 1.605769231
ReliOn Micro (Walmart): 1.375; 1.257142857; 1.269230769; 1.289198606; 1.855555556

And, again, the difference in actual points:

Tru2Go (Walgreen's): diff. 15; 19; 70; 182; 126
ReliOn Micro (Walmart): diff. 24; 18; 42; 83; 154

I suppose I could just double the results from the Tru2Go. However, the ReliOn is all over the place, and, its reliability was rated by CR as excellent.

If you'd like to do your own calculations, here are the actual numbers:

AlphaTrak: 88, 88, 198, 370, 334.
Tru2Go: 43, 39, 98, 158, 178
ReliOn Micro: 34, 40, 126, 257, 150

I only had level 1 for the Tru2Go control liquid, but it tested within the correct range. The ReliOn control liquids are on order, so I haven't yet done the control on it. The ReliOn is brand new. The Tru2Go was received from this group.

I would really like some feedback on this issue. I may very well spend the bucks and purchase an AlphaTrak just to be safe here. In the meantime, I'm thinking of using the Tru2Go and double the results.

DZ and Sarah
 
Re: Compared results between AlphaTrak, ReliOn and Tru2Go me

Home glucometers are intended to give you a clue, not an exact number. In measurement (I've taken these classes), there is always some error.

The question is: Is it good enough? The FDA says being within 20% of the true value is good enough for glucometers.

Now, +/- 20% is a range. It gets bigger with higher numbers.
100 -> 80 to 120
200 -> 160 to 240
300 -> 240 to 360
Etc

This is really not a problem because too high is too high and you adjust doseage following the protocol. Too low, however can be immediately dangerous and you can see that. If you need added safety, take 2 measures when low and the "true" value likely will be in the overlap area between them.
Ex 40 -> 32 to 48
vs 50 -> 40 to 60

Take the low value of higher range and high value of the lower range for the rough range of "true" value.
Between 40-48 is where the "true" value of this example likely is.
 
Re: Compared results between AlphaTrak, ReliOn and Tru2Go me

Hi DZ - I am a math nut too, so I can understand exactly why you are doing this! :-D However, BJM left some good guidance. Glucose meters are not exact devices like calculators or rulers. The actual BG is within some range of accuracy provided by the meter. As BJM showed, the +/- 20% range means that the actual value is really unknown - it could be any value within that range. So, a "100" on the meter is really the same as getting a 120 - there is a lot of slop in the numbers, so comparing them so exactly isn't correct.

For the numbers you provided, the Tru2Go and ReliOn actually *agree* for all data points except one, and I'd argue that the ReliOn is more consistent in trending to the AlphaTrak than the Tru2Go is. BUT - there really isn't enough data to really do the stats for this. Here are the meter values and the corresponding +/- 20 ranges.

Tru2Go Range (low-high)
43 (34-52)
39 (31-47)
98 (78-118)
158 (126-190)
178 (142-214)

ReliOn Range (low-high)
34 (27-41)
40 (32-48)
126 (101-151)
257 (206-308)
150 (120-180)

Let's compare. So for the first data point the Tru2Go meter read 43. So the *actual* value is somewhere between 34 and 52. We don't know, but any one of the values in that range is possible and "correct.* For the ReliOn meter reading of 34, the *actual* value is somewhere between 27 and 41. Since both meters were used with the same blood sample at the same time, then we can look at the overlap in the two ranges to see if it's possible that the two meters are actually displaying numbers that agree with one another. So compare the ranges. The BG according to the Tru2Go is anywhere between 34 and 52. The BG according to the ReliOn is anywhere between 27 and 41. Therefore, if the *actual* BG value is anything between 34 and 41, both meters are "correct," and likely this is the case. The meters "agree" on this data point.

If we repeat this exercise for all 5 data points, you will see that the two meters actually agree on 4 of the 5 points. Only the 4th data point has no overlap, so the meters don't agree on this data point. We don't know which is correct.

So let's take this one step further ... since we know the doctor was doing a curve, we might think that the ReliOn value of 257 is wrong because curves start high, go low, and then come back high, right? (Well, that's IDEAL only!!!) ANYWAY ... look at the AlphaTrak values. The AlphaTrak *also* has a higher value for the 4th data point, so having all three sets of data points, I would guess that the ReliOn is better than the Tru2Go.

HOWEVER!!!! Big Disclaimer - There isn't enough data here to select one meter over another. This is purely anecdotal evidence of one curve. To do a true comparison, you need many many data points over a wide range of values so you can do some statistics. The only take-away from this discussion so far, is that the two meters agree except for one value.

Next ... I would caution you very strongly against taking one meter and doubling the results. I'm not sure why you are dividing values from one meter as compared to the other. That's not how it works, and you have essentially no data to support this. Again, it would take boatloads of data to see if this relationship held over a wide range, which I doubt. I think this is coincidence and should be treated as such.

Here's the bottom line *in my opinion.* Pick a meter with good reviews, especially from people around here. Use it consistently and trust the trends and try not to get hung up on individual values like 70 vs 80, because they are essentially the same value. You will learn how your cat reacts, you will learn how to steer your cat with food, when to make dose adjustments, etc., by sticking with one meter. If you feel that you need to purchase the more expensive one because that's what makes you feel comfortable, then do that. But don't do it because you think it is more "safe" based on this very small data set.

Disclaimer - I use the ReliOn and I am very happy with it. It's inexpensive, the strips are a lot cheaper, I have two (one as a backup) and I can get the supplies online or in person. If the meter is different from another meter by 30 points [edited to add clause], I care less about that than seeing the trends in BG values. If I get a value that doesn't make sense, I test again.

Hope this helps, feel free to PM me with questions if I don't reply back here,
Lisa
 
Re: Compared results between AlphaTrak, ReliOn and Tru2Go me

Thanks so much for all of the feedback.

I guess my concern is that I feel like I'm still flying blind. How anyone is able to make determinations based on all of the inaccuracies is really impressive to me, because I just can't do it. And, yes, I am a bit of a mathematician, so I require exact and accurate data.

So, I will probably shell out the bucks for something more accurate. If my kitty didn't have all of the other issues to look after, I might be satisifed with the averages. However, having 2.5 diseases that are polar opposites in dietary requirements forces me to be much more exact if I'm going to bother with tight regulation.

Regardless, I know all of your calculation examples definitely will help someone who doesn't have to be as anal as I.

Thanks again!

DZ and Sarah
 
Re: Compared results between AlphaTrak, ReliOn and Tru2Go me

DZ, you're going to drive yourself crazy trying to do this!!! Many of us have already tried this - I was given 5 different meters by a WONDERFUL person that lost their diabetic mother. I used them all and tried to compare results but all I did was confuse myself. I did discover that the lower the number, the closer they all agreed. You're truly looking for the TREND of the numbers as well as a number that's too low. If you get hung up on each specific number, you'll miss seeing the overall trend. Just choose one and go with it. My meter of choice is the ReliOn Confirm, my preferred backup is either the Beyer Contour or the WaveSense Pronto.

BIG HUG!!!
 
Re: Compared results between AlphaTrak, ReliOn and Tru2Go me

Short of lab equipment, you are not going to get exact results, not even with the AlphaTrak. And even lab equipment that has been calibrated, tested etc., will have error in the measurement (for those with the stats background, its the SEM - standard error of measurement) because there is no such thing as exact, only exact to a certain number of decimal places.

If you've got the money to spend and can keep testing supplies stockpiled on hand in case issues arise (because you can't get AlphaTrak supplies over the counter, in an emergency), that's great. Many of our members are struggling with the costs and using human glucometers has proven to be good enough; Dr Rand, University of Queensland, worked with the German Diabetes Katzen group to develop protocols using human glucometers, understanding that you only need good enough, not perfect.

Dosing protocol for cats on glargine or detemir using daily home monitoring of blood glucose concentrations to adjust insulin dose
 
Re: Compared results between AlphaTrak, ReliOn and Tru2Go me

Ahhh BJM's link explains a lot! The numbers we're looking for (ie not going below 50 or so in the green zone etc) are for the results we get using these human BG meters! If we switch to AlphaTrak meters....the danger zone changes....don't want to go below 80 or risk hypo etc. The fact that the meters are more accurate once we're getting into the blues and greens does give us exactly what we need, a safe zone to shoot for to keep our cats healthy.......

I do know just what you mean....I did my own little test of Relion vs truetest meter and found that truetest was great with sugar water, but the Relion was better with blood (compared to the vet's values).....both were very close once you got below the 200s BG.
 
Re: Compared results between AlphaTrak, ReliOn and Tru2Go me

too many words....

Alphatrak/pet meter .... OK, but EXPENSIVE strips, and measures higher than human meters.

Relion human meter .... quite fine, reliable, and very economical, but available only in the US.

Tru2go human meter .... crap crap crap... total waste of money.


My favorite meter of all time is the Bayer contour, and my backup meter is the OneTouch meter.
Being Canadian, I cannot purchase any Relion meters.
 
Re: Compared results between AlphaTrak, ReliOn and Tru2Go me

Thank you everyone for taking pitty on me! I am just so exhausted by all of this: not getting much sleep due to dealing with testing, food mixtures and injections as well as taking care of a husband who just had a knee replacement.

What I'm learning from all of you is to just use the meter to make sure kitty doesn't hypo and to watch for trending. So, I guess I'll just be happy with that.

The interesting thing is, based on threads I've read in this group, I totally ingnored the vet who requested I start with 2 units BID. I started with .5, then worked up to 1.5. And, it's a darn good thing, because what the vet saw caused her to knock it back to 1 unit BID.

I can only imagine if I had dutifully followed her instructions. I am so thankful for everyone's coments here!

DZ and Sarah
 
Re: Compared results between AlphaTrak, ReliOn and Tru2Go me

You don't need accuracy in a meter---you need consistency. As long as your meter is reading in consistent range (human meters must read within 20%), then you're good. You're not looking for exact numbers--you're looking for ranges and trends over a period of time, so getting a 200 one day and a 215 the next makes no difference, because you would treat both of those numbers in the same range when determining dosing from the protocol.

I wholeheartedly agree that you should pick one meter, and stick with it for every test (you can keep the others as emergency backup). What you want in a meter is consistency, and to be able to afford enough strips to test as frequently as needed (at least 3 times a day, but probably more). If I were you, I'd pick the Relion--it has good ratings and some of the cheapest strips around. Many, many people use it here because of those reasons and have had good results.
 
Re: Compared results between AlphaTrak, ReliOn and Tru2Go me

Hey DZ good for you for starting low--always be unafraid to question what the vet tells you to do. I have found so many multiple instances of multiple vets misdiagnosing or mistreating or misprescribing for diabetes, kidney disease and heart disease.

The collective info you get hear will really teach you more than what one lone vet claims...especially when it comes to daily treatment of chronic diseases. The vets simply don't know the nuances like we all do--on every disease and on everything from needle size to dosing. And they all seem to to tend overdose, sadly. I think it's because no animal is every in a vet long enough for a low dose to settle in and so they just keep raising it till they see dramatic 'ideal' numbers--when in fact that's too much and when the cat goes home and continues on that wallop he will hypo, as often happens. But then very few people know this because their vets tell them NOT to do hometesting--to only look at urine, which tells little.

And many people's cats die soon after Dx. Most of us hear have had cats live a very long time with Db. My Fred lived 5 years withDb--till 20. I never once, not once, gave him a shot of insuin without first testing his BG. So in over 3600ish shots, he never got one without being tested. Most vets do not say to do this which is malpractice imho.
 
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