One Touch and Alphatrack? Accuracy at low numbers???

Hi all,

I changed Bertie's diet nearly 2 months ago (upgraded to a better quality low carb wet food) and his numbers started to fall. We're seeing the best numbers we've had in nearly 6 years! :shock: And the numbers are much more stable with nice flat curves.

We're seeing a lot more lower numbers (unusual for us!) and I wanted to know how accurate those readings are. According to my One Touch Ultra 2 Bertie is spending most of the day in 'normal' numbers. But after reading a thread the other day about the accuracy of 'human' meters I started to wonder how valid my readings were. I understand that 'Alphatrack' meters are more accurate, and so I bought one... Although I can't afford to use it all the time (Bert has a lot of tests) I had the idea that I'd use it if his numbers dropped low, so that I can get more accurate readings when it really matters.

If the Alphatrack is accurate then I've been deluding myself about keeping Bertie in 'normal' numbers for most of the day. A 6.5 (117) on my One Touch measures as an 8.5 (153) on the Alphatrack. That's a little disappointing... but certainly worth knowing.... :-|

My real concern, however is about the lower numbers....

Yesterday evening at PMPS +3 Bertie gave me a reading of 3.3 (59) on the One Touch, and his BG was dropping at the rate of 2mmols (36) per hour, with about 2 hours to go until nadir.... So, it looked like I needed to take some action to stop him dropping too low and risking hypo. But I then checked his BG on the Alphatrack and that was a 5 (90), a way safer number that might only require me to monitor him and see how things go... But it really left me in a quandry about which meter to believe.... :?

I guess what I'm asking is: Should I trust the readings on the Alphatrack? I don't want to put Bertie at risk, but I DO want to get the best numbers for him...

Any advice would be greatly appreciated....

 

I'm sure I've read that the cat calibrated Alpha Traks read about 2.0 UK points/ 40 US points higher than the human meters. So because we've all been used to human meters we have just got used to working on human meter numbers. So a reading of 6.0 is still 6.0 as we regard it on this board, and as we think of it as being 'normal' because we work on the presumption that human meters are used. So it makes perfect sense that an Alpha Trak will be showing about 2.0 higher. If that makes sense...?

ETA: Sunday morning, haven't long been awake. On re-reading, perhaps I didn't explain that very well.

What I mean to say is that feline diabetes caregivers have over the years developed a range of numbers and categorised them as 'low', or 'normal' or 'high' based on the use of human meters. Now that a cat meter has been made available, it has been discovered that they read a certain amount higher than the human meters. But that doesn't mean that the BG is any higher. In fact, I'm sure I've seen it written somewhere on the board to mention on spreadsheets if you're using an AlphaTrak, as otherwise people will presume that the BG readings are human meter ones, and not account for the ~2.0mmol/L (40mg/dL) difference.

H

 

Hello both - thought I'd post as we have been using an AlphaTrak 2 with Monty since he was diagnosed. I don't have anything to compare it with (other than the initial readings in the vets, which were so high they were silly) but we've found it to be really excellent and accurate insofar as the readings we get seem to correspond to Monty's behaviour. When he was coming off insulin, we were testing through the day and Shaun noticed that he seemed sluggish and sleepy - tested and he was 1.8 - so quickly gave him some food and all was fine.

Helene - I saw your post about the numbers - so when I say Monty is about 5.5 on his Alphatrak does that mean that for 'board' purposes he's actually about 3.5? And is that still ok??

C
xx

 

PS Elizabeth - I did find a slightly more reasonable place to buy the Alphatrak test strips online - I think from our vet they were in the region of £45 for 50 (ouch!) but at Animed I think I got them for more like £32 ish. Still not cheap, but a bit better!!

 

I think there's on average a 30 point difference, with the AlphaTrak being higher - so for example, below 50 on a human meter is hypo, and below 80 on an AT is hypo. They do read a bit higher but human meters aren't necessarily inaccurate. Just remember to put somewhere on your spreadsheet/signature/post when you've used an AlphaTrak so people know to compensate for the slightly higher readings.

 

I've just got to pop out for an hour or so, when I get back I'll locate the source of that info, hopefully it will shed a little more light on whole thing!

H

 

OK, thanks folks, I think I understand... Ummm....no I don't, actually.... :dizcat

I know that the Alphatrack reads higher than 'human' meters, but does it read more accurately?

What I mean is, when I tested Bert last night at +3 was he actually around 3.3(59), the reading according to the One Touch; or was he closer to 5(90), the reading according to the Alphatrack? One number required action nailbite_smile and the other probably not.... :?

 

Aha..., so if that's the case the Alphatrack gives readings higher than they really are...? (Since an actual '80'(4.4) is just a nice, safe normal number....)

So, maybe this Alphatrack meter is of no use to me. I wrongly had the idea that it would give me more realistic readings........ :roll:

 

Elizabeth,

I asked a similar question a while back. One of the replies stated to pick one meter & stick with it. That is what I ended up doing. I use the Relion Comfort and keep my AlphaTrak as a backup. It allowed me to focus on Lizzy, her behaviors and her number patterns instead of the meter.

Andy

 

I've sent you two PM's......please look for them.

 

I would have thought that it is the AT that is giving you the accurate result because it is calibrated specifically for cat (and dog) blood.

 

More accurate to the exact number... maybe. But necessary? No... we do everything largely based on number ranges anyway. Human meters will do just fine and they are far more affordable and supplies are more readily available than the AT. If you like the AT and can afford it, by all means continue using it! But it was just too expensive to justify for me, especially when I was testing upwards of 7 times a day!

 

Got 'em. Thanks so much, Hope! :smile:

 

Eliz - can't add anything to your thread I'm afraid, but just wanted to take my hat off to you for your continued dedication to Bertie's welfare after six years... well of course we would all do anything for our cats and I try to keep up, up to a point, but my head hurts from all the debates and actually I wonder if you should simply follow your gut instinct about what to do here? As is so often said, what is right for one individual isn't necessarily right for another, so if it were me I'd probably do whatever felt best... not very technical I'm afraid, but that's what I would have to do as I don't "do" numbers - seriously :dizcat

I think what I mean is don't make it harder on yourself than you need to, if that makes sense. Actually I don't think it does, what I am really trying to say is that you've been doing a brilliant job for so long, don't derail yourself now...

This is no help at all I know, sorry, just wanted to say hi and will see you soon. Off now for a glass of wine - think you should have one too!
xx :YMHUG:

 

Okay so here are the threads where I've noticed info regarding the differences between the AlphaTrak and human meters:

viewtopic.php?f=10&t=79819&p=862338&hilit=Alpha#p862338

viewtopic.php?f=28&t=83188&p=894736&hilit=Alpha#p894736

viewtopic.php?f=9&t=79803&p=865305&hilit=Alpha#p865305

viewtopic.php?f=28&t=82506&p=889027&hilit=Alpha#p889027

viewtopic.php?f=28&t=80867&p=872254&hilit=Alpha#p872254

No reason to read them all, but it's enough to show that the general consensus is that that AlphaTraks run between 30 and 40 US points higher than most human meters.

So...as had already been stated, it seems a good idea to just chose one meter and stick with it. Because the Alpha runs higher than human meters, it might give a 'truer' reading for actual feline BG. But that doesn't mean it is neessarily more accurate - a OneTouch meter could be just as accurate, but run those few points lower than the Alpha.

Don't get hung up on it, just keep in mind there is a difference, and that doesn't necessarily mean one is correct and one is incorrect, it's just a difference in calibration.

Basically, whatever it is you are doing for Bertie obviously works - so continue with it!

H x

 

I have been using AlphaTrak for 4.5 years. I have dabbled in the human meters and always went back to AT for various reasons (a discussion with links is in the Think Tank - titled "Meter Comparison: AlphaTrak and ReliOn Micro").

That being said, if I were to give advice to someone thinking of switching to AT, I would encourage them to figure out how to customize their human meter to their cat's BG levels and to go forward using the human meter. Reasons:

- Unavailability of the AT strips - you have to either get them at your vet or online, can't just run to Rite Aid in the middle of the night if you need to.
- Inflexible - You feel as though you are "roped in" once you start with the AT.
- Cost - the cost of the AlphaTrak test strips is kooky

 

Gosh what a wealth of info in all those answers... Thanks all.... Will study all that over the next few days...


Diana, thanks for the vote of confidence, you are a dear chum and an absolute sweetie! (Haven't been able to email you cos my computer has broken down and I need to get your address from there! (Am using Chris's puter at the moment....)) Yes, definitely off for a wee glass of something alcoholic now... drinking09 Cheers!

 

Makes sense to just stick with a cheap but accurate human meter & mentally add 30 pts to the number.

I'm just at the closely monitoring stage for a recently diabetic cat now apparently in remission. He's running numbers off insulin in the 80-100 range on a onetouch ultramini. So if his numbers on an alphatrack would be 110-130, it's still not the end of the world. May be a bit above normal for a non-diabetic cat, but by any measure this is tight control.

When I was giving insulin, I was going by the information on Hodgkins' board where the suggestion was to buy a human meter and the sliding scale was based on a human meter anyway.

Cats seem very tolerant of hypo. When I was actively controlling sluggo's BG numbers, I saw a 47 once where he had absolutely no apparent ill-effects, and a 42 where his walking seemed perhaps a bit "drunk". In each case, I simply fed him. Pushing the panic button & giving molasses, honey or caro syrup wouldn't have been the right thing to do in my thinking. And these numbers were with the onetouch ultramini.

 

Hiya,

Yes, some cats can indeed be tolerant of low numbers (every cat is different (ECID)). But we have had cats on this forum who have suffered brain damage or even death through hypo; not often, but it happens. (And it has usually been people new to the forum). But even cats like mine, who eat a low carb wet food diet can hypo (some folks think that's not possible...). Bertie has previously had a rather nasty hypo, hence my concern about the accuracy of meters at low numbers.

And it's not just what the number is, but where it is in the cycle. a 47 (2.6) at the peak of the cycle might be highly desirable if you have tight control of your cat's numbers (and your cat is OK at that number). A 47 (2.6) an hour or so into the cycle is a whole other matter....

I would caution all people new to feline diabetes to be extremely cautious about low numbers and hypo symptoms ("Better high for a day, than low for a minute".) For those with experience, who have the ability to test often, and who know their cat's responses to insulin (and low numbers) really well, then that's maybe a different thing. :smile:

 

Average non-diabetic feline blood glucose ranges from 57-79.

http://petdiabetes.wikia.com/wiki/Blood ... guidelines

And if that's a true blood glucose number, it would range from 27-49 (taking a difference of 30 from alpha-trak) to 17-39 (difference of 40).

In sum, you may see a range of 17-49 in a normal non-diabetic cat using a human meter. Those are "shockingly low numbers", but from discussion of difference with the alphatrack, it's what you get. I'm not suggesting aiming for those numbers in a diabetic cat. No sane person would. On the other hand, allowing the blood sugars to remain in the range many vets recommend (200's for weeks on end) may make remission of the diabetes impossible as the pancreatic beta cells get completely replaced by amyloid and may doom the cat to a lifetime on insulin. Your best chance for a quick, easy remission is very tight control early in the process.

I just got a reading of 50 on Mr. Sluggo who's been off insulin for about a week now, so he's still running a bit high. But his random sampled numbers are settling down toward the normal range.

I think the bottom line is to be a bit sensitive to how your cat looks & acts. After a time, correlating the number with the behavior, you'll get a better idea how to react. Otherwise, you're just treating a number and that's bad medicine. In my cat, on my meter, high 40's is just fine. Low 40's is beginning to get into trouble.

Agree with the importance of point in the cycle. But when I was dosing insulin, I was always using PZI and both checking and dosing @ 6 hours. Hope I don't have to do that again soon. What a pain!

(I'm an MD, not a DVM).

 

Others have addressed the difference between numbers between human meters and the Alpha Track.
Here is my two cents on accuracy (with no real knowledge of Alpha Track meters).

Human meters can have a 20% variance. That means that the "real" number could be 20% above or 20% below the number you see. For example, 100 could be 80 or 120. I'm sure the Alpha Track is the same. Why do I sat that? If the company that makes Alpha Track could get the variance to be less than 20%, I'm sure they would start marketing human meters too! In fact, if the variance eventually DOES improve, my guess is that human meters will have it first.

And really, you are looking for trends when you test - warnings that numbers are going too low, too high or just plain erratic. The number, plus the way your cat is acting, lets you know where you stand. So picking a meter and sticking to it seems to work the best for most people here.

 

What you've said here is completely consistent with what the science says concerning humans and blood glucose meters. For all their flaws & inaccuracies, humans who stick with a blood glucose meter do better in terms of long term complications than those who do not. All I'm saying is that you need to fit the data into a bigger clinical picture. If you have a cat with a 490+ BG who looks and acts just fine, aside from giving some insulin, you really don't need to do anything else (faced that situation while mine was ill). If you have a cat with a 410 who looks & acts sick, you need to RUN, not walk to the vet or even emergency clinic. And it may just be my professional experience with the human animal, but I tend to place much greater trust in that bigger clinical picture than a number from a glucose meter, though I must concede such advice may be dangerous for those who can't tell "sick" from "not sick".