Questions: glargine expiration and ear poking

[Kristin Boel]

Hello,

Let me preface this by saying I haven't shot since early September and there is a gap in time on my spreadsheet because his numbers were consistent until somewhat recently. He's had some spikes above 200 and some lows registering on the Libre. I don't have complete confidence in the Libre, so I got the AlphaTrak3 kit and started it yesterday. Tonight is the first time I've successfully gotten enough blood for it to read and the results were a little alarming (but if I've learned anything from this forum, it's not to immediately freakout): AT3=193 and Libre=167. I tried another poke a few hours after that, but he wasn't having it, so we'll try again tomorrow. I'd like to start my own glucose curve and compare the two methods to get a better feel for the variances. With that being said:

1. I have poked him a small handful of times in the ear using the lancing device/pen and my question is - it appears that there is some discoloration or possibly bruising forming in that area? I can only assume this is normal and of no concern, correct? Should I be constantly switching spots?

2. The date on my glargine is 8/16/24 and I see no expiration date on it. It's been in my refrigerator the entire time. Is this still good or should I get fresh?

Thank you in advance.

 

[Bron and Sheba (GA)]

the lancing device/pen and my question is - it appears that there is some discoloration or possibly bruising forming in that area? I can only assume this is normal and of no concern, correct? Should I be constantly switching spots?

Are you holding a cotton ball over the pricked spot for a minute ? This can help stop bruising. I think it is a good idea to vary the spot you prick.

The date on my glargine is 8/16/24 and I see no expiration date on it. It's been in my refrigerator the entire time. Is this still good or should I get fresh?

The glargine should last 6 months after opening if it is kept in the fridge

looking at your SS I think you should be giving a small dose of insulin. We like to see green BGs for 2 weeks before stopping insulin.
I think you could try 0.25 units twice a day and see how you go.
I’ll just tag @Wendy&Neko to see what she thinks about the dose.

 

[Kristin Boel]

Thank you for your info on the expiration, I will write that on the box. I have not been holding anything over the spot after testing, but I will definitely try that! Thank you. And yes, I have considered .25, but I was nervous because his PS most of the time was around 150 range. Looking back at August's and even September's #'s they seem to be coming up now slightly, so I think I'd be more comfortable shooting. Especially w/ being able to manually test (although I definitely need more practice) and having more knowledge of how to handle potential lows. It's been such a stressful learning experience!

 

[Sienne and Gabby (GA)]

Usually there is an expiration on the pen or on the box. The expiration is typically quite generous based on when you purchased your glargine.

Also the difference between the AlphaTrack and Libre readings is negligible. There can be up to a 20% difference between even two back-to-back readings on the same glucometer. There can always some degree of measurement error that is inherent in either the glucometer or strips/sensor.

I agree with Bron. I don't think Dodge was ready to be off of insulin. We typically look to see numbers in the 50 - 120 range (and mostly in "green" numbers) before suggesting a remission trial. We also taper down the dose.

 

[Wendy&Neko]

The AlphaTrak is a meter designed for pets whereas the Libre is a human meter. Most of the time, the human meters read lower than the AT. What you are seeing is normal variance. The two types of meters tend to be closer in lower numbers, where it counts.

I agree that Dodge could use a small dose of insulin. Just start back when you can monitor.

 

[Lisa and Witn (GA)]

Also you can try poking the ear with the lancet without using the lancet device. Many of us have found that is easier and gives you more control over where you poke the ear.

 

[SmallestSparrow]

Just a quick note on the Alpha Trak—it uses an extremely tiny bit of blood (compared to my human meter at least) which is not to say you’re skill is lacking but rather it may be your timing. If you’ve used a human meter before (or even if this is your first meter) there may be a sense that you need to rush to get a sample. The AT has a long delay before it’s ready to accept a sample, which I actually appreciate because it seemed I had to race while wrestling a cat with the human meter.
But when I first started using thevAT I rushed, grabbing the meter and collecting a drop as soon as it beeped. Then I got an error code. I went through three strips (cursing AT bc I’d never had such problems with a human meter) before I realized it beeped as it started its process, and would flash icons to insert strip, then the pet code, and finally the blood drop and strip icon. I had to wait until after the pet code, until it showed blood drop/strip icons, to collect the sample. The error code wasn’t that the sample was too small, it was bc I’d put the sample on too soon.
Their ears do grow more capillaries with repeated testing so it does get easier.
A high value treat available only after ear pokes helped

also as noted above there is not only variance in how one meter may read the exact sample, but there is variance between how a per meter and human meter reads pet blood. This is because of how much glucose is stored in the blood cells. Human meters were designed to read human blood, and tested before approval and release on humans. Pet meters were designed to read pet blood (with its difference in how glucose is transported) and tested before release on animals (this is why you need to make sure the AT is coded for the correct animal; also make sure with each new vial you’ve coded for that new vial/animal).
Because this forum predates the release of pet meters, and because most here prefer human meters based on cost, you can get used to seeing cat blood read on human meters (generally the number is lower) which can make numbers you see on an AT feel “high” because the standard referenced here is cat blood on a human meter. I wouldn’t try to compare the numbers myself. The good news is there’s a 10% accuracy standard for AT for values of 100 or higher, meaning the number you see on the meter plus or minus 10% is likely the number you’d see in a lab test. Below 100 it’s +/- 15mg/dl.