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  #1  
Old 03-17-2011, 05:23 PM
piperknitsRN piperknitsRN is offline
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Default new to list;alpha-trak and glucose curve questions

Hi:

I recently acquired a diabetic rescue dog who is in foster and I hope to adopt. His name is Tucker; he's a five-year-old Westie and cute as a button.

I just started doing blood glucose checks with the alphatrak system and today am doing an every two hour blood glucose check for a curve (or rough estimate, any way). (He gets insulin twice a day twelve hours apart)

I've noted his foot pad reads higher than the lip reading (when tested consecutively) by about 15 pts. Has any one else noticed this discrepancy? I make sure to wipe the inside of his lip with cotton or paper towel to make sure the saliva doesn't dilute the reading.

I've also noticed an odd trend. This 6 a.m. his blood sugar was 199 prior to eating. Two hours later, 104; two hours after that 164, and it has gradually been declining. At the peak of his insulin (or what should have been) around 2p.m., he was 144! At the 4p.m. mark his paw pad reading was 94. He isn't showing any signs of hypoglycemia but I gave him a treat any way, since I don't think he's been that low.

His nadir doesn't seem to be following the hypothetical peak action of his inuslin (NPH).

Has anyone else had trends that lead them to become suspicious about the readings and accuracy of their glucometer? I wonder if this is a user error issue, but the alphatrak doesn't take much blood.

I go to the vet tomorrow and will report my findings. They also use an alphatrak meter but use venous blood, and his sugars at about 1030a.m. one day were 441 on 3 units of NPH, so last week we went to 4 units.

Any insights into this strange looking curve?

Thanks,

piperknitsRN
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  #2  
Old 03-17-2011, 05:38 PM
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jesse girl jesse girl is offline
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Default Re: new to list;alpha-trak and glucose curve questions

this type of curve seems to be very common the highest point is at the peak of insulin and lowest is at the weakest time at the end of the 12 hour cycle not a problem most would be jealous of those numbers very nice

I use the lip on jesse not much luck anywhere else meters are not exact but can be close especially at the numbers you are testing and with the meter most vets use and other people on this site and they can tell you of the performance

its a great thing to take on this responsibility me and jesse salute you
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Old 03-17-2011, 06:38 PM
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Patty Patty is offline
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Default Re: new to list;alpha-trak and glucose curve questions

Hi and welcome to you! Bless you for taking Tucker in . Are you an RN?

Just based on personal experience, the comparisons I've done have been closer with the lip than with the elbow which I've used a couple of times in comparing to the vet's lab analyzer. But it's really not enough to be too concerned with, a normal variance.

If you're considering comparing your alphatrak at the vet's for accuracy, I would have the vet draw blood to run on his lab analyzer while you test with your meter as you normally would at home using a capillary sample.

We have dogs with all different curve shapes here. It really depends on the food digestion rate and how well it's matched to the insulin. Here's a great link for explaning the food/insulin race: http://www.k9diabetes.com/insulinfood.html

What type of food is Tucker eating? It looks like his insulin starts working before his food is digested enough to convert into glucose in the first couple of hours.

I would also watch the next few days. I'm a bit concerned that on 3u he was in the 400s and with 4u he's in the 100s. I'm not sure how long it's been since his dose was raised but over time the doses can overlap each other and bring blood sugar lower. Do you have syringes with 1/2u markings on them? They make fine tuning doses even by 1/4 units if needed much easier.

Again, welcome to you!
Patty
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Old 03-17-2011, 06:38 PM
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Default Re: new to list;alpha-trak and glucose curve questions

A variance, I believe, is normal between testing locations. Also, a variance at the same test location is not unusual. I believe the industry standard for our handheld meter systems can be as much as +/- 20%.
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Old 03-17-2011, 06:59 PM
piperknitsRN piperknitsRN is offline
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Default Re: new to list;alpha-trak and glucose curve questions

Yes, I am an RN!

I forgot to explain that Tucker is on a homecooked lo-glycemic diet and 1/4 cup of Natural Balance kibble. I wanted to change that to give him some consistency but this was a no-no according to the rescue organization so I went back to feeding him homecooked.

He's been on 4units of insulin for about a week now. My vet uses an alpha trak meter too, and it would be interesting to see what a venous draw value is to a capillary draw on these meters.

Thanks for all the replies--keep them coming. Canine diabetes, while not unheard of, is new to me and it's interesting to see the trends.

Tucker's nadir blood sugar yesterday was anywhere between 272 and 300-something, depending on which reading you wanted to believe (I took them all around the same time, fiddling with how to get an accurate reading--I'm going through strips like mad but Tucker is a real trooper and has only just now gotten touchy about using his foot pad. He doesn't seem to mind the lancet in his inner lip, though).
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Old 03-17-2011, 08:01 PM
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Default Re: new to list;alpha-trak and glucose curve questions

Hi!
I am a nursing instructor and ex director of nursing. GIVE ME PEOPLE!!!!! When it comes to dogs....I'm dummer than dirt.
I also told my vet today that I would like to compare our curves (Ooops, blood not body!)
Sparky's blood sugar takes a nose dive 2hrs post insulin all the time no mater what I do and it is so frustrating.
Well, on a happier note, a big welcome from the desert rats in California!
Carrol & Sparky
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Old 03-17-2011, 08:39 PM
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CarolW CarolW is offline
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Arrow Re: new to list;alpha-trak and glucose curve questions

As Craig said, the industry standard (source: OneTouch Customer Care) is plus or minus 20% per reading. I asked - you mean, 40%? Answer: yes! Even if you use close to the same prick site moments later, you can get a different reading. So we watch trends, and get general ideas.

Glucometers are designed to measure capillary blood, so measuring venous may give "odd" (or different) results if the vet uses a glucometer. A lab analyzer would be a bit more accurate, I'd think, if measuring venous blood.

A BIG FAT welcome to you to this Fabulous Forum (that's how I feel about it, but with good reason, as you'll see). My beloved Kumbi died last year, but I stay because the forum is so great!

Thu, 17 Mar 2011 20:38:33 (PDT)
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Old 03-18-2011, 06:02 AM
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Patty Patty is offline
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Default Re: new to list;alpha-trak and glucose curve questions

What do you use for the homecooked part of his diet?

So I wanted to pull Tucker's numbers from yesterday's curve on 4u NPH
3/17/11
199 - 6:00am fasting
104 - 8:00
164 - 10:00
Do you have a 12:00 reading?
144 - 2:00
94 - 4:00
Do you have another fasting bg?

Did I get this right?
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Old 03-18-2011, 08:00 AM
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Default Re: new to list;alpha-trak and glucose curve questions

The Alpha Trak is designed for:

~testing with fresh whole blood samples
~testing with fresh whole capillary samples
~testing with fresh whole venous samples
~testing with whole blood collected in a syringe

Not to be used with:

~arterial blood
~plasma
~testing with serum
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Old 03-18-2011, 09:30 AM
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Patty Patty is offline
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Default Re: new to list;alpha-trak and glucose curve questions

Interesting Eileen.
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