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Lab quality glucose meter

Discussion in 'Parents of Children with Type 1' started by rulestein, Feb 3, 2013.

  1. rulestein

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    Why do we use these small glucose meters? Does anyone here use a commercial lab grade meter? The ones that I have looked at use a bit more blood, but it seems like the increased accuracy may be worth it. Or maybe they aren't that much better?

    Other than the initial expense, the running cost is the same.
     
  2. Sarah Maddie's Mom

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    And you'd carry this around with you?
     
  3. rulestein

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    I am not sure, that is why I am asking. I assume most T1Ds need to check their BG at each meal regardless of the location. Some of them are AC powered and so bringing them with you might be difficult.

    The meter we use is quite inaccurate and has a 40 point spread. Comparisons of other meters show ridiculous ranges just from testing the same drop on different meters.
     
  4. wilf

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    How big and expensive might such a unit be?
     
  5. Megnyc

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    What meter are you using? I have had good luck with the Accu-chek Aviva and the Freestyle Freedom Lite. I know all meters meet the same standards but I have had less trouble with some then others.
     
  6. swellman

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    The current standard is +/- 20% so they all pretty much have a 40 point spread at 100. At 300 it a 120 point spread and at 50 it's a 20 point spread.

    I think there's a new standard coming that's +/- 15%.

    In any event, I don't think even with these consumer level standards that there's much risk in treatment based on the current standards.
     
  7. kiwikid

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  8. TheFormerLantusFiend

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  9. ecs1516

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    Our endo office uses an Accu Chek Aviva to check all patients meters against when they come in. My friend who is a nurse RN said they always use Accu Chek in nursing school and the hospital she works at.
     
  10. StacyMM

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    Thanks for sharing this. Interesting information. Makes me glad we've switched to Freestyle!
     
  11. rulestein

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    Thanks for the answers. I think the general idea is to keep glucose values within 75% of the target. That seems like it will be difficult if the tools are barely that accurate.

    Also, if a better more accurate tool existed, why wouldn't you want to use it especially for a more difficult case? Maybe the commercial ones aren't that much more accurate, but then why would hospitals use them instead? Maybe there accuracy for home use is outweighed by the disadvantages?

    I am sure there are others, but the specific meters I was looking at:
    Hemocue Glucose Analyzer
    Precision PCx Glucose Monitor
    Lifescan Glucose Monitor
    Epoc Blood Analysis <-- This is the one I saw in the emergency room which I don't actually think would be possible or affordable for home use, but it looks cool anyway.

    With the exception of the last one, the cost of these is hundreds of dollars, but the disposables are the same as our home meters.

    To answer a previous question, we are using a OneTouch meter of some sort that was given to use by the hospital. I don't really have any reason to question its accuracy except for what the bottle of control solution and strips says.
     
  12. Christopher

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    So you say your meter is inaccurate, but then you say you don't have any reason to question its accuracy. I am confused. How do you know your meter is "quite inaccurate"? What are you comparing it to? The bottle of control solution? Maybe describe what you are doing and your thought process and you may find that you are looking at things incorrectly.
     
  13. rulestein

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    My thought process is really just the simple question of why don't we use commercial grade meters?

    The test strips say the control value should be between 120-160. Which to me is very inaccurate and could mean the difference between extra insulin or not. I don't have any reason to suspect that my daughter's glucose readings are wildly incorrect (she seems OK), but then I read the strip bottle and it says itself that it is inaccurate. How in the world are we supposed to achieve accuracy if we are measuring with a "broken" ruler?

    In any other industry commercial grade tools are better. Is that not the case with blood glucose measuring tools? So, I looked into what do hospitals use. Why not use what a hospital uses?

    I am gathering from this thread that no one does use a commercial grade meter, but I don't know the why. Maybe commercial grade aren't more accurate, but then why would a hospital use them?
     
  14. Christopher

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    I see. Well, as others have said, there is a variance of at least 20% for all meters. So you are never going to get a 100% accurate reading. I do understand the need for accuracy when you are dealing with your child's health and it does frustrate me as well that we have to rely on a tool that is not perfect. But life is not perfect and I think we need to accept that we will never "achieve accuracy" when dealing with this disease. We do the best we can, and that is usually pretty good.

    As for the control solution, that is just a way to determine if your meter is functioning correctly. Also remember, as was pointed out before, the commercial meters also have their own variances, so even if you did go with one of those, you are still not going to get a perfectly accurate reading.

    When you think about it, 40 points one way or another most times is not that big of a deal. Obviously, there are instances when 40 points would be a big deal.
     
  15. cdninct

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    I've never heard anyone say or post that they have a commercial grade meter. I have never even considered getting one, and I am sure I am not alone. For me, meters are more or less consumable items. We use one until it stops working, then we get another from the endo. We often have multiple meters on the go, too. I cannot imagine investing a lot in one big fancy meter.

    Yes, you are right-- +/- 20% is a big range and can mean the difference between treating and not treating. I think if the BG number told the whole story, I might be a bit more concerned about the range, but the fact is 100 mg/dL does not always mean the same thing. It means one thing 75 minutes after eating and another 90 minutes after eating. It means one thing 2 hours after a turkey sandwich and another 2 hours after pizza. It means one thing in the morning while watching TV, another in the morning at school, and yet another in the morning while running errands. It means one thing on a "normal" day and another on a day when a bug could be settling in or a growth spurt might or might not be beginning. At best, the number that the meter gives me is a guideline, not something carved in stone.

    The bottom line is if I thought that perfectly accurate BG readings would give me a perfect picture of what was happening and how to proceed (in other words, perfect results), I would seriously consider paying out the extra money. As it is, though, a regular meter is good enough for me, especially when coupled with a CGM to see trends and patterns. I'd pay the extra money for a CGM over a hospital-grade meter any day.
     
  16. Sarah Maddie's Mom

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    From a quick glance at the meters you listed before I came away with the impression that rather than improved accuracy, the commercial grade meters just have more sophisticated software that allows them to track multiple patients and track billing.

    I'm all with you that our ruler is broken, or at least a bit wonky. Yes, meters should be more accurate but they aren't all that inaccurate and truth be told nothing we do is 100%. You can never count carbs 100% accurately, you cannot draw insulin or inject insulin perfectly every time, you can't always have the right I:C ratio, etc. etc.

    If you think that you can actually do the work of a functioning pancreas then you've been misled. Everything we do is approximate even with the best tools and the best of intentions. :cwds:
     
  17. Christopher

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    I also wanted to add that you being newly diagnosed, you probably have an inherent mindset of wanting to have total control over the situation. I believe as time goes on, and you get more accustomed to managing this illness, that sense of wanting total control will give way to a more realistic approach of doing the best you can with what you have and basically just going with the flow.
     
  18. swellman

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    Yes, this ^^^

    As a degreed analytical chemist I fully understand the "need" for much more accurate and precise measurements and, the perception, of better control over the situation. My advice is, the sooner you get comfortable with what we currently have, the better you will be able to focus on what really matters.
     
  19. Mish

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    Agreed. And the whole notion that meters can be off by 20% isn't really correct. If you look at the chart that was just posted many of the meters are performing far better than 20% most of the time. I'll just look at freestyle for example 86% of the time at bg's over 75 mg/dl it was performing within 5% of the actual reading. And 100% of the time it was within 10%

    And for what it's worth, freestyle floors me since many of us have been having terrible trouble with the strips seeming to be so very very off.
     
  20. Ti'sMom

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    My endo switched us to the new Bayer Contour Next meter. Supposedly it's the closest meter out there to an actual blood draw. We've been using it for over a month now and haven't had any issues. I know with the Accu-check we had before we were wasting a lot of strips with a 5 Error???? Haven't had that happen with this one. Either way, everyone is correct in saying that it'll never be perfect. We just have to learn to deal with the realities of life. Diabetes is a beast we will never be able to tame:mad:
     

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