Glucometer Accuracy and Labs! Standards please!

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wa5ekh
Regular Member


Date Joined Nov 2005
Total Posts : 68
   Posted 5/29/2006 2:57 PM (GMT -6)   
I have been in professional labs my entire life. When we measure voltage, temperature, meters, inches, pounds, time .....anything! and we want to know how accurate, or inaccurate, we are ...we must have some sort of a standard to compare to all previous measurements.
One day I was diagnose with type 2. Suddenly I was using a glucometer without a standard. My doctor sends blood to a lab and I don't know what standards they are using(and I get cutoff when I inquire at any level!!). The glucometers seem to "say" they are accurate +_20%(80-120 mg/dl are the same, and 100-140mg is 120+_20%approx.). The only standards I can find are not near enough the 100 mg/dl targets to be of any real use (50, 160, 200, 240-350).

No personal standards are "easily or usually" available. In the literature I read temperature, technique, strip variations, metering variations, certain drugs(probably with certain individuals), illness, ....and several other things can lead up to 50% error (the highest I have read or experienced...without standards).

I have been diagnosed type 2 for 4 years now , gone to hundreds of support groups meetings,…seen various doctors, ADA, Joslin, attempted to engage numerous academics and ...including this list and others ....and have never been able to resolve this.

I have taken several 1-3 month breaks(this was the latest) over the last 4 years for this "quest", tried to calm down out of complete frustration, and each time returned more determined that I will not accept this important, if not life threatening gap " in this medical technology continue to exist, if at all possible.

I realize very few understand this simple concept of using a “standard solution” routinely, but it really isn’t complicated, and can be quite simple. Most people react negatively because their Doctors or their Diabetic training has not mentioned this in their training. It appears to be “new”. As a Diabetic I contend it should not have been overlooked. This could (and in my opinion probably does) have the effect of giving you better control and “understanding” of exactly what effects your BG levels.
If we don't eliminate the confusion, then we must live daily with this confusion. I see this in every diabetic I know.

Has anyone else noticed this? Any suggestions, similar experiences ? I don’t think we can ignore or suppress this issue any longer. We need solutions. I have never trusted glucometry to less than 50% accuracy. Professional labs seem to be immune from any real accountability to the patient. This is just unacceptable.

Post Edited (wa5ekh) : 7/16/2006 9:57:34 AM (GMT-6)


Warren
Veteran Member


Date Joined Oct 2005
Total Posts : 534
   Posted 5/29/2006 7:53 PM (GMT -6)   
When my personal meter (I have two) and my lab results are literally the same (98 lab 99 personal meter) I feel that pursing the topic any further is a waste of my time. I simply accept that my meter is accurate with the standard the doctor is measuring me by and go on with my life from there.

scool Warren
It's not that some people have willpower and some don't. It's that some people are ready to change and others are not. - James Gordon, M.D.
What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease. - George Dennison Prentice

I can only please one person per day, today is not your day...tomorrow doesn't look good either.


Jeannie143
Veteran Member


Date Joined Apr 2004
Total Posts : 6047
   Posted 5/30/2006 10:03 AM (GMT -6)   
The meter is an indicator of blood sugar levels, much the way a sun dial is an indicator of the time. It is much more important to focus on exercise and your food program than it is to be frustrated over meter inadequacies. Number accuracy can be affected by your level of hydration, the thickness of your blood, the size of the drop, the humidity in the air, the level of your batteries in the meter, the age of your test strips.... I could go on and on...

Lighten up on yourself and live a little. Do your food program... enjoy your family and friends... go outside and plant something or paint something... Life is short and ain't none of us gonna get out of it alive anyway so just do your best and KOKO.
~ Jeannie

"People are like stained glass windows: They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within."

- Elizabeth Kubler-Ross


desertdiabetic
Regular Member


Date Joined Dec 2005
Total Posts : 115
   Posted 5/30/2006 7:50 PM (GMT -6)   
Have you looked into getting a hemocue monitor? I know, it is restricted here in the US to medical professionals only. Not to speak expensive. It is supposed to be the only glucose monitor that is lab accurate. The Hemocue people will tell you the accuracy of their meter....

The other problem is Hemocue will not sell their testing supplies to anyone but the original buyer.
type 2 - dx 12/04
metformin 500mg 3x - avandia 2mg 2x


wa5ekh
Regular Member


Date Joined Nov 2005
Total Posts : 68
   Posted 5/30/2006 10:04 PM (GMT -6)   
Finally!.... a constructive response! Thanks! I thought honestly everyone was in complete denial over this issue, though I now ALL Newbies are terribly frustrated by this problem. I'll look it up. .....still looking and wondering why more folks don't express their frustration on this very basic issue.

Jeannie143
Veteran Member


Date Joined Apr 2004
Total Posts : 6047
   Posted 6/1/2006 10:58 AM (GMT -6)   
Wa,
Are you still non-medicated? If so then I understand your dedication to finding a more accurate way of measuring... You need to clock every food response as you go to build up a personal glycemic response index... I was wondering why you were concentrating on this issue and so I went back and read your old posts...

You have chosen the more difficult path of handling your disease. Not all of us are as dedicated to monitoring our food responses as you are. Just wondering how you are doing... Has the exercise/food plan/meditation etc. thing been working? Can you share the positives of your plan? I would like to benefit from the good stuff that has been working for you.
~ Jeannie

"People are like stained glass windows: They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within."

- Elizabeth Kubler-Ross


wa5ekh
Regular Member


Date Joined Nov 2005
Total Posts : 68
   Posted 6/2/2006 11:07 PM (GMT -6)   
Now I'm still Normoglycemic by A1c(if that is truely reliable)...an average you know....started exercising at 300#...gained 20#+_3. After three-plus years of careful restrictive dieting still not reverting to hypogycemic spikes above about 150 ...and much rarer!!... still compulsive benger...but less and less....but cannot tolerate the volumes I use to ..that seems good. Still unmedicated. Still going to support groups and Overaters Anon. (Day by Day Survival)
Still waiting to see if I revert(honeymoon thing you know). Trying to safely loose another 100#, but recently was diagnosed with abnormal EKG....."minor and monitoring!!" quote the Cardiologist. Stiil feel much better than 3+ years ago at about 360-380# and A1c of 8.70(or 9.1)...that was my bottom/top! Need to loose wt and improve my health to set the example to set the example for family friends and others(and me..) in support groups. God knows what damage I caused when I wasn't being responsible....I have seen considerable improvement in my mother's bgs and health (at 80, type 2 insulin therapy). Uses much less!!! insulin than she use to. Got her diet under control and found several trigger foods that were making her "brittle"....stable now! Much lower A1cs too.
Still want to know when I measure....not days weeks or months(A1c) if my bgs were close to my Targets. But without standards(at 100, 140, 180) I can only guess by weight loss or gain(and wt gain is a fuction of exercise which i have to add) too. It would actually make things much!! simpler if standards were available.

Jeannie143
Veteran Member


Date Joined Apr 2004
Total Posts : 6047
   Posted 6/3/2006 7:35 AM (GMT -6)   
I also struggle with my weight. I could easily afford to lose 100+ lbs. and am sure that my diabetes would be much different at that new weight. But I am pleased to relate that I have been running morning sugars of 89-110 on my Lantus and feel much better than I did before starting it.

I'm going to start a new post... about weight loss. See what's working for others. I'd like to start managing this better.
~ Jeannie

"People are like stained glass windows: They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within."

- Elizabeth Kubler-Ross


wa5ekh
Regular Member


Date Joined Nov 2005
Total Posts : 68
   Posted 6/3/2006 8:51 AM (GMT -6)   
How do you avoid hypogycemia on Lantus? That ust be difficult to manage. I have a guess, but I'd rather hear your experience.

Chutsman
Regular Member


Date Joined Jul 2005
Total Posts : 64
   Posted 6/17/2006 9:29 PM (GMT -6)   
wa5ekh, I would also like to find a standard for checking my glucometer.  The so-called "control" solution provided with the meter is a joke.  From the chemistry point of view I don't see why a liquid cannot be made where a properly functioning meter should give a reading of say 100 plus or minus 2 percent.
 
I recently was checking my blood with two different brands of meters from the same drop of blood.  They were so far apart it was unbelievable.  For instance one would read 110 while the other would read 130.  To me that is too much of a discrepancy.
The short form for "you are" is "you're", NOT "your".


desertdiabetic
Regular Member


Date Joined Dec 2005
Total Posts : 115
   Posted 6/17/2006 9:40 PM (GMT -6)   
Chutsman -

Good luck finding anyone in the industry that thinks that we need that much accuracy. The other side of the coin is the technical difficulty of making a machine affordable with that accuracy. There are new developments now that will change how you check blood glucose levels, possibly anyway.

One company is developing a glucose monitor that reads the inside of your eyes. Non-invasive and supposed to be pretty accurate.

Another company has already released a machine for doctor offices that use lighe reflected off the patients skin to give readings to determine more accurately than a fasting blood test. No fasting is required. It probably won't be developed for home use, but the techniolgy will be looked at by other companies and maybe filter down to us.
type 2 - dx 12/04
metformin 500mg 3x - avandia 2mg 2x


Warren
Veteran Member


Date Joined Oct 2005
Total Posts : 534
   Posted 6/18/2006 8:39 AM (GMT -6)   
Chutsman,
 
Next Dr's appointment take your meters to the Doc's office and check your blood from the same blood they take from your arm.  Then a few days later when the lab results come in, check to see how they did vs. the lab measurment.  Chuck the one thats way off and keep the one that mimics the lab. (better yet send it back to the manufactuer with a note explaining that it is too far off the lab measurments and maybe they'll send you a new one for free).  Thats the best you can do cause as desertdiabetic points out, no doc is gonna get worked up over lab standards for meters.
 
scool  Warren
It's not that some people have willpower and some don't. It's that some people are ready to change and others are not. - James Gordon, M.D.
What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease. - George Dennison Prentice

I can only please one person per day, today is not your day...tomorrow doesn't look good either.


Jeannie143
Veteran Member


Date Joined Apr 2004
Total Posts : 6047
   Posted 6/19/2006 8:27 AM (GMT -6)   
wa5ekh,
Sorry to take so long to get back to you... June brides are the worst! And the weather has been extra special hot for baking, too...

about the Lantus, because it's a long acting insulin without a peak time you don't have the highs or lows... no hypoglycemia attacks yet, and I've been on it for 15 months. I had oral meds that gave me more trouble! I'm very pleased with the way it works and I only do one injection a day, at bed time. You might really like this med. It's people friendly.
~ Jeannie

"People are like stained glass windows: They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within."

- Elizabeth Kubler-Ross


Warren
Veteran Member


Date Joined Oct 2005
Total Posts : 534
   Posted 6/19/2006 9:18 AM (GMT -6)   
Hi wa5ekh,
 
Jeannie is right about Lantus.  I used to use it before going onto Byetta because I'd gotten to the point where my oral meds had failed.  I still used the oral meds with the lantus, but the lantus delivers a timed release constant dose for 24 hours.  If you look at the graph for its peak time, it goes straight up almost immediately and then is a flat line for 24 hours before it falls off.  Soooooo, if anything pushes you into hypoglycemia while you are taking lantus, its not the insulin but rather the oral meds. 
 
Initially, the combination of Lantus and oral meds is a guess and one you and your doctor work together to fine tune over a couple weeks.  Actually, my doctor said, "you seem to be savy enough about this, lets start at "x" dose and increase it 3 units every two days until your numbers reach "y".  Worked for me!
 
scool  Warren
It's not that some people have willpower and some don't. It's that some people are ready to change and others are not. - James Gordon, M.D.
What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease. - George Dennison Prentice

I can only please one person per day, today is not your day...tomorrow doesn't look good either.


spooky
Regular Member


Date Joined Jan 2006
Total Posts : 101
   Posted 6/20/2006 2:17 AM (GMT -6)   
Hi there!Glucometers measure" capillary blood "for glucose values and laboratories draw blood  from veins for glucose values(venous sample).A difference in values is to be expected in the range of 5 to 15% between the two measurements and as long as the measurements between the glucometer and lab results are within this limits,we can accept this and be happy that our glucometers are working just fine!Laboratories usually run a quality control test every day before drawing samples and compare it with a central lab for accuracy.Subjective differences in lab values are to be expected even when two technicians draw the same venous blood sample as the pippeting will differ.It is an accepted fact that the same venous sample tested in three different labs will give three different results,but should be within acceptable range of variability.This is my penny,s worth of contribution of this vexing problem of comparison between lab values and glucometer values!

wa5ekh
Regular Member


Date Joined Nov 2005
Total Posts : 68
   Posted 6/24/2006 3:02 PM (GMT -6)   
I recently was vidicated by my mother's doctor(both in their late70s early 80's) , who himself was diagnosed with type 2. He immediately began to complain that the meters were very inconsistant. It seems to have changed the way she is being medicated now. He used to tell her she was "brittle" but now he believes the measuring systems are "brittle" (as we all know vulnerable to our and our monitors and strips mistakes(which occasionally all add up in one direction(high or low).

I frequently use(and always used) two meters , one cheap+ cheap strips, and the other moderate to expensive(both meter and strips). Most of the time these two systems are 30 units apart at 100, that is one reads below 100, the other consistantly 110+ (and my standards solution reflect about the same thing on these two systems. ( the cheaper one is closer usually to the standard solution value...140-160 mg/dl +_20%....I take an average of 3-5 readings on a standard solution(pretty expensive, but I try to limit the se tests.)

Note: diagnosed type 2 ..4 years ago, a!c 8.9, age 54, 200# "overwt"(for sure!!), swollen ankles, IBS, almost every syptom of Diabetes.......todayA1c ~ 5.4 lost 60-80# wo. meds or exercise-restricted diet. only! (not necessarily suggested without very careful health monitoring!!!! recently(age 58) developed irreg. EKG--after working on car in heat----Doctor says its very common in men over 40....???

desertdiabetic
Regular Member


Date Joined Dec 2005
Total Posts : 115
   Posted 6/24/2006 3:31 PM (GMT -6)   
I just got a new meter a coupel days ago. Accu-check Compact Plus - I love the machine. However, it reads something like 18 hight than the older Ane Tough Basic. The One Touch has always tested very close to the lab tests. Both meters check ok with the test solution. The Accu-check people said it could be of by 15 percent and still be okay. Well, I am assumeing that it is reading high. My A1c just 3 weeks ago was 5.2 and I am getting all readings above 100 on the new machine and in the mid to high 80's on the old one. Fasting numbers, that is. I was happy with the lower numbers and believe that they were correct. Now what? It will be a while before I can test against the lab sample...... Accuracy is not a problem unless you think that the meter is wrong, then we get concerned. 15% is a terrible standard..
type 2 - dx 12/04
metformin 500mg 3x - avandia 2mg 2x


wa5ekh
Regular Member


Date Joined Nov 2005
Total Posts : 68
   Posted 6/25/2006 7:22 AM (GMT -6)   
exactly the problem .. A standard at 100 dl/ml 0r 5.2-5.7(units?) makes more sense, since this is the target. I use a 160 mg/dl standard for another machine, but I don't know where it should be. I can only guess and hope there are not simlar issues with the Lab tests. You can't question these lab tests, but i never see any real proof of their standard deviations. I ask my doctor to send a sample to two different labs(i'd pay!) ...he declined.

Chutsman
Regular Member


Date Joined Jul 2005
Total Posts : 64
   Posted 6/25/2006 7:34 AM (GMT -6)   
Now that 60% of the USA's population is overweight, more will be prone to developing diabetes.  And in the case of the children the situation is getting worse in the overweight department.  By the time they approach adulthood, it is likely that 80% of the pop. will be overweight and diabetes will become the #1 ailment.  Maybe then there will be an "act of Congress" to make the glucometers more accurate or to have a test solution that has a tighter range.  Really the test solution that is now provided is useless.

The short form for "you are" is "you're", NOT "your".


Jeannie143
Veteran Member


Date Joined Apr 2004
Total Posts : 6047
   Posted 7/13/2006 12:04 PM (GMT -6)   
Wa,
I stumbled across this info while checking on meter strips to resupply my batch. Thought it would be right up your alley and the best part is, this is the meter I'm using and it's ultra CHEAP!!!

Prestige IQ meter accuracy
~ Jeannie

"People are like stained glass windows: They sparkle and shine when the sun's out, but when the darkness sets in, their true beauty is revealed only if there is light within."

- Elizabeth Kubler-Ross

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