Glucose measurement from serum (frustrating)

Re: Glucose measurement from serum (frustrating)

Michael Woodhouse — Mon, 11 Nov 2013 21:23:50 GMT

We use the Freestyle Optium glucometers as they can also measure ketones. Seem to tally quite well with the Istat and external labs, when run on a yellow top.................

Re: Glucose measurement from serum (frustrating)

Andrew Kent — Mon, 11 Nov 2013 21:21:04 GMT

I'm not sure I would pay for them but I have always been given them for free and like them, mainly because the sample size for the Alphatrak 2 is so small that even the worst of ear pricks will get you a result. I have tended to find them a bit more repeatable as well. And they perhaps give a truer reading as (as Martin says) the human glucometers are calibrated to read low.

I like the kits they do for owners with all the guidance and support to get them up and running as well as it saves a lot of time for them to have stuff to refer back to.

Andy

Re: Glucose measurement from serum (frustrating)

Bob Russell — Mon, 11 Nov 2013 17:17:55 GMT

We have two Woodley ones (G-Pet). The two units cannot agree and neither are that close to the Accuchek we do use. This is consistently one lower than the VetScan so we use the result and add +1!

At the moment Abbott are exchanging glucometers FOC as long as you buy a certain number of (more expensive!) test strips. I am happy to exchange the G-Pet but not the Accu-chek!

Re: Glucose measurement from serum (frustrating)

John Flynn — Mon, 11 Nov 2013 16:20:28 GMT

[quote user="Andrew Kent"]

It's also worth noting that Alphatrac recently updated their glucometers to the 'Alphatrac 2' and at the same time launched the alphatrac 2 test strips. If you use the new strips in the old units then the accuracy is much lower than using the newer units (especially with some species.). Unfortunately you cannot buy alphatrac 1 test strips anymore so they have you over a bit of a barrel!

Andy

[/quote]

I had a rep in at one point about this glucometer.

There may be a reason I would want it, but he was unable to expalin it to me.

As far as he explained it, there was nothing different in the repeatability of measurements or mechanism of glucose measurement, just the calculation used to find the final number - I already have a calculator for that sort of thing if I really cared...

Re: Glucose measurement from serum (frustrating)

Graham Bilbrough — Mon, 11 Nov 2013 15:31:43 GMT

[quote user="Michael Woodhouse"]

So if I continue to send a yellow top and note that on the form you'll run the glucose from the yellow top for the usual fee?

[/quote]

Yes, correct. g

Re: Glucose measurement from serum (frustrating)

Michael Woodhouse — Mon, 11 Nov 2013 15:20:03 GMT

So if I continue to send a yellow top and note that on the form you'll run the glucose from the yellow top for the usual fee?

I've been sending yellow tops and they are being ignored!

Re: Glucose measurement from serum (frustrating)

Graham Bilbrough — Mon, 11 Nov 2013 15:16:28 GMT

Hi, Michael and others

Thank you for the comments. Our hope, when switching to measuring glucose on serum rather than plasma from a fluoride oxalate (fl.ox.) tube, was to reduce frustration.

Quite appropriately, most practices fill the fluoride oxalate tube last. For profiles from cats (also small dogs, rabbits etc), the majority of submissions came with an under-filled fl.ox. tube and all the problems that entails, especially haemolysis. That last drop of precious blood was probably better used to contribute to the serum for other testing. Furthermore, on the human side, it was clear that serum from promptly separated serum gave more accurate results than plasma from a fl.ox tube. Internal work by IDEXX confirmed this to be the case for veterinary species too. Other labs around the world follow this same procedure.

However, we recognize that it isn't always convenient to separate the serum, especially for those working in the field. It is free-of-charge option to include a fl.ox. tube and then we will measure both. Originally, we had suggested simply including a fl.ox. tube in the envelope if that was your preferred that option. In honesty, that is not an infallible system and we now encourage you to write "GLU+" in the test code box.

I hope that helps.

Best wishes

Graham

Re: Glucose measurement from serum (frustrating)

Andrew Kent — Mon, 11 Nov 2013 14:48:56 GMT

And the other thing is that if you use the new strips with the original alphatrak you also do not use the code on the pot.

Andy

Re: Glucose measurement from serum (frustrating)

Andrew Kent — Mon, 11 Nov 2013 14:41:12 GMT

Andy

Re: Glucose measurement from serum (frustrating)

Martin Atkinson — Mon, 11 Nov 2013 14:13:32 GMT

[quote user="Bob Russell"]Which ones do other practices get on with best? We have a couple of 'veterinary specific' glucometers that give quite bizarre reading compared to the human one.[/quote] I presume you mean Alphatrac by veterinary specific Bob? I find they read a couple of units higher than human glucometers (the human ones are calibrated to read low so idiotic people don't let their level go low and go hypo)! I do however they tie accurately enough with Vetscan - they're never exactly the samebut if you ran two Vetscan rotors simultaneously on the same sample you'd get two different readings. This is why you shouldn't just treat numbers and why a 'perfectly stable' patient is in danger of going hypo and care needs to be taken. I also assume that you programme the test strip code number in to the unit!

I rarely if ever send profiles to labs so the oxalate tube doesn't come into the equation, but if I did I would test the sample on the Alphatrac first.

Re: Glucose measurement from serum (frustrating)

Bob Russell — Mon, 11 Nov 2013 09:49:22 GMT

Change of tack!

We have a couple of 'veterinary specific' glucometers that give quite bizarre reading compared to the human one. The human one reads slightly low compared to the Vetscan but at least it is consistent! The other two units now sit in a drawer unused.

I gather we are going to try a new vet specific unit but not sure when it will arrive!

Which ones do other practices get on with best?

Re: Glucose measurement from serum (frustrating)

Rob Loxley — Sun, 10 Nov 2013 14:02:46 GMT

[quote user="Michael Woodhouse"]May I ask why you have started doing the glucose measurement on serum when we still submit an oxalate tube, please?[/quote]

They sent round a circular about this a few months back which announced the change.

[quote user="Michael Woodhouse"]How is this in any way a benefit?[/quote]

I guess ultimately fewer sample tubes to handle keeps the costs down? It also means less blood to collect for us?

[quote user="Michael Woodhouse"]Is it just us frustrated by this?[/quote]

I've not been bothered and not had any odd results, but then I've not had samples sat round for hours. Our other labs still want a fluoride oxalate tube.

Re: Glucose measurement from serum (frustrating)

Gillian Mostyn — Sun, 10 Nov 2013 13:05:04 GMT

hmmm.... how odd. Our lab (CTDS) must still require oxalate - if we don't send a yellow top we don't get a glucose measurement back!

Re: Glucose measurement from serum (frustrating)

Rachael Winder — Sun, 10 Nov 2013 12:31:16 GMT

I've starting doing exactly that- test it on the spot yourself. Same thing, getting odd results back and having to keep rechecking was a pain. I also keep sending yellows to no avail.