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Letters to the Editor

Oct 1, 1995

Glucose Meter Debate!
The following letters are from our new internet users group. Join us at diabetes@netcom.com.

As a result of your comparison of blood glucose meters, I just purchased a One Touch Profile meter. I immediately tried it out and compared its readings with those of the Accu-Chek II meter I've been using for years. The results: the One Touch Profile read 139 while the test result on the Accu-Chek II was 195. An hour later, I took another test. This time, the One Touch Profile read 166, the Accu-Chek II, 225. I checked both meters with their recommended control solution tests and both were in the acceptable range.

I'm on an intensive insulin therapy program, taking six shots a day, and I'm concerned about the large discrepancy between the two meters.

I called Lifescan and was told that the two meters cannnot be compared, and that Lifescan could not account for the difference between readings. Can you explain why there is such a difference between the test results of the two machines?

Thank you for any help you can offer.

Paul
via the internet


Paul,

I don't quite know how to tell you this. Meter specifications say that readings of BGs will vary +/- 15%. Your reading can vary from the actual sample by as much as 15%. Now, (139+195)/2 = 167 and 15% of 167 is approximately 25. That gives you a range of 142 to 193.

Both meters are in range by that standard. Problem is, how do you know which is off? How were your A1cs with the Accu-Check II? If you constantly ran BGs in the near 200 range (fasting), and got an A1c that showed something much lower, then I'd suspect the AC. On the other hand, if your A1cs showed that your average was about what the AC indicated, I'd suspect the Profile.

Lifescan was right in saying that you can't compare two different meters to one another. Sometimes, even the same make and model of sensor will give different readings. There may also be a difference between the "first drop" and "second drop" of blood (due in part to stuff on your finger, even if it's just water from washing).

If you did not suspect the AC-II, why did you get another meter?

John F Davis
via the internet


Paul,

Your readings can vary within minutes using the same meter. Any tiny trace of sugar can spike a reading; samples from different fingers can vary; the size of the sample can alter readings; and, keep in mind that blood glucose is dynamic and continually changing.

The technologies of different meter manufacturers vary in accuracy and sensitivity. You may have to adjust your routine to a new meter. Also, capillary blood glucose readings (by hand-held meters) will be X number of mg/dl different than venous whole blood glucose readings done with laboratory equipment. I don't remember the exact number.

I use a One Touch II, and trust it more than any other meter I have ever owned. It was given to me during a LysPro clinical test I participated in-the clinicians felt it was an accurate meter with a good amount of memory. I've had it for well over a year and adjust my insulin based on its readings without any problems. I will say, however, that my One Touch readings differ from my Medisense Companion readings by as much as 30mg/dl or more within minutes.

If you do suspect an accuracy problem with your One Touch, return it for another and try again.

Scott Rassmussen
Woodstock


Paul,

I would suggest checking your two meters against a lab BG test to see which reading comes closer to that of a venous sample, and to determine what the percentage variance is. I did this on a couple of occasions with my Exactech meter, and each time it read 13% low, or 87% of the actual value. So when I get a result, I divide by .87 to get the actual reading, and proceed accordingly.

Gary Benjamin
via the internet


Paul,

Take your meters along with you to the lab for your next FBS. Have the tech draw your blood and then immediately check both meters and note the readings. When you get the results of your FBS, you will know which meter is right. The FBS will usually be higher than the meter. It's nice to know how much the percentage difference is.

I don't think anyone will be able to answer your question until you perform this experiment. Please report back to us. My Lifescan unit (the Basic) is about 12-14% lower in the reads than my usual FBS.

Todd Hostetter
via the internet


Research Fundings Need Support

I hope you can find room for some important information about diabetes research. I am the parent of three children, two of them teenagers with diabetes. I am also a volunteer Government Relations State Leader for the Juvenile Diabetes Foundation's (JDF) Government Relations Committee in the Metropolitan.

We, as people touched by diabetes, best understand diabetes and the need to find better treatment, a prevention, and a cure. We must stand together to let our representatives and our senators know that biomedical research in general, and specifically diabetes research, is a priority for this nation. In terms of quality of life, the advances made thus far and those predicted within the research community are unimpeachable. In the last 25 years, federal funding has gone from $18 million per year to over $300 million per year. In terms of economic stability, medical research just plain makes sense: every dollar spent in research saves eight to 13 dollars in medical costs. Since diabetes is one of the most expensive diseases, imposing its burdens of $105 billion annually upon the U.S. medical thirteen dollars in medical costs.

On Friday, Aug. 4, after a long process of budget and appropriations, the House passed its bill for funding of the National Institutes of Health (NIH). The news focus was very good: the House approved a funding increase of 5.7%, translating roughly to an increase of $645 million! This legislative response was due, in large part, to the strong public support for medical research as documented in a recent Harris poll, and to many calls, letters, faxes, and personal visits nationwide with Representatives who heard a clear message!

Now comes the battle in the Senate, predicted to be an even tougher fight. The Senate Budget Committee recommended an NIH decrease earlier this year, but the Appropriations Committee will actually make those "dividing the pie" decisions, beginning in September. Senators across the nation need to hear one clear message, loud and strong; we must write, call or fax and urge them to support beginning in September. Senators across the nation need to hear one clear message, loud and strong; we must write, call or fax and urge them to support H.R. 2127.

Please take a few minutes to write to both of your senators now; the committee decisions will be made in early September, with floor consideration on Sept. 15 followed by Conference Committee. Our senators must go into the Senate chamber as advocates of biomedical funding! Tell them, in a short letter, of your personal connection with diabetes, of the importance of research funding, and of your desire that they support a minimum 5.7% increase in NIH funding through the bill H.R. 2127.

I think the future for my children depends, in large part, upon government-funded research.Together, we are strong; together, we can meet at this crossroads to the future and direct our leaders down the path of revelation, understanding, and, ultimately, elimination of one of the world's oldest and most devastating diseases-diabetes.

Judy Haley
Houston, Tex.


Categories: A1c Test, Blood Glucose, Diabetes, Insulin, Letters to the Editor



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