not so accu

I’m assuming the “accu” in accuchek stands for accurate.  Or at least is meant to evoke the word “accurate”.  But a side by side comparison of the two blood sugar meters leaves something to be desired in the accuracy or even convergence department.

I blogged about my blood sugar being so very low lately.  And I realized that one possible reason for the very low readings is that I have a new monitor.  The last time I was checking my sugar, I was using the meter my insurance company would pay for, the aviva accuchek.  When it came time to renew my prescription, my insurance company wouldn’t pay for the test strips, instead recommending a new monitor with new strips.  The Freestyle lite.  Was the change in monitors what lead to the change in blood sugar patterns or was it that months ago, my blood sugar was just better?  I got some aviva test strips to do a side by side check.  Here are the results:

Blood sugar monitor comparison
Person accuchek aviva freestyle lite Difference (raw)
1 105 83 22
2 121 111 10
3 124 106 18
1 99 84 15
1 114 83 31
1 108 86 22

And so we have some good evidence that the freestyle is reading consistently lower than the aviva.  But which one is “right” or closer to right?  For that, I’ll need my doctor’s help.  See, I do have a problem with recognizing when my blood sugar is low.  As I blogged about before, I feel crappy a lot and a lot of my crappy feelings are similar to symptoms of low blood sugar.  So I have the possibility of symptom masking going on.

So we could approach it from a different angle then.  There are times when I have eaten not long ago that my sugar SHOULD be higher, certainly higher than the readings I’m getting from the freestyle.  Like a half hour after eating or drinking soda and the meter is telling me my blood sugar is  in the low 80s.  That’s some decent evidence that the freestyle is giving false lows, telling me that I’m hypoglycemic when I’m not, and that I’m not suffering from hypoglycemia unawareness as much as I’m suffering from screwed up blood sugar monitor.

So what then should I assume is going on when it reads 55 and I feel bad but not markedly worse than I’ve felt when it reads in the 70s or 80s?  If it the monitor reading is falsely low, and if it is anywhere from 72% to 79% of the reading I’m getting from the aviva, then even a falsely low reading of 55 would be a low reading on the aviva (somewhere around 69 to 75).  And if the aviva is the (more) accurate blood sugar value, or at least less inaccurate, then that means my sugar is between 69 and 75 when the freestyle says 55, and I should still feel low.  But I don’t.

My guess is that it’s a combination of factors which are contributing to my blood sugar readings.  I think I am a little unaware of when I’m low.  I’m a bit autonomically screwed, I think there’s plenty of evidence for that.  And I have a history of passing out from hypoglycemia, which is what happens to people who get low without the “boy I sure need to eat something” feeling kicking in.  And I think that the fingersticks are at best a rough estimate of blood sugar.  These two things together mean that I’m going to have a hell of a time keeping my blood sugar where it should, of avoiding getting into a blood sugar trough (hypoglycemia begets hypoglycemia) if I can’t identify an accurate means of measuring my sugar or a constant to apply to the inaccurate reading which will make it accurate.

From what I’ve read, from journal articles to manufacturer’s specs to patient boards, it seems a clear conclusion that the glucose meters are basically inaccurate as actual measures of blood sugar and are better at providing blood sugar trends.  I guess I can thank god I’m not an insulin dependent diabetic.  I’d hate to have to rely on these things to determine insulin dosing – nightmare!

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