December 8, 2010

Little Help - Can Anemia Mess Up Diabetes Blood Glucose Readings?

Doh! I feel like Homer Simpson asking that.

Someone out there should probably hit me with dope slap upside the head.  Of course {fill in the blank - including anemia} has an impact on blood sugar. What is the name of this blog again?

How does it mess with meters?

Diabetes plays games and one is to make me feel powerless. This is one of those times and I need a little help.  I am curious does anemia mess up glucose meters? I would love some experianced feed back.

It is more than just the readings - does anemia stop the frogging meter from working at all? Does it make the meter throw off used strips like beads from a Mardi Gras float with nothing to show but error messages?

We use WaveSense Jazz meters at school. Over the past few weeks our school nurse reports increasing instances of meter errors. As in it takes 2-4-6 up to 10 strips to get a reading. This is an experienced nurse and kid with 6+ years since type 1 diagnosis. They have literally thousands of blood test between them. They know the ropes of finger pokes.

The kid had lingering cold. That with exposure to whopping cough led to a doctor visit.  The visit in turn called for a blood draw that showed nothing but low iron. Which in turn led to a more detailed blood test that isn’t back yet.

Meanwhile the nurse is getting a more and more checks that just fail to give a reading. 2-4-6-8-what don't we appreciate? Using boat loads of strips to get a single Meter Readings! Yeah BG!!

Oh and some consistency between readings would be cool too. Three days ago after a bunch of errors the nurse got a BG reading of 22. That seemed suspicious given the circumstances (a word that hear means: a lack of hypo symptoms factored in with prior tests that day, the amount of insulin on board and time since eating.) So being familiar with such circumstances, they tested again. Three minutes and another bunch of strip later the low transformed into a 308. I don’t think anyone wants to confuse a 22 and a 308. Certainly not our nurse. She is tip top.

She called and sensibly but timidly asked for another meter. I love her. No worries I could swap out one from home with fresh strips in minutes. Guess what? - That replacement had the same issues and more the next day.

Could this explains some of the resistance to checking we are seeing at home? Gee I don't know - finger pokes are not that much fun to begin with so yeah maybe having them not work could be frustrating.

So I dragged a Tru2Go ninja meter up to school today when they called (3rd day in a row!). Would a different blood electrochemical process make any difference? Yes - No problems giving a reading, we'll see what tomorrow brings.

Now I for one don’t think a kid should have to poke her finger 5-10 times to get a reading. Also all in all I would prefer not to burn through strips at a rate of 2 to 8 errors for each reading. And lastly and I know this is being really picky of me I would prefer not to see 280 point swings between hypo and hyper in three minutes.

I asked the 800 number if they were aware of any issues. The operator at the call center was sure it is temperature. I know the environment well so I know it isn't about temperature. I called WaveSense directly, they said they 'wanted to support' me in the use of their product but little else.  Nothing about low iron and strip issues. 

I can find academic articles on the subject: Error Rates Resulting From Anemia can be Corrected in Multiple Commonly Used Point-of-Care Glucometers and Anemia causes hypoglycemia in intensive care unit patients due to error in single-channel glucometers: Methods of reducing patient risk.  I guess is a very scholarly, Yes - anemia can mess up numbers. But it isn’t much more helpful than my opening Doh!  

How about any of you out there in the big wild blue yonder of the DOC? Does anyone have experience with low iron and meter errors? If so what did you do about it? (Other than cursing - Kerri says we can’t curse. I may have forgotten that.)


  1. Of course it affects the accuracy of the meter! My meter (OneTouch) even comes with a hematocrit range listed in the insert. I'm surprised the person who answered the helpline didn't know that.

  2. It can also affect the A1c, btw.

  3. Not sure about the Anemia but we are struggling through a couple vials of bad strips ourselves. (I think.)

    We have been getting error after error recently too. We have a Flash - but the fact that you are fighting errors too makes me wonder what the heck is going on.....

  4. I went through a bout of severe anemia (like, close to needing a transfusion) and my meter tended to run lower than I really was - as did my A1c. I didn't experience meter issues beyond that.

  5. I am so glad to hear the meter is affected... I have had nothing but high numbers for while and needing iron infusion today.. also my last A1c was high too so it does affect the readings...I thought I might go crazy,,,