44 replies to this topic

[xEva]

Now that I looked at the pictures of meters, I remembered what keto meter I used, ~5 years ago, and it was NovoMax. And while its ketone readings were within the expected norms on a fast (and correlated with urine strips, and so I'm confident it was good) -- its glucose readings were the worst out of 3-4 meters that I had at the time. 

 

I think these combo meters are primarily designed to measure blood ketones. NovoMax was the first on the market, whose strips cost less than the average at the time, which was $7 a pop. Then, NovoMax keto strips were $4 a pop in the US, but I found them in Canada for $3. (and now I see you can get all sorts of keto strips for only $1 a pop! amazing). Anyway, I think these keto meters were designed to measure ketones and that's what they do well. Adding the 'glucose feature' was done for convenience. But this was a while ago and I tried just one brand.

 

What blood ketone meters would you guys recommend now?

[HaplogroupW]

Right, the big attraction of the keto mojo for me initially was the < $1/strip price on keto strips.

 

My impression is that the market for these glucose meters was overwhelmingly for those with T2D just trying to know if they should shoot up more insulin to get their glucose in the sane range:

 

 

Current ADA guidelines call for achieving HbA1C levels of less than 7.0%; this corresponds to an average blood sugar level below 154 milligrams per deciliter (mg/dL). The ADA also recommends striving for fasting blood sugar levels below 131 mg/dL and peak post-meal levels below 180 mg/dL.

https://www.health.h...w-should-you-go

 

So the intended use was for people trying to get down to mid-hundreds mg/dL; there was no notion of being accurate below, say, 100 mg/dL.

 

Keto mojo's  intended market is aggressive health-optimizers like us, (calorie restriction, keto and/or fasting) practitioners who are trying to get our glucose as low as possible. So my expectation (hope?) is they took more care to be accurate in the lower range. They claim measuring hematocrit helps make their glucose measurements more accurate:

 

We use the Hematocrit (HCT) number and run that through an algorithm with the Blood Glucose (BG) so we can get a tighter accuracy on the Blood Glucose. By using the additional calculation we can achieve an industry leading accuracy standard of deviation of only 5mg/dl under 100mg/dl or 5%. The FDA standard is that you can be out by 20% and still be approved, this is what you find with many other meterers

https://help.keto-mo...Txuy-hematocrit

 

So I'm allowing myself to put more confidence in the keto mojo more so than the others. It's possible my judgement is being coloured by what I want to be true, as it reports the lower number compared to the others.

 

This reference describes at least 4 different strip technologies that are used, and reports Mean Absolute Relative Difference (a measure of error) for a number of meters. Keto mojo is too new to be in the list.

http://sites.bu.edu/...echnol-2016.pdf

 

 

 

 

 

 

 

 

 

 

[Nate-2004]

The precision xtra I've been using may be high or low or accurate for all I know, it's hard to know without comparing to lab and other meter tests. I'd have to do a test right before I get a lab done which is not only costly but involves a bit of strategy. 

I trusted the ketone measurements were accurate on this one. When I was on keto it was always around 15 to 25 carbs per day consistently and on the 4th or 5th day I'd hit around 1.5. By week two I was consistently at 2.9 to 3.1 and on some crazy days I'd hit 3.9. There was only one day when I once hit 5.0 and I think that was when I was fasting during keto.

 

Probably harder to judge accuracy on ketone tests.

[sthira]

Isn't the gold standard here an OGTT under controlled conditions performed by professionals who do this for a living? Rather than futzing with consumer glucose meters, if you're truly concerned I'd see a doctor.

About keytones, a doctor may also measure keytones in urine; if ketones come back high in urine they'll be flagged as abnormal. Every time I get a checkup and I am asked to "fast" prior to tests, I get, in urine: "Ketone Urine Qualitative: 80 mg/dL (Abnormal)"

[pamojja]

Isn't the gold standard here an OGTT under controlled conditions performed by professionals who do this for a living?

 

Problem is for low-carbers an OGTT is such a sudden high bolus of glucose not used too, it would almost always give diabetic results.

[maxwatt]

Typical accuracy for a glucose meter is +/-20%.  Consumer Reports tested some for accuracy, but even the most accurate were around 10%.

I think they're designed for diabetics with glucose spikes of 400 to determine insulin doses. 

You might take your meter with you when you give a blood sample, and see how an on-the-spot reading compares with the lab test.

[xEva]

thanks Haplo! that mojo meter does sound good.  But did you ever compare the keto numbers between NovoMax and mojo?

 

 

Nate, re your keto meter, the numbers it gave you sound a bit high to me. 3+ mmol/dL are the fasting values, which you get already several days in ketosis of starvation. I have never seen such numbers reported on a keto diet -- but who knows?  Maybe you're an alien after all 

 

Next time you're having blood draw, if keto numbers are applicable, you could check the accuracy of your keto meter too (though if they turn out high, be warned, it freaks out the medical professionals -- get ready for them to come running to save you from diabetic coma). 

Edited by xEva, 05 April 2018 - 09:27 PM.

[Nate-2004]

If I'm staying under 20g of carbs I would think 3.0 is pretty normal for a keto diet. It's been pretty expensive to keep getting lab tests at the doctor's so I dunno what's up with the keto meter, no reviews on my meter seem to report high numbers there though. It's just therapeutic levels of ketosis, most people aren't as hardcore with it as I have been, I kept the protein pretty low as well.

Edited by Nate-2004, 06 April 2018 - 05:50 PM.

[xEva]

you'd think it's normal, but no need to think here  -- this info is widely available. 3 mmol/dl is rare and the highest reported on a keto diet. It's not normal. Normal is 1.5-2.0

 

PS

re blood draw, it does not have to be you. could be a relative or a friend. give them the thing and ask for a favor. 

Edited by xEva, 06 April 2018 - 06:46 PM.

[Arnulf]

I don't know much about keto diets, but I'm also having high fasted blood glucose, but good numbers the rest of the day, and an HbA1c of 5.0. I also have low SHBG (21), so I assumed it was some fatty liver from a poor sugary diet as a kid. I am 28 now. Anyway, I don't have much to contribute, but I just wanted to say that I am very interested in what answers you might find on your quest to figure this mystery out. Following this thread

[Nate-2004]

you'd think it's normal, but no need to think here  -- this info is widely available. 3 mmol/dl is rare and the highest reported on a keto diet. It's not normal. Normal is 1.5-2.0

 

PS

re blood draw, it does not have to be you. could be a relative or a friend. give them the thing and ask for a favor. 

 

I noticed that it was a lot lower in the morning than when I tested in the evening around 17:00. This is when it would reach 3.0. In the morning it would be around 1.2.

[Heisok]

you'd think it's normal, but no need to think here  -- this info is widely available. 3 mmol/dl is rare and the highest reported on a keto diet. It's not normal. Normal is 1.5-2.0

 

PS

re blood draw, it does not have to be you. could be a relative or a friend. give them the thing and ask for a favor. 

 

I think that you are perhaps generalizing too much. I had some lab work, and my test result was 3.8. The Dr. was concerned, so to assuage his and the Endocrinologist's worries, I went off Keto and was .2 a week later. I do not test numbers at home. I just double checked some numbers from a trustworthy (To me) person who has eaten  strict Keto for years. They had done a series of tests over multiple days. The  numbers were 5.1, 4.0 and 5.9. They are very strict long term Keto. They advocate less than 20 gms total carbs, around 60 gms protein for themselves and the rest fats.

Edited by Heisok, 06 April 2018 - 08:10 PM.

[xEva]

I think that you are perhaps generalizing too much. I had some lab work, and my test result was 3.8. The Dr. was concerned, so to assuage his and the Endocrinologist's worries, I went off Keto and was .2 a week later. I do not test numbers at home. I just double checked some numbers from a trustworthy (To me) person who has eaten  strict Keto for years. They had done a series of tests over multiple days. The  numbers were 5.1, 4.0 and 5.9. They are very strict long term Keto. They advocate less than 20 gms total carbs, around 60 gms protein for themselves and the rest fats.

 

 

thank you, very informative. Though I still doubt this -- maybe because this is the first time I see such numbers reported on keto diet (more people should contribute! ) On this forum, Chupo (-?) posted that he had ~3.0 in the evening, after his high fat supper. But 5.1-5.9 are the numbers one gets after a week-two  of starvation. 

Edited by xEva, 06 April 2018 - 10:49 PM.

[HaplogroupW]

thanks Haplo! that mojo meter does sound good.  But did you ever compare the keto numbers between NovoMax and mojo?

 

 

You're welcome xEva

 

Regarding the ketone measurement: Yes. I don't recall the exact numbers, just that they were close-ish; maybe similar disagreement in percentage terms. Your question made me reflect on why I'm not as concerned about the keto accuracy as I am the glucose. I think it's because small differences in fasting glucose (e.g. 90 vs 110 mg/dL) can mean the difference between being healthy and having metabolic syndrome, whereas ketones only have  meaning within relatively large ranges e.g. moderate ketosis (0.4-1.0 mmol), heavy ketosis (1.0-2.X) jumbo ketosis (2.X+). So I don't really care if I'm 1.7 or 2.2 mmol.

 

Well one scenario where I care more about ketone accuracy is in computing the GKI "glucose ketone therapeutic index":

 

https://nutritionand...2986-015-0009-2

 

I occasionally do the extended fast, and it takes until the 5th or 6th day before the ratio of ketone mmol : glucose mmol gets above 1. I try to keep it there for a day or so before breaking the fast. There's a certain "boredom" associated with fasting, and having some kind of goal progress with reward of real-time feedback makes it more interesting.

[xEva]

so I had a chance to test ReliOn micro meter recently. It was just 1 mg/dL above the lab value. 

the same strips are used for their Confirm meter. They cost twice as much as for their Prime model, which is useless for a non-diabetic. 

Edited by xEva, 27 July 2018 - 05:19 AM.