Type 2 Diabetes: Preventing Complications
Meters with Voice-Output Capability
From Access World: Technology and People with Visual Impairments, (September 2002, Volume 3, Number 5). Reprinted with permission of the American Foundation for the Blind. Available free online at www.afb.org. Funding for this product evaluation was provided by the Teubert Foundation, Huntington, West Virginia.
By Mark Uslan, Caesar Eghtesadi, Angie Spiker, Karla Schnell, and Darren Burton.
Speech output modules were examined for speech quality, speech controls, and convenience. The criteria we used to evaluate the meters were as follows:
1. Does the meter use a code key or strip for calibration?
2. Is the lancet depth adjustable to control puncture depth?
3. How small is the required blood sample?
4. Are the test strips touchable, and do they use capillary action to draw blood onto the strip?
5. Does the meter allow for the application of more blood after the test starts?
6. Does the meter require cleaning after use?
7. How long must you wait to get a reading after the blood is applied?
8. Is the meter calibrated for plasma values—the standard used by health care professionals?
9. Is the meter small enough to fit in a pocket or pocketbook?
10. How accurate and consistent is the meter?
11. Can the test data be downloaded to a computer?
12. Is the meter priced competitively?
The Accu-Chek Voicemate, by Roche Diagnostics, combines a meter and voice output module in one device. Three other meters on the market—the One Touch SureStep, the One Touch Basic, and the One Touch Profile, all made by LifeScan—can be used with voice modules that are purchased separately. The One Touch Basic and the One Touch Profile are not as up to date as are the One Touch SureStep and the Accu-Chek Voicemate. Although we put them in our Product Feature Chart and Ratings Chart, they don't measure up to the Voicemate and SureStep. The real competition is between the Voicemate and SureStep, and it is these two products that we think buyers should focus on.
Accu-Chek Voicemate
The Accu-Chek Voicemate is composed of the Accu-Chek Advantage blood glucose meter, which is plugged into the Voicemate's speech output module. The one-piece unit is the largest of the systems we examined (6.5 in. × 3.0 in. × 2.5 in.)— small enough to carry around, but too large to fit into a pocket or pocketbook. The Advantage is powered by two lithium batteries. Its screen is slightly smaller than the SureStep, and the font size (½ in. high) is also slightly smaller and not as thick and bold. Voicemate documentation is available on tape and in large print.
Consumer Reports evaluated the Advantage but not the Voicemate's speech module. Overall, the Advantage was rated second best from among 11 blood glucose monitors that it evaluated and was given a "very good" rating on both accuracy and consistency. Consumer Reports defined consistency as "the ability to give similar readings on successive tests of the same blood sample" and accuracy as "how closely the readings agreed with the standard lab results."
However, we noticed that the Advantage that came with the Voicemate looked different from the one purchased separately that was pictured in the Consumer Reports evaluation. We purchased one and found that its screen font was bolder and easier to read and that it is incompatible with the Voicemate's speech module. We contacted Roche Diagnostics and received verification that the separately purchased Advantage differs in packaging details, screen font, and layout, and is incompatible with the Voicemate. We were told that, with the exception of those differences, the technology used in the separately purchased Advantage is identical to the one that comes with the Voicemate.
There is a slot in the Voicemate for a code key for calibrating the meter for test strips. It uses touchable test strips that have a notch cutout to identify tactilely where to apply the blood. In addition, you can apply more blood after the test starts. The Voicemate requires four microliters of blood—less than half the amount used by the SureStep, but considerably more than many meters that do not offer speech output.
The response time can be quite slow, as long as 40 seconds. The Voicemate does not require cleaning, and, as an added extra, it has a built-in insulin vial reader that reads Eli Lilly insulin vials. It has an earphone jack. Memory download requires the purchase of special Accu-Chek software and a cable. We found the software unusable with a screen reader.
The Voicemate enunciates the meter's blood glucose reading only once. It has a repeat button, a feature that is preferable to the annoyance of continuous enunciation, and a thumb wheel control for on/off and setting the volume. The Voicemate can be operated by an external power supply or a nine-volt battery and is not rechargeable. The speech quality is good.
One Touch SureStep
Accessing the One Touch SureStep with speech requires the purchase of a separate voice unit from Science Products (800-888-7400 or 610-296-2111). The SureStep is slightly larger than the Advantage, but when combined with Science Products's smallest voice unit, the Mini-Digi- Voice, it is half the size of the Accu-Chek Voicemate (4.5 in. × 2.6 in. × 1.8 in.). It is powered by two AAA batteries. The documentation is available only in small print.
We purchased the SureStep for $65 and received a $40 rebate. Overall, it was rated fourth best by Consumer Reports and was given a "very good" on consistency and an "excellent" on accuracy. The response time is 15 seconds—better than the Voicemate but not as fast as some others.
Unlike the Voicemate, the SureStep must be calibrated manually by pushing a button until the number on the screen corresponds to the number located on the vial of new strips. Its blood glucose test strips are touchable, but require 10 microliters of blood, and you cannot apply additional blood after the test starts. The unit requires cleaning. Memory can be downloaded with free software, which is available on LifeScan's web site, and you need to purchase a cable. We found the software difficult to use with a screen reader, and some reports it generated were not accessible.
Science Products offers two versions of its Digi-Voice speech module for the SureStep, Basic, and Profile: the Mini-Digi-Voice or the Digi-Voice Deluxe. We prefer the Mini-Digi-Voice, because it is half the size of the Deluxe and costs $75 less. Unlike the Deluxe, the Mini does not have an external power source or an earphone jack and uses only a nine-volt, nonrechargeable battery.
The Mini uses cabling that plugs into the data port of the SureStep. Its speech quality is comparable to that of the Voicemate. However, the Mini's speech is continuous, with no way of silencing it, short of shutting down the SureStep. Turning on the SureStep will automatically turn on the Mini, which is a practical feature. But volume can be adjusted only by selecting one of five setting options that are spoken when the unit is turned on. The speech quality is good.
The Bottom Line
If you need speech output and you want the most up-to-date blood glucose meter, you are limited to two systems. Expect to pay about $260 for the One Touch SureStep with the Mini-Digi-Voice speech module or $495 for the Accu-Chek Voicemate. Check with your health insurance provider to find out if the cost of these units is covered.
The SureStep with the Mini-Digi-Voice module is smaller than the Accu-Chek Voicemate, offers slightly faster response time, and was slightly more accurate in tests done by Consumer Reports. The Accu-Chek Voicemate is easier to use because of such features as code key calibration, capillary strips with a tactile notch, and the use of a smaller blood sample. In addition, it does not require cleaning. Speech access is acceptable in both.
To control diabetes, you need to use a blood glucose meter often. Since the meter is a device that, by the nature of what it does, is somewhat unpleasant to use, we think ease-of-use is extremely important and outweighs a slight difference in accuracy, a longer response time, and a higher cost. The One Touch SureStep used with the Mini-Digi-Voice speech module is a good system, but the Voicemate is our choice because it is easier to use. We are not comfortable recommending systems that are based on the One Touch Profile or the One Touch Basic, since they are not as easy to use as either the Voicemate or the SureStep.
Interviews with Four Users of Blood Glucose Meters
By Mark Uslan, Karla Schnell, and Angie Spiker
[Editor’s Note: The availability of the following meters may vary. For more information, contact the manufacturer.]
We visited four visually impaired users of blood glucose meters to observe how they used their meters and to interview them. All four have had diabetes for over 20 years and experience fluctuation in their remaining vision. One person was visited at her place of employment, and three were visited at home.
One person tests her blood six to eight times a day. She uses two meters, the Accu-Chek Voicemate at home, and the Accu-Chek Complete outside her home, because she thinks that the Voicemate is too bulky to take anywhere. To read results on the Accu-Chek Complete, she either uses her closed-circuit television (CCTV) or her vision, when possible, or asks someone to read it. She wishes the Accu-Chek Advantage were smaller and the Accu-Chek Complete would have speech output.
Two people use the Glucometer Elite from Bayer. One of the two tests his blood once a day and uses his vision to read the results. He likes using the code key to calibrate the meter and being able to apply more blood after the initial application, but he wishes his meter had a larger screen. The other person tests her blood four times a day and uses her CCTV to read the results. She likes the code key feature and the capillary strip feature. She wishes her meter had speech output.
The fourth person uses the One Touch SureStep from LifeScan. She tests her blood once a day and gets help doing it six days a week. On the one day a week she tests her blood independently, she uses a magnifier to read the results, but has some difficulty getting blood on the test strip. Sometimes she has to repeat testing up to three times. She wishes the process were easier.
Product Information
Product: One Touch Ultra
Manufacturer: LifeScan, 1000 Gibraltar Drive, Milpitas, CA 95035; phone: 800-227-8862; web site: www.lifescan.com.
Product: Accu-Chek Advantage
Manufacturer: Roche Diagnostics, 9115 Hague Road, PO Box 50457, Indianapolis, IN 46256; phone: 800-858-8072; web site: www.accu-chek.com.
Product: FreeStyle
Manufacturer: TheraSense, 1360 South Loop Road, Alameda, CA 94502; phone: 888-522- 5226; web site: www.therasense.com.
Product: Prestige IQ
Manufacturer: Home Diagnostics, 2400 N.W. 55th Court, Fort Lauderdale, FL 33309; phone: 800-342-7226; web site: www.prestigesmartsystem.com.
Product: Sof-Tact
Manufacturer: Abbott Laboratories, Medi-Sense Products, Bedford, MA 01730; phone: 866-763-8228; web site: www.medisense.com.
Product: Digi-Voice for One Touch SureStep, Basic, and Profile
Manufacturer: CAPTEK, sold by Science Products, Box 888, Southeastern, PA 19399; phone: 800-888-7400.
Product: Accu-Chek Voicemate System
Manufacturer: Roche Diagnostics, 9115 Hague Road, PO Box 50457, Indianapolis, IN 46256; phone: 800-858-8072; web site: www.accu-chek.com.
Product: One Touch Basic
Manufacturer: LifeScan, 1000 Gibraltar Drive, Milpitas, CA 95035; phone: 800-227-8862; web site: www.lifescan.com.
Product: One Touch SureStep
Manufacturer: LifeScan, 1000 Gibraltar Drive, Milpitas, CA 95035; phone: 800-227-8862; web site: http://www.lifescan.com/.
Product: One Touch Profile
Manufacturer: LifeScan, 1000 Gibraltar Drive, Milpitas, CA 95035; phone: 800-227-8862; web site: www.lifescan.com.
Product: LHS-7 for the One Touch Profile
Manufacturer: LS&S Group, PO Box 673, Northbrook IL 60065; phone: 800-468-4789; web site: http://www.lssgroup.com/.
© 2005 American Foundation for the Blind. All rights reserved. This material may not be shared, reproduced, or duplicated without the prior written permission of the American Foundation for the Blind www.afb.org.