The Newest in Blood Glucose Monitoring Devices (Continued)
On another positive note, I thought the OneTouch Verio Gold test strips had several notable innovations. Most important, they were very accurate in the hypoglycemic range (see table at end of article for more information). The strips also had very good blood drawing action, a larger and clearer sample window, and allowed me to apply blood on either the right or left side of the strip (as opposed to straight on the front tip of the strip). One downside, however, at least for me – due to their razor thinness, I often found it hard to pull just a single strip out of the bottle. The meter uses the OneTouch Diabetes Management Software to download results to a computer (unfortunately PC-only) using a provided mini-USB cable. Unlike the software for Telcare or the FreeStyle InsuLinx, the Verio IQ software must be downloaded and stored locally on a computer. On the other hand, I did like that the meter's battery can be charged using a single provided cord – either through a computer's USB port or plugged into a wall outlet using a provided adaptor.
The Verio IQ has already been made available through pharmacies around the US, although in February, LifeScan issued a voluntary recall of the device due to a software bug with the meter's settings. In certain cases, the Verio IQ delivers an error that causes the meter to turn itself off when a user attempts to access the "Results Log" to view past test results. When this error occurs, the meter enters "set up" mode when it is powered back on. The date and time settings must then be reset before testing can occur again. This does not affect the accuracy of test results, meter functions, or test results stored on the meter. The company is currently removing and replacing all OneTouch Verio IQ Meters in the US and has developed the software update to correct this issue. Product shipments have resumed, and the meter will soon be widely available.
The Verio IQ's out-of-pocket retail price is $69.99, though depending on your insurance coverage, the price might be less. OneTouch Verio Gold test strips are covered by Medicare Part B (all test strips, regardless of brand, are covered at the same rate), while co-pays for private insurance will vary by health plan.
- Automated wireless upload of blood-glucose results
- Feedback messages and easy strip reordering
- Online platform and iPhone application
We first wrote about Telcare's new meter when it debuted at the American Association of Diabetes Educators (AADE) annual meeting last August. As a reminder, the meter's major innovation is the inclusion of cellular (3G) connectivity. After a blood glucose test, the meter displays the reading in large font. The user then has the option of tagging the reading beyond the standard pre-meal and post-meal marks (e.g., exercise, illness, etc.). Whether the result is tagged or not, it is automatically sent to Telcare's server 20 seconds after the test. If there is no wireless reception, the result is stored on the meter for later transmission.
I was definitely a big fan of this automatic upload. Considering the hassle of downloading most diabetes devices (I never do it even though I know the data is really valuable!), it was amazing to see my test results immediately available online at https://mytelcare.com, Telcare's secure server, and through Telcare's free iPhone app. I think this would also be quite useful for parents of children with diabetes, especially if the kids are very young, away from home and in the care of others, and/or prone to erratic high and low blood sugars. I found the iPhone app much more intuitive and better designed than the online interface, though both offered many charts, graphs, statistics, and information to spot areas for improvement.
The meter also gives the user constant feedback on testing averages and trends through an innovative communication feature. Following a test result, the Telcare system analyzes a user's data and sends customized messages right to the meter. Some examples that I received included: "Adam, you have completed 90% of your targeted tests this week and your glucose is within 20% of target," (cool!) "In the past 7 days, your pre-meal BG average is 118 mg/dl (6.5 mmol/l)," and "Your average BG today is 106 mg/dl (5.9 mmol/l)." Target ranges can easily be set and changed by a patient or a healthcare provider using Telcare's online system. Doctors or nurses (or assistants at medical offices) can also communicate directly with a patient's meter: "Susan, our records indicate that you have an appointment this Thursday. Please confirm by calling (555) 555-5555." Given the high percentage of missed appointments, such reminders are a powerful feature of this meter.
The most impressive message I received was, "You are running low on supplies. Would you like to reorder? (Y/N)." After pushing a couple of buttons, I was surprised that I could actually order strips and have them sent to my house. Compared to my usual, often hassle-filled trip to the pharmacy, this was an obvious improvement. Additionally, I sometimes forget to check my supplies and end up with mild-panic-inducing shortages of strips, insulin, or infusion sets and reservoirs. It's really useful that this meter could at least help alleviate this problem for meter supplies.
I found Telcare's full color screen bright, easy to read, and very useful when graphs were displayed. The meter is powered by a rechargeable battery and has an on/off power switch on its side. Telcare's battery definitely wore out faster than that of the rechargeable Verio IQ, which likely reflects the cost of having cellphone connectivity built in to the meter (note: the battery life can be extended by turning the meter off between tests, though I found this hard to do in practice). I thought two other areas Telcare could improve on are the meter's buttons and user interface. I found neither to be as simple as those for the Verio IQ or FreeStyle InsuLinx (e.g., Telcare's buttons were located on the side of the meter, there were many more submenus, there was no back button). As we understand it, Telcare is working on several improvements for a new version of the meter, which should be out by the end of the year.
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Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...