Diabetes Complications

Diabetes and Visual Impairment: An Update on the Blood Glucose Monitor Market

By Darren Burton.

The latest demographic research shows that 3.2 million Americans with diabetes are blind or have low vision. Because of the close relationship between diabetes and vision loss, the researchers at the AFB TECH product evaluation lab have kept track of the devices that are used to manage this disease, which is affecting more and more people. In the March 2007 issue of AccessWorld, we introduced the Prodigy and the Advocate, two small, inexpensive blood glucose monitors that are produced in Taiwan by Taidoc Technology. These monitors have some speech output to accommodate people who cannot read the screen, but the speech output is limited and does not communicate all the information on the screen. This article examines the SensoCard Plus and the new Prodigy Voice, both of which feature much more accessibility and usability for people who are blind or have low vision. It also briefly discusses the new Advocate Redi-Code and Prodigy Auto Code, both of which are similar to the originals but eliminate the need to calibrate the monitor to each new container of test strips.

Diabetes is a disease in which the body is unable to use and store glucose properly. It is a serious health problem in the United States—16 million people have the disease, and over 5 million of them experience some form of vision loss. Using devices that measure their blood glucose levels enables people to keep those levels within a normal range by taking a dose of insulin or eating a certain food. Blood glucose meters have revolutionized diabetes care by allowing individuals with diabetes to have more active control over their condition.

Why is an accessible blood glucose meter so important? The answer is simple: If you are not able to operate the meter and read the results, the meter is not usable. There are about 30 blood glucose meters on the market, including a few that have speech-output capability or can be used with a separately purchased speech module. Some visually impaired people may be able to use an off-the-shelf meter without speech output, but others with less vision need speech access to test their blood independently.

Readers who are interested in the accessibility of blood glucose monitors should be aware that the Accu-Chek Voicemate talking blood glucose monitor that we evaluated in the September 2002 issue of AccessWorld was discontinued by its manufacturer, Roche Diagnostics. Although the price of the Voicemate was high ($500), and the monitor was heavy and bulky compared to other monitors, it was at one time the most fully accessible monitor on the market. It is disturbing to see it disappear from the market without a replacement being introduced, and although a replacement unit may still come on the market, we have heard no news from Roche to support this hope.

For readers who are not familiar with the issue, here is some brief information from a previous AccessWorld article explaining the use of a blood glucose monitor to manage diabetes:

Because with diabetes, the body is unable to use and store glucose, or sugar, properly, it is necessary for people with this disease to monitor their blood glucose levels. You measure your blood glucose level by placing a small sample of blood on a test strip inserted into the monitor, and the monitor analyzes the blood and determines a blood sugar level. Using a blood glucose monitor to measure their blood glucose levels enables people to keep these levels within a normal range by taking a dose of insulin or eating a certain food. When not managed properly, diabetes can be a deadly disease, attacking several internal organs, including the heart and pancreas, as well as the eyes. Blood glucose meters have revolutionized diabetes care by allowing individuals with diabetes to control their condition more actively. If you are not able to operate the meter and read the results, the meter is not usable, and you have a much lower chance of keeping the ravages of diabetes at bay.

The SensoCard Plus

The SensoCard Plus is distributed by BBI Healthcare in the United Kingdom and is manufactured by a Hungarian company called Electronica 77. It is priced in Europe at £49.99. BBI is in the middle of the cumbersome process of gaining approval from the U.S. Food and Drug Administration (FDA), so the SensoCard Plus is not yet available in the United States. However, BBI hopes to have FDA approval soon.

The SensoCard is a thin, credit card-sized monitor with built-in speech output that supports all its functions. It weighs 2.5 ounces and measures 3.5 by 2.2 by 0.3 inches, with a small speaker protruding an additional 0.25 inches from the back of the bottom panel of the monitor. It has a 1.3-inch-square black-and-white LCD (liquid crystal display) screen and only three control buttons. The round main control button is below the display screen on the right, and there are two arrow-shaped Up and Down buttons on the right side panel. There is a small slot in the front panel of the monitor for inserting a test strip and another slot on the bottom of the left side panel for a code card strip that calibrates the meter with each new container of test strips. There is an infrared data port on the back panel for transferring data to a PC, but there is no headphone jack.

The Prodigy Voice

Priced at $79.99, the Prodigy Voice is distributed by Diagnostic Devices and is manufactured in Taiwan by Taidoc Technology. It came on the U.S. market on November 19, 2007, and its speech output supports every function of the meter, far surpassing the accessibility of the original Prodigy, which we reviewed in the March 2007 issue of AccessWorld.

The Prodigy Voice weighs 2.7 ounces and measures 2.0 by 3.5 by 0.8 inches. The front panel has a 1.34-inch by 1.75-inch monochrome black-on-gray display, with three control buttons just below. The round Power button is on the right and is larger than the other two buttons. It turns the meter on and off and is also used to enter Memory Recall mode. The Settings button is in the middle and has a smaller, triangular shape. The Repeat button is on the left and replays the last spoken message or test result. The speaker is just below the buttons. On the right side panel are two triangular buttons pointing up and down that are used to adjust the various settings and to scroll through the various readings in memory. The Eject button, on the top of the left panel, allows you to eject a used test strip easily and safely without touching it. The standard 3.5 millimeter ear phone jack, near the bottom of the right side panel, allows you to use a headphone for privacy or to connect a speaker to amplify the speech. The data port, just below the ear phone jack, allows you to download the meter's test results to a computer using Prodigy's download software.