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From Deborah Greenwood APRN, BC-ADM, MEd, CDE:

Laurie,

I did some online research and made a few phone calls. Unfortunately this is a very difficult situation. Most of the devices made for people who have diabetes and are blind are designed to work around
touch. You would think with the many people that do end up with neuropathy secondary to diabetes that they would try to address some of these issues.

The Accu-chek Voice Mate appears to be the best voice system on the market for testing blood sugar. I have copied information I found on product reviews. (see below)

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 (∏ 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.

Insurance will usually cover Accu-chek voice mate as Durable Medical Equipment.

MY THOUGHTS:
There is a new lancing device made by Accu-check called the Multi-clix. The benefit of this lansing device is that there are no lancets to handle. You insert a drum of six lances into the device and then can
advance to each subsequent lancet when ready. A family member could insert the drum to help your mother, then she would just need to handle the pen device. Of course, this one solution, doesn't help with the others.

Unfortunately the Accu-check compak does not have voice activation. That meter comes with a drum of strips, so you do not have to handle test strips. I asked the help line if they had any plans to add voice to this meter and they said no.

Can your other feel her palm or forearm? Most meters can now use alternate sites to test blood glucose. If she can feel a drop of blood on her palm or forearm, then she might be able to tell if the blood is
there, and then the meters will usually not function if not enough blood is applied to the strip. This is about the best option at this time. Use the Accu-chek multi-clix lansing device, use the palm or forearm to draw blood, with a Accu-chek voice mate system.

If your mother is having problems with low blood sugars and needing to test when she is alone, you may want to consider continuous glucose sensing. These new systems are not easy to use without vision,
however, they may be a safety measure to help your mother if needed. The sensor continually traces blood sugar as it changes during the day, with visual readings on a "meter like" device. She would need help with placement of the sensor (worn on the abdomen and changed every three days) and she would have to do two blood glucose tests per day to calibrate the sensor. Of course she would not be able to read the real time results, but you can set alarms for high and low blood sugars which can possibly be of some assistance in overall care.

Has your mother contacted the state to see what services they provide to assist persons with blindness? There are many state and federally funded programs available for training and for assisted care that your mother might qualify for.

I wish I had better answers for you. I do not think you are alone and I think this issue needs to be addressed. Hopefully it will be in the future.

Good luck!

Deborah Greenwood APRN, BC-ADM, MEd, CDE