Meter/Test Strip Price Balance

[Deleted member 308541]

The $ fooled me

Australia got rid of the £ sign and introduced the $ sign when we went on to decimal currency in 1966.

Many other countries use the $ sign as well.

 

[Scott-C]

I'm sorry, but you guys are living in a fantasy world when it comes to measuring bg. You could drive yourself mad thinking about accuracy but it doesn't actually matter that much at all. They are all near enough to make no odds.

Accuracy is an illusion: home meters aren't accurate, hospital meters aren't accurate.

Anything after the decimal point is a broad indicator, not truth. The same goes for the number before the decimal point too.

I'm saying that as a T1 who started out 30 years ago with colour changing strips where we had to guesstimate what the colours were showing - see pic below.

Modern meters give an illusion of accuracy because of the decimal point but they are still just guesses. They are all still measuring electrons coming off a glucose oxidase reaction. It's measuring flittery ghosts.

If I was to measure at 5.5 on one meter and 6.3 on another, the treatment would be the same - it's about 5 to 6'ish for my purposes (and please do remember that the treatment is insulin, which might kill me if I get it wrong).

Sure, I like it when my bling cgm tells me that my delta change from the last 5 min read is 0.05, but I know that that is not true. It's just a broad indicator, taken along with the last 20 minute readings, that I'm kinda stable.

T1s, especially those of us from a colour changing strips background, tend to think of bg in terms of ranges, rather than numbers. Is it 4 to 7, rather than 5.4? We can see 5.4 on a meter, but we know it's unlikely to be that, but are reassured that it's generally in the 5'ish range instead of 9.

 

[BloodThirsty]

I'm sorry, but you guys are living in a fantasy world when it comes to measuring bg. You could drive yourself mad thinking about accuracy but it doesn't actually matter that much at all. They are all near enough to make no odds.

Accuracy is an illusion: home meters aren't accurate, hospital meters aren't accurate.

Anything after the decimal point is a broad indicator, not truth. The same goes for the number before the decimal point too.

I'm saying that as a T1 who started out 30 years ago with colour changing strips where we had to guesstimate what the colours were showing - see pic below.

Modern meters give an illusion of accuracy because of the decimal point but they are still just guesses. They are all still measuring electrons coming off a glucose oxidase reaction. It's measuring flittery ghosts.

If I was to measure at 5.5 on one meter and 6.3 on another, the treatment would be the same - it's about 5 to 6'ish for my purposes (and please do remember that the treatment is insulin, which might kill me if I get it wrong).

Sure, I like it when my bling cgm tells me that my delta change from the last 5 min read is 0.05, but I know that that is not true. It's just a broad indicator, taken along with the last 20 minute readings, that I'm kinda stable.

T1s, especially those of us from a colour changing strips background, tend to think of bg in terms of ranges, rather than numbers. Is it 4 to 7, rather than 5.4? We can see 5.4 on a meter, but we know it's unlikely to be that, but are reassured that it's generally in the 5'ish range instead of 9.

View attachment 29122

I thoroughly enjoyed your post but isn't this just what I have been rambling on about?

As you rightly say, urine sticks provide a broad range to give a quick and dirty estimate of blood glucose, ketones, or whatever. All very well, but hang on a mo... these things cost 9 quid for 150 whereas glucose and ketone test strips cost around 15 times more. Should we be paying exorbitant developmental costs (the price justification?) for a technology that you accept as being little more than a numerical illusion?

Despite my pontification I do have several meters that produce consistently repeatable results in a relative way and also provide an acceptable level of HCT correction which suits me but not necessarily everyone else. I therefore contend that greater accuracy is readily achievable but arguably not encouraged in a commercial environment where the hardware is considered a throwaway item.

I smirked at your bling reference knowing that my own search for accuracy is not remotely connected with life or death therapeutic decisions but purely to do with ego. As someone who controls his T2D solely through diet I am royally hacked off when my FBG exceeds 5.4 mmol/l.
Being of an obsessive disposition, something like this can really ruin my day.

 

[Mr_Pot]

We have had several threads on here bemoaning the lack of accuracy of meters with the assumption that manufacturers can't be bothered to do anything about it. There are a vast number of meter manufacturers all competing for business. If one of them could make a significantly more accurate meter, I am sure they would for the commercial advantage. The fact that they haven't shows that sometimes things just aren't possible yet.

 

[BloodThirsty]

We have had several threads on here bemoaning the lack of accuracy of meters with the assumption that manufacturers can't be bothered to do anything about it. There are a vast number of meter manufacturers all competing for business. If one of them could make a significantly more accurate meter, I am sure they would for the commercial advantage. The fact that they haven't shows that sometimes things just aren't possible yet.

Perhaps the fact that meters can be obtained complementary or for a few quid on Amazon and eBay dictates their ultimate specification. As a glucose strip purveyor, why should I reduce my lucrative profit margin by developing and manufacturing a state-of-the-art meter when other providers view their machines as expendable costs of sales and effectively give them away?

I am merely exploring the notion that IF providers adopted a new business model whereby they spent considerably more on the appliance to encourage pride of ownership, brand loyalty and technical excellence, then maybe end users would be motivated to fork out for such a device.

As things stand, it is not in the best interests of big pharma to improve on the standards laid down by MHRA or FDA when these can readily be met with cheap hardware and obscenely good markups all round.

 

[Scott-C]

As you've got an interest in the subject, @BloodThirsty , I thought I'd just mention that there's a more modern version of the colour changing strips I mentioned earlier, Glucoflex-R.

https://www.betachek.com/gfx

I went on a bit of a nostalgia trip a year or two ago and bought a couple of packs of them, about £15 for a hundred.

I'd forgotten just how much blood is needed for them compared to modern meter strips - a fairly large hanging drop which you've then got to carefully splodge onto the top without smearing.

Back then, it was a minute wait, clean it off, wait another minute, then compare. These more modern ones were a mere 30 seconds, swipe, another 30 second!

We got quite adept at seeing tiny nuances in colour to decide which block it lay in or between.

And I can still remember my first DSN saying to me, "Scott, these are new and they're expensive for the NHS, so it's better if you cut them in half and get twice as much, and you'll need less blood too." I spent many patient minutes with scissors chopping them in half.

Anyway, just a little trip down memory lane!

 

[BloodThirsty]

As you've got an interest in the subject, @BloodThirsty , I thought I'd just mention that there's a more modern version of the colour changing strips I mentioned earlier, Glucoflex-R.

https://www.betachek.com/gfx

I went on a bit of a nostalgia trip a year or two ago and bought a couple of packs of them, about £15 for a hundred.

I'd forgotten just how much blood is needed for them compared to modern meter strips - a fairly large hanging drop which you've then got to carefully splodge onto the top without smearing.

Back then, it was a minute wait, clean it off, wait another minute, then compare. These more modern ones were a mere 30 seconds, swipe, another 30 second!

We got quite adept at seeing tiny nuances in colour to decide which block it lay in or between.

And I can still remember my first DSN saying to me, "Scott, these are new and they're expensive for the NHS, so it's better if you cut them in half and get twice as much, and you'll need less blood too." I spent many patient minutes with scissors chopping them in half.

Anyway, just a little trip down memory lane!

Of course you should have cut them in half... it makes good fiscal sense.

I really appreciate frugality but I'm not quite as careful as Warren Buffet (on a good day the second richest man on the planet) who encourages his wife to collect discount coupons.

On the other hand, and thinking about it, maybe that's the reason why he is absolutely loaded.

 

[bambee3]

To bloodthirsty and brassyblonde, no offence but why are you using so many meters. By using so many you are just adding to the confusion in your readings and you are in turn then stressing out over the different results you are expecting, again this can affect your levels . Yes I agree all are not equal but they have to pass specific criteria before they can be put on the market. Are you aware that you can use the same prick site and put blood onto different strips in the same meter test one straight after the other and get different results. You will also get this if you prick two different fingers at the same time and use the same meter and get two different results.

To brassyblonde, why are you testing blood ketones for your diet? You only need to do a urine test for ketones which is present if you are loosing weight.. Ketones from diet is different to blood ketones and diabetic ketosis, which normally as a type 2 you should not have to be concerned about.,

Not that you have to take note of my post, but both of you would be better off staying with one or two meters and no more. I have one for home and one in my handbag for when I am away from home. That way if I loose one or forget to swap from bag to home it doesn't matter. A plan of action my Diabetes Ed encouraged

 

[bambee3]

As you've got an interest in the subject, @BloodThirsty , I thought I'd just mention that there's a more modern version of the colour changing strips I mentioned earlier, Glucoflex-R.

https://www.betachek.com/gfx

I went on a bit of a nostalgia trip a year or two ago and bought a couple of packs of them, about £15 for a hundred.

I'd forgotten just how much blood is needed for them compared to modern meter strips - a fairly large hanging drop which you've then got to carefully splodge onto the top without smearing.

Back then, it was a minute wait, clean it off, wait another minute, then compare. These more modern ones were a mere 30 seconds, swipe, another 30 second!

We got quite adept at seeing tiny nuances in colour to decide which block it lay in or between.

And I can still remember my first DSN saying to me, "Scott, these are new and they're expensive for the NHS, so it's better if you cut them in half and get twice as much, and you'll need less blood too." I spent many patient minutes with scissors chopping them in half.

Anyway, just a little trip down memory lane!

Hi Scott, I also remember my first unit back about 1982 ish, and cutting the strips in half to make them go further.. Checking the colour of your results, sometimes a problem if you were having a bad day with high readings and your vision was a bit fuzzy.

 

[bambee3]

I thoroughly enjoyed your post but isn't this just what I have been rambling on about?

As you rightly say, urine sticks provide a broad range to give a quick and dirty estimate of blood glucose, ketones, or whatever. All very well, but hang on a mo... these things cost 9 quid for 150 whereas glucose and ketone test strips cost around 15 times more. Should we be paying exorbitant developmental costs (the price justification?) for a technology that you accept as being little more than a numerical illusion?

Despite my pontification I do have several meters that produce consistently repeatable results in a relative way and also provide an acceptable level of HCT correction which suits me but not necessarily everyone else. I therefore contend that greater accuracy is readily achievable but arguably not encouraged in a commercial environment where the hardware is considered a throwaway item.

I smirked at your bling reference knowing that my own search for accuracy is not remotely connected with life or death therapeutic decisions but purely to do with ego. As someone who controls his T2D solely through diet I am royally hacked off when my FBG exceeds 5.4 mmol/l.
Being of an obsessive disposition, something like this can really ruin my day.

As for Scotts post the test strips are not for urine they were for blood testing. I also used the same type in 1982ish.

 

[bambee3]

sorry everyone, still getting used to using this. my post landed up in Bloodthirsty's post and not as my own. Therefore deleted it from there and reposted. Just noticed my message was not showing. So I will try again.

The article listed at the top of Bloodthirsty's message seems to take the article as gospel. I have read the article and they pointed out several issues that can affect test results.
"
We used discarded blood samples that were deidentified.
We did not have information on possible medications and
other patient conditions that could interfere with blood glu-
cose measurements. Since many samples came from hospi-
talized patients the array of possible interfering substances
may have been larger than would be encountered in the out-
patient setting. We added glucose or incubated blood sam-
ples to produce samples with very high and very low glucose
levels, respectively."

"The accuracy of blood glucose monitoring systems
depends on many factors, including the strip enzyme, the
manufacturing consistency of the strips, the algorithms used
to produce PG results, temperature, humidity, altitude, interfering substances, sample source, collection method, and
hematocrit level.
2
"Most of the recently published studies have
compared meters that are commonly used in Europe.
9,12-16
but not all of these meters are available in the United States,
and some of the meters sold in the United States may be dif-
ferent from their European counterparts with the same or
similar names.

These comments have been copied straight from the study you provided and they are all important issues when reading this report and justifying your issues with your meters

 

[bambee3]

My Abbot and Accu-Chek strips cost me $1.30 for 100 at NDSS subsidised prices, and at the present time they are free as I hit the PBS safety net in July.

Hi Tipetoo, I also live in Bundy. I can’t believe the issues that diabetics in England have with their diabetic supplies. It is scary, we have it so much better here. Nursing for 32yrs in both NSW and QLD

 

[JohnEGreen]

no offence but why are you using so many meters.

I also have/use several meters but I just like gadgets and don't fret or stress over the differences between them. Just have fun with them if you can call it that.

 

[bulkbiker]

To brassyblonde, why are you testing blood ketones for your diet? You only need to do a urine test for ketones which is present if you are loosing weight.. Ketones from diet is different to blood ketones and diabetic ketosis, which normally as a type 2 you should not have to be concerned about.,

Not sure I would agree with you there.
Urine sicks for testing for nutritional ketosis are fairly notoriously inaccurate once the body stops "wasting" them so a pee stick may show no ketosis when in fact we are running quite happily on ketones. Blood or breath meters are well know to be far more accurate.
Beta hydroxybutyrate is measured by blood ketone meters and is what is measured in both nutritional ketosis and when looking for diabetic ketoacidosis. DKA is usually only when there is an absence of insulin and blood sugars are extremely high except when taking certain medications for Type 2 (the SGLT2 inhibitors- the "flozins").

 

[BloodThirsty]

sorry everyone, still getting used to using this. my post landed up in Bloodthirsty's post and not as my own. Therefore deleted it from there and reposted. Just noticed my message was not showing. So I will try again.

The article listed at the top of Bloodthirsty's message seems to take the article as gospel. I have read the article and they pointed out several issues that can affect test results.
"
We used discarded blood samples that were deidentified.
We did not have information on possible medications and
other patient conditions that could interfere with blood glu-
cose measurements. Since many samples came from hospi-
talized patients the array of possible interfering substances
may have been larger than would be encountered in the out-
patient setting. We added glucose or incubated blood sam-
ples to produce samples with very high and very low glucose
levels, respectively."

"The accuracy of blood glucose monitoring systems
depends on many factors, including the strip enzyme, the
manufacturing consistency of the strips, the algorithms used
to produce PG results, temperature, humidity, altitude, interfering substances, sample source, collection method, and
hematocrit level.
2
"Most of the recently published studies have
compared meters that are commonly used in Europe.
9,12-16
but not all of these meters are available in the United States,
and some of the meters sold in the United States may be dif-
ferent from their European counterparts with the same or
similar names.

These comments have been copied straight from the study you provided and they are all important issues when reading this report and justifying your issues with your meters

You are of course quite correct insofar as it is uncommon to conduct a study without some limitations and these you succinctly paraphrased.

In this particular exercise the researchers were exploring one specific interference factor - hematocrit, identifying from a sample of 17 those devices that provided the most effective correction.

Low hematocrit is particularIy televant to myself and I was therefore interested in the graphical variances which supported my own casual observations.

Forgive me if I implied that this was the whole story.

 

[CHICKY53]

Last year my surgery near Cardiff made everyone change onto the Accu-chek performa as they were less than £10 for 50, thats a 2 month script. I did object as I use a Contour next which plugs into my computer to record info and charge.
I have been a T1 for over 62 years and as I drive we are supposed to check blood levels before we start etc. I find 50 strips do not last me 2 months.
I did buy a box of extra strips last year they were £44.00 as a pensioner thats a 1/10 of my pension

 

[Deleted member 308541]

Last year my surgery near Cardiff made everyone change onto the Accu-chek performa as they were less than £10 for 50, thats a 2 month script

They would cost you the subsidised equivalent of $65.00 for 100 Performa strips across the counter here in Australia.

Hi Tipetoo, I also live in Bundy. I can’t believe the issues that diabetics in England have with their diabetic supplies. It is scary, we have it so much better here. Nursing for 32yrs in both NSW and QLD

Same here re supplies.

I hope you were one of the great nurses in the MCDU at the base hospital four and a half years ago,

 

[bambee3]

They would cost you the subsidised equivalent of $65.00 for 100 Performa strips across the counter here in Australia.



Same here re supplies.

I hope you were one of the great nurses in the MCDU at the base hospital four and a half years ago,

Unfortunately not. I Was fired after having sick leave for 4 weeks despite being told my job was safe. Since then have been diagnosed with other issues related to my diabetes and so no one will look at me re work.

 

[Deleted member 308541]

Unfortunately not. I Was fired after having sick leave for 4 weeks despite being told my job was safe. Since then have been diagnosed with other issues related to my diabetes and so no one will look at me re work.

Sorry to hear that...

 

[bambee3]

Sorry to hear that...

Thank you