Blood Testing & Self Treatment: Your Current Experiences

[Calum Fovargue]

Hi fellow Type 1's,

I'm currently undergoing a university project where I'm trying to come up with a new design of blood testing meter, and wanted to get different peoples opinions and/or problems they face with their current blood glucose meters.
Also, when it comes to managing and self adjusting your treatment - is there anything you find that hinders or helps about your blood testing meter?
And what experience do you have getting treatment advice from your healthcare specialist? (Doctor, diabetic nurse etc.)

My own experiences living with type 1 have helped me so far in this project, but I'm trying to figure out what real problems people are facing today and to try and address them in my design. I was thinking about writing up a questionnaire, but I thought bringing open-ended questions to a forum would be better.

Many thanks,
Calum

 

[Bluetit1802]

Can Type 2's join in? We test as well but aren't normally lucky enough to get GP prescriptions and have to self-fund.

I have an Accu-chek mobile provided by my nurse. However, no prescription for the strip cassettes that fit neatly into the meter without any need to handle them. The cassettes are a brilliant idea.

My only problem is expense. They cost 50p a test full price. I can get them just about half price on-line but still very expensive. If you could design a meter with cassette strips that cost a lot less I would buy it!

No other problems

 

[mo1905]

Good point. There are meant T2's who test and a big issue is cost. If you can reduce unit cost and improve accuracy you'll be a rich person

Sent from the Diabetes Forum App

 

[noblehead]

Currently use the Accu-Chek Aviva Expert, it's a little bulky but it's a really good meter. My only gripe with Accu-Chek meters is the time it takes for it to register the test strip on insertion, sometimes I put the blood on the strip before the screen changes and the strip is wasted, never had this problem with the Contour Next meter. Probably asking for the impossible but it would be good if the meter, lancer and pots of strips were much smaller and compact so you are carrying less bulk around.

As for HCP's, overall they've been fantastic and I can pick up the phone at any time and get to speak with a DSN, if not they will return my call by the end of the day, my diabetes check are done at the hospital diabetes clinic although I get my bloods taken at my gp surgery.

Good luck with the project Calum and do keep us informed on your progress.

 

[DunePlodder]

I wish meters were more accurate.
+/- 20% is the official minimum standard, I believe.
I think in practice most are better than that, but I'd like to see something nearer to +/- 5%.

 

[AlexMBrennan]

I'm using an Accu-Chek Mobile, and the main reason for picking it is that I found having to handle lancets and test strips very annoying (e.g. removing a lancet from one of the other lancing devices on train without injuring yourself, or dropping it can be fiddly, and then you don't have anywhere to store or dispose of the medical waste until you get home...)

Having a cassette instead of individual test strips is nice (it does make things easier), but as pointed out earlier you do pay extra for the convenience but not absolutely necessary.

Also, when it comes to managing and self adjusting your treatment - is there anything you find that hinders or helps about your blood testing meter?

Only to the extent that some meters make it difficult to test without a square meter of desk space for all the fiddly bits, forcing you to test later than you ideally should or causing you to miss tests entirely.

If you are referring to the "wizards" some of the new meters come with, I don't consider them very helpful since dose adjusting isn't exactly rocket science and I generally don't think that you should be using a wizard if you can't do without them.

And what experience do you have getting treatment advice from your healthcare specialist? (Doctor, diabetic nurse etc.)

My experience is that I do not need treatment advice beyond what the DSN covered when I was still in the ICU - at the end of the day, diabetes has to be mostly managed by the patient themselves and involves a lot of trial and error that the doctors can't necessarily help with anyway.

 

[oldgreymare]

It is easy to forget just what a revolution for diabetic care self blood glucose meters represent. That said biggest challenge most users face is expense of strips - diabetes is a growing epidemic worldiwde, so plenty of incentive for suppliers to grow volume and reduce prices.

Other pet peeve is connectivity. Many meters store data and are compatible with monitoring software, BUT almost all do not include USB cable with meter (Impossible to source in many countries). Also software often only Windows compatible ;-( . Imbedding a wireless app in all meters is long overdue.

 

[Brightside]

Agree with "old grey mare" just recently got my unit, bg star from sanofi! Nice little unit, but strips are expensive, and if I hadn't have especially asked for the software from the supplier I would have had to write all the results in a book! I this the 21st century?
Oh and the software only works on vista or xp....hellooo....Xp?.....that went out ages ago and since April is not supported anymore by Microsoft!


These units need to connect automatically to my PC and update without me having to touch a button! Also the software should be imbedded in the unit, after all my phone/internet dongle doesn't need a disc, it's all preprogrammed in the unit itself!

The software itself is rather basic and doesn't allow much manipulation, but it's better than hunting for a pen and a little book....


The test strips ....well now there's something in need of improvement!


Sent from the Diabetes Forum App

 

[ElyDave]

accuracy/repeatability and reduced uncertainty
size
waterproofing

 

[ElyDave]

I wish meters were more accurate.
+/- 20% is the official minimum standard, I believe.
I think in practice most are better than that, but I'd like to see something nearer to +/- 5%.

latest standard is +/- 15% for most readings but many will still be based on the old standard

Working with other meters regularly in my job, I can't believe that the standard for a critical meter used to make daily decisions affecting health is so loose.

 

[Jaylee]

Hi Calum,

I'm not sure what direction you are taking design..

But if had the recourses & "da brain". Lol I would go for a device about the size of the current Accu-Chek finger pricker that has a cartridge of "one off" lancets. (like the current six barrel loaders)
These lancets would draw up & test the blood In "one movement", with maybe a "traffic light" readout on the side of the unit which would also send a mmol/L reading to an app while tethered to the phone via Bluetooth or length of wet nylon..?
I would call it.... The Mosquito!

Though I'm quite happy with my Accu-Chek Mobile which I call "Enid"..

 

[yingtong]

I currently use Abbotts Freestyle InsuLinx,which I think is a excellent meter.I like many others are concerned with accuracy and the lack of meters compatible with Apple,especially iPads.I think a Bluetooth connectable meter would be both useful to us Diabetics and the professionals who look after us.I have been given a new meter by my DSN to review,it is MyStar Extra which will also give me a estimated A1c.I will let you all know how I get on.


Sent from the Diabetes Forum App

 

[Charles Robin]

I would like to see a meter that does not start the test until it knows it has enough blood to register a result. Modern meters require far smaller samples than they used to. However, I still occasionally get the problem of putting my finger to the test strip, and the strip not taking enough blood. The meter still starts the test, but it gives an error message because the strip is not completely filled. That strip is then unusable, which is a big waste.

All that would be required is a button on the meter that you have to press to start the test, once you have applied the blood.

 

[ElyDave]

I would like to see a meter that does not start the test until it knows it has enough blood to register a result. Modern meters require far smaller samples than they used to. However, I still occasionally get the problem of putting my finger to the test strip, and the strip not taking enough blood. The meter still starts the test, but it gives an error message because the strip is not completely filled. That strip is then unusable, which is a big waste.

All that would be required is a button on the meter that you have to press to start the test, once you have applied the blood.

If it's working on an enzymatic basis as some do, then that may not be feasible as the enzymes have already started to react. Might work with other technologies though. I've had this problem myself as well.

 

[noblehead]

I would like to see a meter that does not start the test until it knows it has enough blood to register a result. Modern meters require far smaller samples than they used to. However, I still occasionally get the problem of putting my finger to the test strip, and the strip not taking enough blood. The meter still starts the test, but it gives an error message because the strip is not completely filled. That strip is then unusable, which is a big waste.

All that would be required is a button on the meter that you have to press to start the test, once you have applied the blood.

So true Charles, a waste of a good test strip.

 

[Jaylee]

If it's working on an enzymatic basis as some do, then that may not be feasible as the enzymes have already started to react. Might work with other technologies though. I've had this problem myself as well.

So true Charles, a waste of a good test strip.

Could it be that it's better to have an error message in the meter due to "insufficient" blood, rather than reading a possible "false low"...?

I love a good blood bath when I draw it... But I do empathise with the squeamish...

 

[AlexMBrennan]

Iirc one of the Bayer meters allows you to add more blood if the initial drop is insufficient so it must be possible to do this somehow.

 

[Bluetit1802]

I would like to see a meter that does not start the test until it knows it has enough blood to register a result. Modern meters require far smaller samples than they used to. However, I still occasionally get the problem of putting my finger to the test strip, and the strip not taking enough blood. The meter still starts the test, but it gives an error message because the strip is not completely filled. That strip is then unusable, which is a big waste.

All that would be required is a button on the meter that you have to press to start the test, once you have applied the blood.

I've wasted 2 today for that very reason. £1 down the drain

 

[noblehead]

Iirc one of the Bayer meters allows you to add more blood if the initial drop is insufficient so it must be possible to do this somehow.

They do.

 

[Calum Fovargue]

Hi all,

There's been a fair few interesting responses from you all - which I'd like to address.
Just so there is no confusion, I understand that cost of test strips is a concern for type 2's who don't receive free prescriptions though the NHS like type 1's...unless this forum is open to international diabetics?

Some of you have discussed the error message displayed on meters when too little blood is applied. I too have wasted a fair few strips because of this, and even though I don't pay for mine, I am aware they cost alot to the NHS and are a continuous flow of revenue for pharmaceutical companies (meters are given to NHS for free I believe). I also find personally I run out of strips fast (testing for every meal and high corrections, lows etc.) and results in more trips to the pharmacy for repeat prescriptions - which is often inconvenient.

With regards to my current ideas on the meter - my main focus thus far has been on better connectivity of meters and the data stored on them. I currently use the Aviva Accu-Check Expert and the bolus advice is useful, but even being one of the most advanced blood testing meters availible, the blood test data recorded is useless as it relies on dated infra-red technology and a cable that isn't included with the device. Trends and patterns which I think could be better utilised are displayed on a small screen - near impossible to help me analyse my insulin levels.

Though some meters I've researched have software capabilities and iphone connectivity, I don't think there's one thats made good use of the potential of today's interconnected devices and technology.

As for the Bayer meter AlexMBrennan mentioned, I'm going to try and look into it.

Really good responses from you all so far, it would be interesting to know type 1's - whether you have been on a course like DAFNE or trained in a method of carb counting for your insulin ratios.

Thanks for the continued help,
Calum