Dario - A proper review

tim2000s

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Having spent a bit of time (200 or so test strips) getting to know Dario over the past couple of weeks, I've come to find that it's actually a pretty nice system to work with.

The app is available in the iOs App store - I'm not too sure of the availability on Android. The system is split into a device that plugs into the phone and the software, which you can use separately from the device. The device is available from Advanced Therapeutics at a fee now, however when I obtained it, you paid nothing for it.

For those interested, the test strips on the NHS cost £14.95 per 50, and I'll soon be checking whether the SD Codefree strips also work in it - there is a marked similarity in the way they appear...

The device consists of a strip holder that goes into the headphone socket, a lancing device and a strip holder. The strips come in packs of 50 that are sealed into two pots of 25. They come with a warning that they should not be used after being unsealed for a month, and when I tried to use a set that were some 6 months open, this warning was pertinent as the strips read approximately 6mmol/l too high. A warning to be heeded.

As a device it's very pocketable and seems to work nicely.

The bigger piece here is the software. It's very simple to enter a reading and comes complete with a bolus calculator. I've been using this for the last week and it seems to do a decent job of estimating the required bolus, although I have been having to add 50% of my protein intake as carbs in order to get the correct dose. As a bolus calculator it seems as good as that on the Abbott Libre, however it is much easier to use by virtue of using the iPhone and not the rubbish interface of the Libre.

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It also provides a useful statistics overview screen, estimating what your Hba1C is, and showing how you've done against your input range.

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In combination with this is a personalised website, very similar to that which you get with Diabetes Connect. All your data is logged to there and you can generate PDF reports and CSV files for your own use. The format of the CSV files is a little sub-optimal but all in all, it seems to work.

I'm surprised by how easy it has turned out to be to use and integrate with life, and the fact that the bloods are always added to the phone and synced to the cloud and the insulin is worked out and synced makes it a really, really easy platform to use to capture all of your data together in one place.

If there is one thing I'd like to see improved, it's the graphs, which could show insulin and carbs more effectively when trying to pattern spot. As a product, it's probably the best I've seen in terms of linking all of these together when using MDI.
 
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tim2000s

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So, a brief update on the SD Codefree strips. When one is laid side by side next to the Dario strips, the similarities are all far too obvious. Take a look at the picture below:

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The one on the left costs the NHS 29.9 pence. The one on the right, 14.0 pence. For two items which clearly share IP and manufacturing, what a difference. Looks like Dario are either trying to make their money out of the test strips (what's new?) or recover the cost of the R&D on the software and hardware design through this route. Slightly frustrating that the paths on the strips are basically a mirror image of one another so that you can't interchange them...
 
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pinewood

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Thanks for the useful report, Tim. Are Dario strips available on prescription and do you know if it's difficult for GPs to agree to prescribe them given the cost?
 

tim2000s

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Thanks for the useful report, Tim. Are Dario strips available on prescription and do you know if it's difficult for GPs to agree to prescribe them given the cost?
Yes, they are. Given they are cheaper than Aviva, Contour, Contour NEXT, all of the Abbott strips, most of the Glucomen strips and the Onetouch brands, it should be fairly easy.
 
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pinewood

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Thanks. One more question - how have you found the accuracy?
 

tim2000s

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With the new strips it's as good as anything else I've used.
 

iHs

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As great to use as the Dario might appear to be, you will lucky to get a GP who is not governed on they can prescribe, to just write out prescriptions for whatever and not give the third degree as to why you cannot use a bg meter that takes cheaper strips.
As for Glucomen....the GM and another strip is 9.95 per 50.
Where I live which is heavily populated, most type 1s have been requested to change to the Glucomen if they don't use a pump that will only work ok with a specific brand of teststrip.
 
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Neemo

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There is a current transitionary process underway to standardise BS meter/strip usage (numerous, different meters/strips used across the country). Invariably, cost cutting is the principal driver.

Example; A recent document circulated to HCPs within the Greater Huddersfield CCG area. Note; some exemptions apply, e.g paediatric, manual dexterity etc.

For reference, below is a strip cost comparison that was conducted a couple of months ago, by Greater Manchester CCG.

2015-09-29 23.28.37.png
 

tim2000s

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@Neemo, that data is pulled directly from this page and graphed: http://www.drugtariff.nhsbsa.nhs.uk/#/00241786-FA/FA00241579/Part IXR - Chemical Reagents

Which documents the change in costs on a month by month basis. Based on that, you either have strips for a bolus calculating system, (Aviva, Freestyle Lite or Optium and Dario) or you end up with Codefree, unless you are using a pump that requires something different.

I am happy to argue for a bolus calculating system strips as that in the long run helps my control. They struggle to argue that point.
 
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AndBreathe

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@Neemo, that data is pulled directly from this page and graphed: http://www.drugtariff.nhsbsa.nhs.uk/#/00241786-FA/FA00241579/Part IXR - Chemical Reagents

Which documents the change in costs on a month by month basis. Based on that, you either have strips for a bolus calculating system, (Aviva, Freestyle Lite or Optium and Dario) or you end up with Codefree, unless you are using a pump that requires something different.

I am happy to argue for a bolus calculating system strips as that in the long run helps my control. They struggle to argue that point.

Very few GPs actually prescribe the SD Codefree strips, even though they are so much cheaper then most of the competition. I've helped a couple of people in the past with the relevant processes, because few pharmacies actually carry any stock, and they's a special order first time they're ordered. Thereafter, as the pharmacy already has the PIP code stored, they find it simpler.

I have asked the UK distributors if they know why so few GPs prescribe the strips (ignoring the T1/T2 hot potato) and they have told me why. Frankly it's a bonkers reason, but I'm not entirely sure about certain aspects of Practise funding/cost centre analysis to know if there's an underlying reason, rather than the free meters Practises receive from Abbott and the like, which HomeHealth won't supply.
 

tim2000s

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So what you are basically saying @AndBreathe is that because the others supply free meters, they will prescribe those in spite of the strips costing way more, and the fact that saving from the first prescription of the strips from codefree more than covers the outlay for the meter? That's bonkers and a half.
 

andcol

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So what you are basically saying @AndBreathe is that because the others supply free meters, they will prescribe those in spite of the strips costing way more, and the fact that saving from the first prescription of the strips from codefree more than covers the outlay for the meter? That's bonkers and a half.
probably comes out of capex/opex type budget decisions.
 

tim2000s

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I wonder whether the metres aren't actually available on prescription @Andrew Colvin and that's why they can't apply the CCG budget? Can't see them on the NHS list I posted earlier.
 

Kevin1987

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My doctor agreed to prescribe the Dario strips but did take a few discussions and a letter stating why it was helping me! But I love the Dario meter just having a meter I can have in my pocket all the time
Is the best thing. Plus the app is really good to use. It's database for food is good as well for carb counting
 

Mep

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I just purchased the dario device and downloaded the app for it. I am having problems here finding the test strips though, so haven't even used it yet. It looks like i have to order them through one place in the country... stupid. The only downside is I had a giggle at the spot where the test strips are supposed to go because the lid just slides off with the slightest touch... if I actually used it for this purpose I would probably have to sticky tape the lid on or face losing my test strips. I think I will be keeping the test strips separate. Also it is funny how it comes with lancets and no test strips, then I get asked to fill in a feedback form as soon as I got it and I couldn't answer all the questions because I haven't even used it because of not getting hold of the test strips.
 

tim2000s

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The test strips come in their own pot complete with secure lid that goes in the test strip space. It all work very well together.
 
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iHs

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Billion dollar question???? Do the code free strips fit this meter so that a bg reading be obtained or not?????????
Over to you @tim2000s :rolleyes::rolleyes:
 

tim2000s

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Billion dollar question???? Do the code free strips fit this meter so that a bg reading be obtained or not?????????
Over to you @tim2000s :rolleyes::rolleyes:
Sadly not. While they are clearly made in the same facility they are a mirror image to the Dario ones meaning they simply don't work. So Dario get to charge £15 for 50 while Codefree charge £6.99. Thought I'd posted that up somewhere! Oh well...
 

Kevin1987

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I love my Dario meter best one iv had so convenient, I wouldn't want to change now! You need the test strip pot in first then the lid clips on to that.