Too Much to Ask?

I’ve posted before about the lack of glucose meter accuracy and if we’re friends on Facebook, you’ve seen pictures I’ve taken comparing meter results. When I was using the One Touch Ping meter that worked with my pump, I had issues with it giving me false low readings. Luckily I have the Dexcom CGM so in seeing the discrepancy between meter and sensor readings, I would retest to get a higher reading. One Touch was very accommodating and sent me a new meter which solved that issue. Mostly. At the time my CDE suggested I try the Freestyle meter which I did and switched for some time to primarily use the Freestyle Lite.  I did many comparisons between the two meters with the same blood sample and got substantial differences. I put a stop to that pretty much for my own sanity. In the end I stuck with the Ping meter mainly for convenience of the remote bolus function with my pump and also being a long time One Touch user.

Then, two months ago, I switched to the OmniPod system and the Freestyle PDM became my primary meter since it also functions as the manager to all insulin dosage functions. In that same time period, I purchased the new One Touch Verio IQ meter. Although the Verio is not my primary meter, I do like it a lot. Of course I have done some reading comparisons between the two. And I’m back to getting very considerable differences.

A couple of weeks ago I read a post by Mike over at Every Day Ups and Downs. He had reviewed the new iBGStar meter from Sanofi. In his review, he noted that the iBGStar was giving him readings higher than other meters (Accu-chek Expert and Contour Link). In posting his results, he got confirmation from Sanofi that “the iBGStar has been developed to give readings which are automatically corrected against Haematocrit* and plasma values. Both of these corrections can mean that your new iBGStar monitor may give readings higher than you are used to. If you have any concerns over what this change of readings may mean, we would advise you to consult your doctor or other healthcare practitioner for further training.” This made me wonder if the new Verio has been developed similarly.

Also, a few days ago I read a post by Adam over at diaTribe, reviewing the new meters on the market, including the Verio. In his findings, the Verio had 100% accuracy with results under 75 mg/dL and 95% accuracy with results over 75 mg/dL compared to lab readings. That is some pretty solid findings. It also made me wonder about my own comparisons using the Verio.

While I appreciate all the new technology coming out or being worked on – mySentry, Telcare, AP, etc. and think they are hugely beneficial to the lives of those living with diabetes, what I want the most is a BG meter that will give me results I can rely on. One that will not be just plus or minus 20% of my actual BG. My next endo appointment is in 3 weeks and I plan on taking both the PDM and Verio meters to be tested at the lab. If the Verio results are indeed more “accurate”, as much as I wouldn’t want to, I would consider changing it to my primary meter. It will be an inconvenience in some ways but may be worth it if it means trusting the results more.

FDA and BG meter companies – without accurate BG readings, all else in our management means nothing. I can eat all the right things, count every last carb, test 20 times a day, exercise every single day and dose the most precise amount of insulin. But if my readings aren’t accurate all of those other things will not help me keep my diabetes in control. I can’t help but wonder if this is the very reason I cannot seem to get my a1c under 7. My BG levels may not actually be what they seem. And that to me, as a person with diabetes, is a huge problem.

10 thoughts on “Too Much to Ask?

  1. Geez. I only use one meter, the OneTouch ultra-mini. I’m pretty sure I’ll need a new one soon and will probably get the Freestyle that comes with the OmniPod. So I haven’t actually worried about this issue. There have been a few times I felt lower than I what the meter said. This post could explain that.
    Is it just me, or is the medical technology for diabetics far, far behind technology in other parts of our lives?
    I’ve ranted before about my phone (HTC Evo) only costing $400 (before rebate), a year and a half ago when I purchased it…and it does dozens and DOZENS of things…so why does an insulin pump (or other D supplies for that matter) cost SORIDICULOUSLYMORE when it has fewer things to do/keep up with??

    1. Me again. Just had an experience with this last night. My OmniPod system came, and along with it came a new (separate) Freestyle meter. So of course I busted it out and started testing it right off the bat, even though I’m not getting set up with my OmniPod system for a few more days. Flash forward to about 8:30 last night and I felt low. Checked on my OneTouch, 40. !!! I started drinking juice, then immediately thought of this post. Before the juice could hit my system, I checked on my new Freestyle meter. 64. WTD?? “We’ll just see about that,” I thought. Checked again, same blood from the same finger since it was still available…43.

      1. I love it. I am on cgms and have fought – yes fought my way thru the different meters.

        They are not the same and have different responses depending upon ones hemocrit, water and oxygen content of blood.

        The other fracas has to do with trick sugars that for some folks DO NOT SHOW UP in blood stream but get properly cracked then sent out as glucose D.

        I have cgms with filters on probe to isolate out the crap. If your body is outputting tricvk sugars – ie liver sends them out around the body loop for a second pass thru your liver, your meter will read higher depending upon how well it reads only glucose D and ignores the trick stuff.

        I have run extensive tests on these meters and I found Accuchek the worst, One touch off if body moisture – water dehydration is up. I used to test every hour – 30 tests a day, proper clean procedure – no shortcuts. I would routinely see in early am after wakeup – all meters ran similar numbers and good tracking.
        Trick: when comparing meters one needs to ensure that both meters must sample exact same fingerstick sample at same time to minimize other body goofy factors.

        The real test comes 2 hours after a meal to see how they track, and low and behold , meters I thought should be good were in fact 40 to 100 points off reliably reading glucose D plus trick sugars nee corn sugar, dextrin et all. This would last for about 6 hours till liver and kidneys swept the crap out. Then both meters would go back to tracking good.

        Your new meter will in fact read lower if it is only reading glucose D, the other susceptable parties need to be shot along with some other illustrious approving agencies. The issue is not properly reported/documented and latest tack is to allow meter guys to send out useless specs detailing their performance. Your car probably has a better manual today.

  2. Right on. I think this is a huge issue. We require accurate test results. It’s a matter of justice. Something we need to work for because like you said, we can do everything right on our part (which is hard enough!) and still lose because our meters are not accurate enough. So NO, I don’t think that’s too much to ask for in 2012. great post, Stacey!

  3. Great post Stacey and something that needs repeating again and again and again. Meter manufacturers need to understand how important accuracy has become. Time (and the management of D) has moved on and +-20% is no longer anything like accurate enough. Even inaccuracy itself would be workable if it were consistent. But a combination of inaccuracy *and* inconsistency can make the data difficult to use.

  4. There’s a huge difference in the way we’d manage low 200’s vs mid-100’s!!! It pretty much drives me bonkers. Love your point that the new technology is awesome….but…..really what we need are accurate meters to be the foundation of all of it.

  5. Yes, I agree , diabetes technology is definitely lagging big time with inadequate technology to quickly monitor and observe the multi-organ – multi hormone of the human body chemical processing plant in real time to get accurate picture on problems. One shot lab tests and present caveman machines while a place to start are not adequate. CGMS is definitely a better step forward but is primative in ways.

    I would vision a pack one wears for a few days that captures key hormones, glucose levels , hormone levels as well as basil activity for a 3 to 5 day 24/7 that can be dumped into a computer and data analyzed to give detailed summary to Doctor so that medical aspects, diet/carbs, exercise and liver activity as human chemical plant operating.

    From this, Doctor cand tune/adjust medical issues, assign dietition, exercise coach, and Diabetes trainer to help get body operating properly as suggested by Dr. McCoy in Start Trek movies with the analysis wand and the computers on the bridge of the Enterprise crunching data and reporting.

    With no offense to our Doctors doing their best and with grateful thanks, much of what is being done is barely above mideval medicine, wand of merlin and educated best guesses and experience.

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