Bite Me, Accu-Chek

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Since my diagnosis more than fifteen years ago, I have used OneTouch meters exclusively. The reason why is simple: that’s what Kaiser supplies.

So, I was excited to discover that the lab uses a Roche Accu-Chek Aviva meter for measuring the blood glucose of mice. Sweet! I thought. My first-ever chance to compare!

My initial thoughts were simple– the strips are bigger, and it’s weird that the meter still uses coded strips, since OneTouch did away with that a while ago. My first and second uses went without incident; the Accu-Chek meter seemed boringly comparable to the OneTouch I have.

The third instance of use, however, proved unfortunate. Before I get to the details here, let me give you the setup– how exactly does measuring the blood glucose of a mouse work? My procedure goes something like:

  1. Gather tools– meter, strips, incision device, something to write with.
  2. Go outside and downstairs to the vivarium.
  3. Suit up– disposable gown, hair net, shoe covers.
  4. Enter mouse room and find mice.
  5. Remove mouse from cage by tail.
  6. Insert strip into meter.
  7. Snip mouse tail.
  8. Squeeze a drop of blood out of mouse tail. Try not to lose the drop as mouse sniffs and forages about.
  9. Hold strip to tail.
  10. Wait, wait, wait. Confirm blood amount was sufficient.
  11. Put mouse into separate cage.
  12. Record blood glucose value.

Here’s the problem: On instance three of measuring the blood glucose of my twelve mice, step 10 didn’t work. No blood glucose value appeared; instead, I got an “Err 1.” Darn. Try again with that mouse. Err 1. Hmm, I think. Skip to step 11, and put mouse in separate cage. Repeat steps 5 – 10 with another mouse. Err 1. Hogwash. Try again? Err 1.

So, much to my irritation, I return mice to appropriate cage, pack up meter, exit mouse room, disrobe, go back outside and back upstairs, and consult with my colleague. She doesn’t know what that error is, but the meter had worked for her a few days prior.

I consult the user manual– Error 1 means, “Your blood sugar may be extremely low, or the test strip may be damaged or not properly inserted.” Bull-oney. So I grab my own meter, and prick my finger. I measure myself using the Aviva. Err 1.

Bite me, Accu-Chek, I think. I grab a new box of test strips, and switch out the little coding dongle. Test myself again. 138. Well, at least it works.

So I take 0.1 units of insulin, pack up the meter, go outside and downstairs, suit up, enter the mouse room, and successfully measure the blood sugar of my mice, grumbling that what was supposed to take twenty minutes now has taken an hour. And fussing around with mice is not easy; I’d prefer not to have my tools complicate the matter!

Now, to be clear: this was a minor, minor inconvenience, all considered. And this is one anecdote that is entirely unfit, scientifically speaking. But, still– I have never, ever had a whole tube of OneTouch test strips just go bad. And for the three times I have used a Accu-Chek meter, to have one of those be a flop does not leave a good first impression.

Accu-Chek was happy to mail me a replacement tube of test strips, but the representative couldn’t really advise as to how to prevent this problem in the future. She said sometimes the strips were damaged in transit (although strips from the same bottle had worked for my colleague), or were compromised by moisture (seems unlikely, given that the strips were used in relatively controlled contexts).

So, I have to ask– who uses Accu-Chek meters? Do they work? Is this just a fluke? Or should I expect a high failure rate? Reason leads me to believe that the meter would not succeed and sell if it failed one in three times, but one in twenty is not unimaginable. How from the mean is my experience?

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Comments (9)

  1. 1) So interesting to hear about you testing mice BG’s!  As much as we hear about them being cured, we never hear about all of the day-to-day stuff that happens in the lab.

    2) I use an Accu-Chek compact when I’m out on my bicycle.  It’s the one with the drum of strips and the lancet that connects on the side.  Have never had a problem with it, even when I’m all sweaty and grimy from riding. 

  2. Drew Maruyama at

    Karmel,

        I just got switched by my health plan to an Accu-Chek Aviva, and have been having the same problem.  poke finger, test, get E-1 message.  Still able to get blood out of last poke, test again, make sure there is enough blood, E-1 message.  Third time, have to poke, same message.  Test with One Touch to makes sure i am not low, and I am above 100.  4th time is a charm with the Aviva.  THis has happened to me at least 4 times in the past 5 days, so I am not happy at all with the Aviva.

  3. Karmel Allison
    Karmel Allison at

    Hmm. Based on our sample size of three, then, I can conclude that:
    – the Aviva in particular is troubled, or 
    – there is an unequal distribution of luck amongst us.

    I think we need a bigger sample size. Anyone else out there idly watching want to weigh in? Roche? 

  4. Jack E at

    I’ve been testing about once a week. Last week and previous weeks have gone by without incident. Today I had 6 or 7 strips fail in a row. E-1 error message. So I called their 800 number. After one of the most tedious and annoying robo-questioning sessions I finally talked to a nice fellow with a Punjab accent.
    He instructed me to hold down both arrow buttons at once for a few seconds until the meter displayed a diagnostic: H37. Whereupon he told me my strips had been “compromised”. And here I didn’t even know they they were under age!
    He explained that dampness or high humidity can typically cause this, especially in the case of the strips not being stored in their original vials or leaving the cap open. I explained that I store mine tightly sealed in their original vials, my hands are dry, the room they are in is dry, etc.
    He graciously offered, AS A ONE TIME COURTESY, to send me a package of test strips. How nice of them. 
    I’d really like to see their full list of diagnostic codes…

  5. That is a very interesting study and more interesting that the meter had issues. I picked mine up from <a href=”http://www.accuchekavivameter.com” target:”_blank”>Accu-Chek Aviva Meter</a> and they specialized in this meter, so they might have some answers for you. I do business with them and found them very informative on the subject.

  6. Luke Henry at

    I started out on OneTouch and was switched to AccuCheck after 7 years or so.  Once I got used to it I didn’t mind it at all though it did seem to require slightly more blood.  I’ve gone back to OneTouch because it talks to my insulin pump but I have had no issues with AccuCheck.

    On a side note, I actually happen to work in the manufacturing facility that produces Roche meters, including the Aviva.  It’s a top notch made in America product that many consider the cadillac of glucose meters.  I realize that doesn’t help you, but it’s actually a great meter.

    As for OneTouch not using codes anymore…that must be something new because mine certainly still does?  I found the “chip” that came with each box of strips on my Aviva pretty simple but to each his/her own I guess!

  7. Jean at

    I’m a pedi RN who has had Type 1 for almost 30 years.  I used One Touch meters almost exclusively up until the last 3 years or so (changed due to insurance).  I actually like the Accu Checks – they took some getting used to, and don’t appear to be as “slick” as the One Touch meters, but after 30 years of testing, my fingers are quite calloused and sometimes getting enough blood out to fill the test strip reservoir is an issue.  I was having to discard several One Touch test strips due to insufficient blood fill.  With the Accu Checks, there is a window of time in which you can apply more blood to the strip & still have the test work.  That has been a huge help to me.  I do not like the coding keys, but once you get used to that, it’s not a big deal.  Their customer service has been exceptional.  Our insurance may change again, but I’m not sure I’ll go back to the One Touch (the communication with the pump is no longer an issue for me – I use continuous glucose monitoring & you enter calibration glucose levels by hand, selectively).
     

  8. Tom at

    I have used Bayer Contour for eight years since diagnosed with Type 2. I changed insurance companies and the Bayer product were no longer ‘medically necessary’ because I had not used either of their preferred meter suppliers, LifeScan or Roche. I had my doctor order whatever complied with their suppliers. I got an Ultramini One Touch. The meter worked, but because I did not get testing solution I was not sure about the accuracy. The problem I had was the lancet device, Delica, it did not puncture deep enough to draw blood, and when it did occasionally, it was insufficient to use on the strip. I do not carry my kit with me often, but the container has rigid molder holder for the meter and the lancet device, so alternative devices made the kit extra bulky. This meter had no average for getting a quick trend over time.
    With the Bayer I had free software and the cable came free from them to up load to my computer. After I called LifeScan, they sent me a replacement lancet, and when I spoke to the technical service, I was sent a cable for free. The new lancet device for the Delica, continued to not break my skin at the highest setting for puncture.
    I looked up the other preferred supplier, and call my doctor to order an Accu-Chek Aviva-Plus. I have only used it a couple of times, but it also requires the use of a control solution for multiple check, one for low and one for high levels. The Bayer required no coding of any kind, and came with a test solution, used to check the meter only before its first use. Additional checks could be done for new strips if they showed different reading than expected, but other than that it was not needed after that initial test.
    When I call my pharmacy about the new meter I had ordered, I mentioned the problem with the lancet device from LifeScan. He does diabetic education and has found the Delica lancet does not puncture many people’s skin deep enough to draw blood, he even tried it on himself and had no success with several tries.
    As i have use software to track my readings, I began to look into what Accu-Chek had, and have found that the software and cable/communication device are not free, but appear com come in two packages, one at $39.99 and the other at $99.00. If they maintain this price, I will tell my insurance company I have used their preferred and did not find them suitable because of problems with the lancet for and excessive cost and use of test strips and solution control testing for both and prohibitive cost of software and connecting device for the other.
    I only test twice a day and do not see the need for the additional steps when the previous meter met my need in a simple way.

  9. Ken Kraft at

    I  find it interesting of the comments that relate to the E-1 Error. I also on two different tubes of stripes had many E-1 errors.  Calling at 3 am the person from Accu-chek said that my strips had been compromised.   What a word to use.  I live in a house that is air conditioned with low humidy. This is the second tube of strips that have failed.  If these strips fail thatquickly I think that Roche needs to get their R&D Group out and start making some improvements. I get these strips from The VA. Not happy about what is being provided. 

  10. EK P at

    This is interesting. I recognize that how you handle and store the One touch test Strips may compromise them. In a recent conversation with m Kaiser PCP I learned that the one Touch meters have a 10 % +/- accuracy. As a Type II, my glucose is usually well below 120 or is that 132 or 108. Recognizing that any meter just provides us with a 90% accurate indication of our glucose at any given point in time. Folks we’re not doing brain surgery or launching a moon shot so expect some test strip waste and variations between lots of test strips as well as manufacturers. Be healthy my friends!

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