The number of blood glucose meters on the market today is staggering, and one of the most frequently asked questions in diabetes forums is “What meter do you use?” So, how do you choose? Do you need a meter that offers more help understanding the values and applying them to your life? Do you need something discreet? Do you want to share your data with a family member or health care provider? Do you care about the software it uses to connect to your computer?
Since the development of SMBG (self monitoring of blood glucose) devices in the 1980s, meters have gotten smaller, faster, and sleeker. My first blood glucose meter in 1990 took time and effort to read a sample. It required an enormous sample from my tiny ten year old fingers, the blood had to sit on the pad of the strip for one minute, then I wiped the blood away with a cotton ball, then waited another minute or more to get the sample from the meter – a machine bigger than today’s largest smartphones.
The array of meters available in 2015, however, offers options for the patient consumer looking for a meter that fits their lifestyle and even type of diabetes. In an age where we speak of precision medicine catering to the needs of the individual, we have individualized options at our…fingertips.
I will unabashedly admit to loving the One Touch Verio IQ blood glucose monitoring system. It is slim enough to pocket, with bright readable data, and – my favorite feature – a port light that spans the top of the device that is substantial enough to check my blood glucose in the dark of night or in a movie theater without being offensive to those around me. The Verio IQ, much like its smartphone-connected sister the Verio IQ Sync, is a rechargeable meter. These two meters are marketed to tech-savvy type 1s or others who check frequently and are accustomed to interfacing with technology.
In contrast to the IQ series, which caters to the intensely managed insulin users and frequent BG checkers, is the latest offering from One Touch: the One Touch Verio. Using the same Verio gold strips of the IQ meters, Verio is specifically marketed and designed for people with type 2 diabetes. It is a traditional battery-operated meter, which means it cannot power both a bright color screen (which it certainly has) and a port light. (Sorry, dark testers.) The meter is designed to fit the curve of your hand, with an egg shape to its backside. It’s an excellent choice for people with type 2 diabetes because it gives useful feedback on data, pointing out to the user any patterns it detects in the data and how to interpret those patterns.
Providing useful real-time feedback is one direction in which the future of glucose monitoring is headed. Actionable feedback makes a phenomenal difference in the quality of self-care that people with diabetes can achieve between visits with their health care providers. Where to next? Getting that data into the cloud to share with others.
Livongo, an exciting newcomer to the digital health space, offers its customers not only a sleek, modern-feeling meter with a bright color touchscreen, but with its cloud-connectivity, data from a blood glucose check triggers a response on Livongo’s end and offers the patient real-time counseling around data. The user is never more than a text message or phone call away from a CDE who can interpret the reading.
Another key feature of Livongo is that users have unlimited test strips, which means the patient has the flexibility to live life with diabetes without the threat of an insurance company or physician restricting the amount of test strips used each month.
Real-time feedback and slimmer profiles with state-of-the-art interfaces are two areas where we see blood glucose meters advancing, but one meter I’m particularly excited about takes the concept of avoiding the middle (insurance plan) man and completely reinvents the model.
Abbott’s Freestyle Precision Neo is as slender a meter as you will find on the market, with a battery that will last for thousands and thousands of blood glucose checks. While the meter itself is inexpensive ($22-27 depending on retailer), one of several features of the Neo that is revolutionary is that the strips are priced low enough that Abbott tells customers they can “skip the co-pay.” A box of 50 strips is less than $25, as low as $19 from some retailers.
What else makes this practically credit card-sized meter particularly innovative? This is a meter with strips that are designed specifically to reduce the ever-present and genuine threat of contamination in hospital and shared-use facilities. When a nurse checks a patient’s blood glucose and has to stick a finger into a traditional test strip canister, all sorts of biological contaminants are introduced into that once sterile canister. Abbott took the concept of foil-wrapped strips (familiar to users of their Precision Xtra Ketone meters) and made all strips for the Neo foil-wrapped. Another benefit to foil-wrapping of strips beyond the fact that each new strip is guaranteed to be sterile is that strips will not be expire as quickly.
With test strip manufacturers losing out to some health plan and pharmacy benefit management firms in terms of who remains on formulary, having solutions for the customer that (a) are produced by trusted industry leaders, (b) feature new innovations worthy of what we expect from diabetes devices in 2015, and (c) allow the customer choice, affordability, and safety without us having to fight our physician, payor, or PBM are precisely what we deserve as consumers.