Medical Devices

I was fortunate and when I was diagnosed in 1984, home glucose testing had already hit the market. People diagnosed before me did not have meters. My first meter was made by Boehringer Mannheim. I actually used the test strips alone for a few months before getting the meter. They were called Chemstrip bG and you held the strip up to the vial to compare colors and get an estimate of what your blood sugar was. My doctor had to write an appeal letter to my insurance company in order for me to get the meter. Today, meters are handed out like candy.

My first meter was the original Accu-Chek. Once you put blood on the test strip, you would hit a button on the meter. The meter would count down 60 seconds and beep. After the beep, you would take a cotton ball and wipe the blood off the strip. Next, you would put it in the meter and after another 60 seconds, the meter would display your blood sugar. The original meters were giants in size compared to today’s meters.

In some respects, we have come a long way with meters. There are plenty of brands to choose from. Meters are smaller and faster than what they used to be. You don’t have to wipe blood from the test strip before putting the strip in the meter. Unfortunately, the accuracy has not improved. Some people, including me, think accuracy has actually gotten worse.  The FDA allows a 20% rate of error and some of the meters cannot even manage to get that. It is very frustrating when you are trying to keep your blood sugar normal and you get completely different readings if you check your blood sugar several times in a row.

There have been several papers released on testing the accuracy of various meters. This study tested 27 different meters and over 40% of them did not even meet the minimum accuracy requirements – 40% is pretty darn close to half! Yet we are supposed to make treatment decisions on meters that don’t even meet minimum requirements. You can read one of those studies here.

Last fall, I wrote about my experience trying the Wavesense Presto. It seemed to run about 20 points higher than my Aviva. One day my Aviva had me in the 40s and the Presto had me in the 60s – I felt low and was even sweating.  Guess which one I believed. The Presto did not seem to recognize anything below 50. I tested the Presto against the lab and the lab had me at 84 when the Presto was 110. Needless to say, I decided to stick with my Aviva.

The original meters did not have the capability to transfer readings to your computer. If you wanted logs, you did them by hand. When I was able to get on the internet (the internet did not exist yet in 1984), I found a program that you could enter your readings – by hand, but at least they were typed up and you could print them. The first time I took that into my endo, he complained that it made him dizzy. He walked out of the room and came back with the old fashioned log books. I hated those things!

Now I am able to put my meter in front of a USB cable and transfer my readings to my computer. I have a variety of reports that I can choose to look at. I am able to set my target ranges and know what percent of the time I am in range. I know what my average blood sugar is. I can look at my standard deviation to know how much my blood sugar is fluctuating. Much more information without having to handwrite all that stuff!

Kelly Booth picture of Aviva in front of USB

My computer died in February and my new computer doesn’t have a serial port – my old Accu-Chek cable required a serial port. The old software also does not work with Windows 7. Roche sent me the updated software and a USB cable. Several weeks after I started using the Accu-Chek 360 software, I had to call Roche because the software could not find the database. During that call, I found out although the software has a backup and restore feature, and it goes thru the motions of backing up, that backup is useless. Why would anyone in this day and age produce software that you cannot backup your data? I am sure there are people that don’t care if they can back up or not, but I am not one of those people. I have to be able to produce logs to get my test strips. I want to be able to backup my data so that if my computer crashes, I can restore it and not lose everything.

Although having a meter is very crucial, having a Dexcom has literally been a lifesaver. I am hypounaware. Having alerts go off when my blood sugar starts to drop has really cut down on the passing out. Those arrows are priceless. You don’t have to guess what direction your blood sugar is moving in or how fast it is moving. If my Dexcom beeps at me that I am 68 with 2 arrows pointing down, I know that I need to be more aggressive with my treatment than I would for a 68 with a straight across arrow. The same goes when you start going high – 2 arrows pointing up get treated more aggressively than just crossing my threshold with a straight across arrow.

I also have gastroparesis and I try to match up my insulin with when my food digests. Without the Dexcom, I can easily be 80 several hours after a meal and then climb to over 200 just 60 minutes later. Like most people, my highs are easier to treat before they get too high. I have my high alarm set for 120 and my Dex beeps at me as soon as it realizes I have hit or gone over 120. I have been able to cut down some of the highs because I am able to get insulin sooner than I would just relying on my meter.

I have been trying to get more sensors authorized and am currently out of sensors. I feel like my lifeline has been taken away from me! I have had several bad lows. I have over-treated some lows and end up going sky-high. I don’t kow when my blood sugar is going up or how fast. I feel like I went back to the dark ages of looking at those colors on the test strip!

This post is my July entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2011/july-dsma-blog-carnival/
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4 thoughts on “Medical Devices

  1. I was diagnosed in 1979 and tested my urine in a test tube with fizzy tablets. I remember that first brick of a glucose meter – but I had forgotten how we had to wipe the blood off after 60 seconds!!! Thanks for the walk down memory lane. And I agree 100% about the accuracy being unacceptable.

    • Thanks Karen! Looking back, I wish I had saved one of those meters just to put it side-by-side with one of today’s meters. Those things were huge! I was lucky and did not have to do the test tube & fizzy tablets.

  2. I was dx’d in ’74 when they still used urine tape.
    When Chemstrips came out, I cut them in quarters, but it was still hard to match the colors. I was using a pin to lance my fingers, and finally got a copof DB Forecast magazine where you could order a lancing device.

    • Kathy, I forgot about cutting the Chemstrips. I just cut mine in half (I think!). It was hard to match those colors. The nurse had me doing it in front of her and she was the one that convinced my doctor I should get a meter.

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