OurDiabetes Tweetchat: Blood glucose meters: choice & accuracy

Last night, I was lucky enough to host the OurDiabetes tweetchat. The topic was blood glucose meters: accuracy and choice. The only problem with Twitter, is that you are limited to 140 characters. So, this has led me to producing this blog post. I really enjoyed hosting the chat, it was positive to hear everyone else’s experiences of checking their blood glucose levels. I’m happy to say that I have even learnt a few things, thanks to Kev and Simon.

Q1. What do you like about your meter?
I’ve just started using the Aviva Accu-Chek Expert. I’ve only been using it a fortnight or so, after using the Aviva Accu-Chek Nano for 2 years. The transfer came about after completing my DAFNE course in August, and not being able to make the changes to my insulin regime, that I felt I needed to.
I have always like the Nano, because of it’s simplicity, and its’s convenience to carry around with me. Never being exposed to the more complex meters, I was content with what I had. However, the Expert is miles ahead of the Nano, in terms of its potential. The ability to input my personal ratios, correction doses, log all the data I need to reflect on my readings, sounded perfect. And as a meter, the Expert is pretty impressive. I like the fact that the meter does the maths for me, and so I can concentrate on giving myself more precise levels of insulin. For example, a ratio of 1:1 was too much, but 1:0.5 wasn’t enough, and sent my bg levels up in the evening. With the Expert, I can do something as pedantic as 1 unit of insulin for 13g of carbohydrates.
At the moment, I do like my new meter, but it’s going to take some getting used to. I’ve had some disagreements with it, as it has told me to inject more insulin than I know I need, for something in particular. This isn’t a huge issue, but I don’t want to keep arguing with it!
The one thing I don’t like about my new meter, is that I have no way to use the data that it collects. Having looked on the Roche website, there is a software package, selling £24.99. Someone please tell me why I have to pay for something that other companies provide free of charge?! I’ve seen there used to be a cable that allowed the meter to be connected to the pc, but this seems to not be sold anymore. Darn. I would consider buying the recommended software, if it proved useful. Thoughts and opinions from people using it, already, please give me your feedback! I don’t mind paying for it, I’d just rather save my money!
Q2. How often do you check your blood glucose levels?
I check my blood glucose levels anywhere from 4-8 times a day. My GP actually laughed at me, when I told him this (excellent bedside manner, Mr GP!) However, the reason why I check so often, is simple. I want to know where I am at with my diabetes!
I check before meals, before driving, before exercise, before bed, after exercise, sometimes after eating. I also check when I’m ill, or haven’t eaten for a long time. Another issue I have, that perhaps other people with diabetes, might not, is hypo unawareness. Generally, I don’t feel ‘low’ unless I’m below 3. DAFNE principles class a hypo as 3.5, but they recommending eating to boost your bg levels, from 4.5. That’s worrying then, that I don’t feel different until below 3. I don’t think I’ll ever forget the time I checked my bg levels, as I was about to inject my basal insulin. I’d been watching tv with my boyfriend, and we were having a laugh. You can imagine my shock then, when my meter read 2.7! I make a point of mentioning this scenario, any time the GP dares to restrict my test strip allowance!
On another note, you might have noticed how I say ‘check’ and not ‘test’. My diabetes’ management is a big enough challenge, I don’t need to be stressed out by ‘tests’ all the time!
Q3. How do you record your blood glucose levels?
For  just under 2 years, I recorded my blood glucose levels in my monitoring book. I’m an old woman trapped in a young person’s body, there’s nothing wrong with good old pen and paper! However, I’m not that mathematical, or artistic. This meant that while it was handy to take my record book along to my diabetes appointments, there wasn’t a lot I could to, in terms of analysing the data. Thus the installation of various apps on my phone! There are a lot of apps available on the iphone and Android, some free of charge, and some that you can download for a small price.
My favourite and current app, is the official DAFNE app. What I like about this app, is that it connects to the DAFNE online website (you can gain access to this site on completion of the DAFNE course).  The app on my phone allows me to enter my current bg level, reason for testing, how many carbs I’m consuming, what insulin I’m taking, and where and when. It’s very comprehensive.  I have to say, I am so completely impressed/amused/speechless at what can be done with this data. So many pretty graphs! The 7, 14, 30 & 90 day average figures, also give me an idea of what my HbA1C might be at my next appointment.
Q4. Do you trust your glucose meter to give you accurate results?
Those of you who read my blog, will remember a couple of months ago, my experiment with a number of different meters. I spent a good hour checking my bg level, and using 7 different meters, that I own. I was expecting a certain level of differentiation between the meters, but the results shocked me. One meter told me I was 8, whereas the next meter (with the same blood) told me I was 15! I couldn’t think of any good reason why this would be so different. I wasn’t suddenly overwhelmed with stress, I hadn’t eaten for the past 3 hours, and I checked the two meters within about 5 minutes of each other!
With this in mind, I wouldn’t trust a variation of meters’ results. However, I do generally trust what my normal meter tells me, purely because I have used it for so long, and have carried out so many checks with it. If my meter tells me my sugar levels are in the teens, I will probably be feeling tired, thirsty, and ‘high’. My hypo unawareness means that if my meter tells me I am below 4.5, I have to trust the meter, and treat it as a hypo.
Q5. Are testing strips freely available for your chosen meter?
Eurgh. As I write this, I am reeling with frustration at the NHS. My DSN has written to my GP twice, asking to increase my test strip allowance to 200 a month. This is what I need, due to the number of times I have to monitor my bg levels. After my DAFNE course, the diabetes centre wrote again, informing the GP the reasons as to why I need so many test strips. DAFNE guidelines suggest people with diabetes should be checking their bg levels at least 4 times, excluding exercise, illness etc. I have been in contact with Diabetes UK about my problem. I am not the only one. So much so, that Diabetes UK have produced an advocacy pack for people with diabetes, who have problems regarding test strips’ availability.
Just this morning, I picked up my repeat prescription. Instead of 200 test strips, I have been given 150. If I am to check my bg levels as I currently do, I need at least 180. It annoys me, when the receptionists at my GP surgery tell me I’m not allowed more. Who are they, who have no medical experience, know nothing of my lifestyle and situation, to tell me “it’s too soon to get more test strips”?!
What makes it worse, is that it seems my local pharmacies are having trouble getting new stock in. I’ve been to 2 Tesco stores and an Asda store today, and no one has any.
Q6. Does checking your blood glucose levels have an effect on your attitude towards your diabetes?
Checking my blood glucose levels has a huge effect on my attitude towards my diabetes. If I didn’t check my levels, I would probably have a high HbA1C level, or I would be in a coma, due to hypo unawareness. I can’t imagine how difficult/near impossible it was to cope with diabetes, before the days of meters!
If you’re on Twitter, be sure to follow @OurDiabetes and join in the Tweetchats every Tuesday 8-9pm!

One thought on “OurDiabetes Tweetchat: Blood glucose meters: choice & accuracy

  1. Sorry to have missed the chat. Q4 is right at the heart of an issue we are trying to get to the bottom of here in USA. We have no real way of knowing if the brand of meter we use, typically chosen by an insurance purchasing agreement- NOT they patient or their doctor, is accurate.

    That is what http://www.StripSafely.com is all about. Interesting to see that both you and I were reading some of the same papers about accuracy. I know our friends in New Zealand are having issues too.

    Accuracy Matters.

    Keep up the good work.



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