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    I am not a doctor (oh thank God). I am not a certified diabetes educator. I have no medical degree and I can't even juggle. Nothing on this site qualifies as medical advice. This is my diabetes life - if you are interested in making changes to yours, please consult your doctor.

August 06, 2007

Agamatrix Keynote Meter

Impressions on the Agamatrix “Keynote”
Agamatrix KeynoteHaving lived with type 1 diabetes for over twenty years, I have seen my fair share of glucose meters.  (I also remember using the “Bill Nye the Science Guy” test tube sets for urine glucose testing.  Blood meters were a significantly less creepy change of pace.)  Accu-Check, One Touch, Bayer, Freestyle ... I’ve used almost every meter and thousands of test strips. I test over 11 times per day, I use an insulin pump, and I am extremely sensitive to both insulin and exercise, so my meter and I are rarely separated.

I’m not a medical expert, but I am the target market for anyone looking to sell a glucose meter.

The Meter Itself

My initial impressions of the Agamatrix Keynote meter were open-minded, coming off the heels of receiving blood sugar results from my One Touch UltraSmart that varied from 121 mg/dl – 259 mg/dl within a five minute span.  (See my blog post for further explanation: Meter, Meter, Average Eater.)   Confidence in One Touch shattered beyond recognition, I embraced the Keynote with open arms.

First impressions:  The meter looks like the TRS 80 computer I had from Radio Shack when I was ten years old.  With diabetes technology taking a more commercial and savvy route, the Keynote looked clunky when compared to my streamlined, green UltraMini from One Touch.  I carry my meter everywhere I go and having it as a stylish and easily-integrated part of my twenty something style makes me more apt to tout it proudly. 

The Keynote, though, is relatively small and the case itself was tiny compared to my One Touch Ultra Smart 2 case.  The lancing device was a nice, small size as well but it felt flimsy when compared to my other device (OneTouch UltraSoft).  It also wasn’t springloaded to hit my fingertip deep enough, despite the fact that I turned the dial to the deepest setting.  (This is the price I pay for testing so often - very calloused fingertips.)  However, the tiny size of the meter case, the meter itself, and the lancing device made for a streamlined bag that was easy to toss in my purse.  The two side pouches are a nice change from the single zippered pocket I was accustomed to, making it easier to store an extra pump battery and backup lancets away from my used test strips.

The Numbers I Rec’d

However, (and this is a huge however) a meter should not be judged by how it looks but by the results it throws.  What good is a meter that looks like an iPod nano but gives results that don’t make sense?  Accuracy:  that’s the most important thing.  When compared to the One Touch, the Keynote gave steadier and more dependable results. 

What I noticed most was that the Keynote was consistently higher than my One Touch meters.  Here are some sample results, all taken within 15 seconds of one another:

OneTouch Ultra2:  251 mg/dl
Keynote:  265 mg/dl

OneTouch Ultra2:  120 mg/dl
Keynote:  154 mg/dl

OneTouch Ultra2:  135 mg/dl
Keynote:  153 mg/dl

OneTouch Ultra2:  48 mg/dl
Keynote:  70 mg/dl

Here is where things get tricky:  My blood sugars are very sensitive to insulin and emotions.  A stressful work situation can send me up 100 mg/dl within 20 minutes, and ½ of a unit of insulin brings me down almost 30 mg/dl.  Accurate results from my meter are crucial, particularly when aiming for a low standard deviation and a lowered A1c result. 

Results that vary when my blood sugars are out of range towards the high side don’t bother me as much, because I realize that meters throw results that are more variable as blood sugars rise.  I am willing to correct the high and test to confirm.  However, it’s when blood sugars are closer to “in range”, i.e. the 120 mg/dl vs. the 154 mg/dl, when things become more irritating.  At a blood sugar of 120 mg/dl, I would not correct.  At 154, I would.  This is problematic because the .7u of Humalog I would take to correct down from the 154 mg/dl could end up causing a low blood sugar if I was, in fact, at 120 mg/dl. 

Overall, the Keynote threw higher numbers at me.  This was difficult for me to accept at times, because it caused my mental A1c to rise.  It’s easier to accept a lower result because it makes me feel like I’m in better control.  (Same as wanting to convince yourself that it’s not the store making their sizes a little bigger, but that you are, in fact, a size 6.   Some variables are good variables.)  However, in the case of meters, accuracy again reigns supreme.  I only want to see 100 mg/dl if I am actually at 100 mg/dl.  My ego will have to suffer the blow, but I want the best diabetes control possible.

By talking with other diabetics, I realize that using one meter most steadily is the best way to retain some semblance of consistent control.  That way, you are correcting, treating, or holding steady against the same set of variables. 

The Zero-Click Software

I hate logging blood sugars.  I’ll be the first to admit that I only log my blood sugars when someone is checking, i.e. my endocrinologist, or if I feel like my control is sliding a bit.  Anything that makes the rudimentary logging of blood sugars easier is something I’ll embrace. 

The Zero-Click software is very similar to other blood sugar management softwares I have used in the past.  Options like pie graphs to show “successes” (and thank you for not making the “highs” come up as a deviant red.  The rose pink is a nice change and makes me feel less guilty) and logbook printouts are crucial for someone who doesn’t have the time to manually log results every night.  One of the best features I have ever seen is, in the logbook screen, being able to click on individual blood glucose results and view the time, date, and specific comments pertaining to the result.   Comments per result?  I hate to sound overzealous, but AWESOME FEATURE.  This makes a blood sugar of 354 mg/dl first thing in the morning seem less random when accompanied by a comment like “Woke up 3 am sweating, woozy.  Didn’t test – tumbled out to the kitchen and drank cup of juice and ate 14 marshmallows.”  This comment feature made my blood sugars actually make sense to me. 

Also on the “bravo!” side of things, the virtual meter is a nice touch.  Being able to bang against the actual buttons helped me understand how to program my meter more easily.  The ability to email my reports without having to close out of the software is also a plus, and I appreciated the fact that it was automatically converted to a PDF.  For a parent looking to monitor their child’s blood sugars, this is a handy fail-safe that keeps kids from doctoring the data.  Also, my results were saved to my desktop as a PDF, which was very convenient.

On the less-than-bravo side of things, the hardware associated with the software was a bit of a pain to install.  My computer, a PC purchased 18 months ago, took a very long time installing the software.  It also took a long time to recognize the uploading cable and required me to restart my computer twice in order to use the software.  I thought this may have been an at-home glitch, but I ran into the same issues when installing the software on my brand new work PC.  However, after the tangled start, the software worked fine.

Overall, the software is very strong and easy to use, among the best I have come across.  It’s not cluttered with a lot of nonsense, and I feel that the “comments” on blood sugars helps keep data from becoming convoluted. 

Overall Impressions

I’m proud to say that I’d choose accuracy over accessory any day.  Healthy over fashionable.  Despite its clunkier look, the Keynote proves to be a more accurate meter.  I’d like to use my Keynote at my next A1c appointment and compare hospital laboratory results for myself, but I’d be inclined to peg them as close.  The Keynote rang my results in higher than I’d expected, but consistent and (hopefully) more accurate than my OneTouch, which is sometimes nothing more than a random number generator.  I’m interested to see what Wave 2 produces, and in the meantime, I’ll be aiming to lower my A1c. 
 

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