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Posts tagged ‘blood sugar checks’

Sweet Little Lancet.

Sweet little lancet
You are so damn tough.
I keep you until
All your edges are rough,
Until your sharp peak
Becomes dull and harpoons.
Oh sweet little lancet,
I will change you soon.

Sweet little lancet,
You deploy with a thud.
It can take several tries
To get you to draw blood.
And at that point, you’d think,
I’d wise up and swap out.
But sweet little lancet,
You should have your doubts.

Sometimes I forget
I have a vast collection.
No need to reuse!
I’m inviting infection.
I should change you out
Before you get strange,
But it takes a reminder
(Like when the clocks change.)

Sweet little lancet,
I respect what you do.
My supply closet’s stashed
With an army of you.
But in the event
There’s a cure that’s clever,
I’ll repurpose your ass;
I’ll have thumbtacks forever.

Livongo Health: First Impressions of Their Meter.

Disclosure:  Manny Hernandez, SVP of Member Experience at Livongo Health, reached out to me a few weeks ago about test driving the Livongo meter.  Manny is my good friend, and diabetes is not my friend, so anything that helps a friend and also helps me take a bite out of diabetes is a welcomed opportunity.  For the purposes of this post, please know that the Livongo meter starter kit was sent to me at not cost, as were the test strips.  I offered to write about my experiences.  I’m not being paid for any of this.  All perspectives are mine.

For the last few weeks, I’ve been trying out the Livongo Health glucose meter.  These are my first impressions.  For another take, check out this post from the College Diabetes Network.  Time to purge thoughts:

The glucose meter is solid, and familiar enough to not be confusing.  The meter itself is big, but nice.  It’s much bigger than the Verio Sync that I’ve been using for the last two years, and I have a fear of dropping it on the floor and having it smash into a thousand pieces (as is my life trend).  The meter also did not fit into the bag I have been using for my One Touch meter, so I had to find a bigger bag.  The test strips are also much bigger (almost comically so).  But size, for me, doesn’t matter too much since my meter exists on my kitchen counter or in my purse, never in my pocket.  The color screen is very cool.  The touch screen is even cooler, and was appropriately responsive to commands from my digits.  Nicely done.

On the whole, checking my glucose was easy, especially since I’ve used lots of different meters in my years with diabetes.  The meter lets you know when the strip is ready for blood, and while you’re waiting for the countdown to the result, the meter gives you a little health fact.  “Did you know that laughing is a great way to reduce stress (make you feel better)?”  I would have loved to have been a fly on the wall for the meetings where they came up with dozens of these gems.  I enjoyed every, single one of them, even the repeats.  They gave a dose of personality and humanity to a task that is oftentimes less-than-enjoyable.

Syncing my results to the cloud wasn’t always seamless.  More often than not, my meter would claim that the connection to cellular signal {EDIT – I originally thought this was a wifi signal, but Manny let me know it’s a cellular connection.}  was too weak, and promised to send the result after my next check.  This didn’t bother me too much, but I with there was a manual way to send my results, instead of having to wait until the next check.  Hopefully that comes with the next iteration.

On the meter, the Snapshot Summary is very useful for me.  That’s why I like the Verio so much, because it uploads to my phone, giving me at-a-glance access to what my numbers have been like for the last two weeks.  The Livongo meter hits that same sweet spot.  The Logbook screen is basic and if this was my primary meter, it would be a good screen to track.  Same for the Patterns & Stats screen.  This screen was particularly helpful because it tracked my averages for specific times of day, and then gave me a percentage in-goal range on the same screen, for 14 days, 30 days, and 90 days worth of data.  Again, it’s hard to get a full feel for how functional these screens would be in my life because I’ve only been using the meter for about two weeks.  But a meter that logbooks automatically (automagically?) is an asset for someone like me who loathes to logbook.

The Activity option on the meter confused me, to be honest.  I wear a FitBit and I enjoy those competitions, but it’s easy to wear the FitBit on my wrist while I’m moving around.  Trotting around with my glucose meter on my hip is not going to happen.  Ever.  If this setting expanded to include activity trackers outside of the Livongo brand, that would be awesome.  Otherwise, this setting becomes akin to the one on the Apple watch (for me, anyway):  I already have a fitness tracker.  I don’t want to use four of them.  Communicate with the one I already use, or maybe allow for manual input?

The online portal is comprehensive.  I like logging into the online portal and seeing the weather for my location.  It was a touch creepy at first (I am predictably creeped out by how much the Internet knows about my location), but then it became a nice thing.  Like, “Hey.  Good morning, Kerri.  It’s 54 degrees out in your sunny corner of Rhode Island.  Put on a coat before walking to the bus stop, kitten.”  Only it didn’t call me kitten.  Though I’m sure that can be programmed in.

Two notes:  In updating my personal health profile on the Livongo portal, I entered my diagnosis date (9/11/1986) and realized that the year option only went back to 1979.  Is that because it was taking my birthday into account?  If so, clever.  Less-than-clever is the field about my last A1C.  I was able to note when my last A1C was taken, and also what the value was.  But I did not have the option NOT to enter a value.  I didn’t like this.  When it comes to health information stored on an external website, I prefer the option to share or not share.  Forcing the A1C value felt … forced.

The online portal allows me to add folks to access my data, in as much real-time as possible.  I can add people (Chris, my mom, my best friend) to be alerted to my blood sugars when they are out of range.  If I had a child with diabetes, this would be a terrific option because it would help me stay on track with what’s going on when my kid is out of my arm’s reach.  But as an adult with diabetes, I don’t need to alert my family and friends if I check and am low or high.  I realize this flies in the face of my decision to share CGM data, but there’s a difference for me:  my CGM data will stream to the cloud and alert my family in the moments when I might not be awake or aware enough to check my blood sugar.  A low in the middle of the night is not always confirmed with a glucose check.  Most of the time, I wake up knowing I’m in trouble, and I treat without checking first.  The important thing is bringing up the low; I don’t need to know the exact number.

The portal also allows a health team to be created (or at least documented), letting me add my doctor to receive updates from my meter in a comprehensive way.  Again, this isn’t something I have any plans to take advantage of, but for people who need and/or want to be in more constant contact with their medical team, this is a terrific option.  (I don’t think my doctor wants to hear from me all the time, but when I was pregnant, I know she would have loved receiving my logs every two weeks, instead of me faxing them to her office.)  Through the portal, you can also access a Livongo health coach (from their team of CDEs) who will walk you through different issues at a pace set by you.  I haven’t tried this feature out yet, but if you have and can offer some feedback, I’d love to hear it.

The meter results are what matter most to me, though.  Size, color, bells, whistles, etc don’t matter when it comes to accuracy.  I have an inherent mistrust of all data (I think it stems from the lack of trust I have for my stupid pancreas), so I check and double check new devices until I feel comfortable with them.  To that end, I’ve used my Verio meter every time I’ve used my Livongo meter, and have checked both of those results against my CGM data.  (Excessive?  Yep.  But the meter came as part of a trial experience, so it wasn’t an out of pocket cost.)  Overall, the Livongo meter ran lower than the Verio meter.  Not enough to cause an uproar, but enough that I noticed every time.  My Verio meter was closer to my Dexcom on the whole, but I also use the Verio to calibrate my Dexcom, so there’s a data bias in play.  But everything was in line, well enough, to make me feel comfortable making insulin decisions off the Livongo results.

Did I trust the results?  Yes.  Well enough, at least, to be honest.  It’s hard for me not to defer to the tech that shows me as higher because when shown lower results, my brain immediately thinks, “Yes, but what if I’m actually the higher number?  That should be corrected.  I don’t want to be lulled into a false sense of security.”  I plan to use the Livongo meter to calibrate my next Dexcom sensor, to see if that shows a noticeable trend difference.  I’ve talked about new tech here on SUM often, and the running theme seems to be that I balk at change.  “New” and “different” are always initially met with a “get off my lawn” response, because I don’t like adjusting to anything new.  (Case-in-point:  The clip on the Animas pump made me crazy at first, because the top of it was just ever-so-slightly different from the Minimed one.  It took me at least two weeks to adjust to how that felt.  But then I got used to it.  Same with the new G5 transmitter, which is slightly thicker than the G4 transmitter, and it currently feeling like a doorknob attached to my thigh.  I’m sure I’ll adjust to that newness, too, but it takes me some time.  Also, you’re welcome to stay on my lawn.  I don’t mind.  It will just take a few days for me to get used to you being there.)

Looking at the cost.  There is an early access program being offered by the Livongo team right now (but rapidly drawing to a close, so if you want to sign up, I’d recommend doing that today.  Manny advised that the offer is “winding down as we speak.”).  For more details, you can click on this link or on the image below.  I’m not sure about insurance coverage for this meter and it’s associated services, but I do know that the early access program offers a deal with subscription.  From the website:  “The In Touch blood glucose monitoring system and all supplies, including unlimited strips and lancets — even shipping costs — are covered as part of your subscription.  Your participation as an early access member costs only $25 per month (guaranteed for 2 years).”  It’s the “unlimited” promise, as it pertains to the test strips, that peaks my interest for sure.  Strips are the priciest part of testing my blood sugar, so “unlimited” is a nice and welcomed bonus.

I’ll check back in a few weeks with second impressions of the Livongo meter.  If there’s anything specific you’d like to know more about, please ask!  Thanks to Manny, and the team at Livongo, for letting me give this meter a go.

 

 

Verio Sync: Second Impressions.

[Second Disclosure Verse, Same as the First:  I have received the Verio Sync meter for review prior to the full US launch. I was not asked to write this review.  Opinions shared, for better or for worse, are mine.  Typos, too.]

It’s been about five weeks since I started using the Verio Sync, and after getting over the initial “eh, the screen isn’t as nice as the Verio IQ,” the transition was smooth.  The meter performs similarly to the Verio IQ, but it does have some potent perks.

Ahem.  Potent perks:

  • The battery life on the Sync is better than that of the IQ.  I think.  I actually haven’t seen the “low battery” icon yet on the Sync (except when the meter starts up after sticking a strip in, so I at least know the meter has a low battery icon).  With the IQ, I was charging it every five days or so, and it only lasted that long when I would manually shut the meter down after testing (holding the button down until the meter screen went blank).  The Sync turns off automatically much faster.  For now, I charge the Sync when I charge my Dexcom, which is every five or six days.
  • The syncing feature of the Sync doesn’t drain my iPhone battery as much as I’d thought, because I don’t leave the Bluetooth feature on my phone enabled all the time.  I enable Bluetooth as needed, uploading the results once or twice a day instead of every time I test.  This helps conserve battery on all fronts.
  • As a PWD who has always struggled with logging blood sugars, the app for this meter is awesome.  Not because it does anything truly remarkable (it doesn’t fly, and it doesn’t make me fly), but it does what it’s supposed to do:  automagically sucks my blood sugar results from the meter and loads them into the app.  For someone like me, who struggles with making the time to download meter results, this is extremely useful.  At a glance, I can see how things have been going, and it’s powerful motivation for me to either continue on the same path or to change the course of it … blood sugar-wise.  (See also:  things have been good the past few weeks, so lots of green on the graph.  But back in mid-December, there was more red up there than I’d like.  Something about keeping the green as the dominant color serves as incentive.  In other news, a bell just rang and now I’m craving a snack.)
  • I also saw some of my first pattern alerts crop up, which were more common with the Verio IQ.  Tagging doesn’t seem to be tied to “I ate” or “I didn’t eat” but more to time of day, seeing as how manually tagging blood sugars is a feature that was removed for the Sync.  (Again, this didn’t affect me much because after about four months with the IQ, I turned off the tagging feature.  It frustrated me that I could only be a “full apple” [before meal] or a “bitten apple” [after meal].  I needed a third icon for simply “not eating.”)

  • Another powerful bit of information for me is the ability to see my 14 day averages portioned out by time of day.  Again, being able to score at-a-glance information about when my blood sugars are in range, out of range, and free range (read: bonkers) is very useful and helps me make tweaks as needed.
  • I do not like swapping one feature for another, though.  The Ping meter had the ability to send results straight to my insulin pump, and I was to remote bolus using the meter.  The Verio IQ and the Sync do not.  And as I mentioned before, the Sync seems like an aesthetic step back when compared to the IQ.  I really wish glucose meters, as they are improved, didn’t take features away as they moved forward.

But, as previously mentioned, it seems accurate.  So far, it’s matched very well with the results I’ve seen from my Dexcom G4 sensor, and it’s also lined up neatly with the results I’ve seen from hospital-grade lab work (A1C draws).  Bells and whistles are nice, but accuracy and dependability reign absolutely supreme in this house.

Diabetes Art Day: Strip Safely Edition.

A long weekend’s worth of test strips for the Diabetes Art Day:  Strip Safely edition.

Managing a disease and making medication decisions based on data that’s built on shifting sand is scary.

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