Tag Archives: meter

Bolus Advice: MDI With Less Math

A couple of weeks ago, my husband and I went to the beach for the day after church. It was a nice, cool, breezy day and it was good to get away and relax for a bit.

We were on our way home, and we stopped to get a frozen yogurt treat with the kids. I bolused with my pump, and half way through, I received an occlusion. The second one for that weekend.

True, this may not be a big deal, but it was the final straw for me. It’s true — occlusions are things that come with the territory when using an insulin pump, and that specific event isn’t what had me frustrated. It was a lot of things:  having a curious baby who likes to pull on my tubing, sites that were seeming to fail after just 2 days, and the more and more frequent “bleeder” sites.

That last occlusion was it. We made it home and I pulled out my Levemir backup pen that my endocrinologist always gives me to keep on hand in the case of pump failure. I had no idea how this was going to go, but my frustration outweighed my fear of the unknown-to-me territory of MDI (multiple daily injections).


I took my total basal amount, added 20%, took the injection, and unhooked my pump. It’s been in my desk drawer ever since.

As soon as I injected the Levemir and started to get ready to inject for supper, I felt overwhelmed by things like accurately calculating doses and keeping up with IOB (insulin on board), and I quickly emailed my Accu-Chek rep and pleaded with her to chat with me that night or the next day to set up my Connect App in my phone.

Why would I need her?

See, Accu-Chek now has a meter, the Accu-Chek Connect, that connects to your phone via Bluetooth, and you can see your readings, log food and insulin doses, and even program the app to text your readings to a family member if you need help.


It also has an option for Bolus Advice. With this enabled (via prescription from your health care professional), you can use the glucose number that is sent to your phone to calculate insulin doses if you are a MDI user. To me, this is great because it’s like having the best part of the pump without the pump!


The app even lets you see how the calculation works, and whether you need to increase for correction, decrease for active insulin, or if you’re low — how much food to eat. It’s really intuitive.


I honestly don’t know that I would still be on MDI if it weren’t for this app. I’m loving being pump-free without having to be bogged down with math.

I don’t know how much longer I’ll be on MDI, but I don’t feel as if I need to rush. I feel comfortable to be pump free as long as I have help calculating my doses and keeping up with active insulin — which is exactly what this system does.

While the meter was provided to me at no charge, I was not asked to review it. This is my honest opinion from the bottom of my heart. I cannot be more thankful that there is a company that not only wants to create an insulin pump product, but also to help those on MDI to have the best care possible.

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Thank You, CVS!

The hubby and I decided to see if my sister and her family would like to eat dinner together at the beach this past weekend. They were already there finishing out their vacation week, and Erik had coupons to a local restaurant we love to eat at there, so we figured it would be a nice trip to go see them, hang out and have some good food.

We packed everything. Beach towels, clothes to change into after swimming on the beach, extra diapers, insulin pens, extra pods… almost as if we were planning to stay an entire weekend… except for one thing. Strips.

I didn’t even THINK to check for strips. And it wasn’t that I didn’t have any at home to bring as a friend who went off of her Omnipod system sent me a ton of strips she wasn’t going to be using anymore… so that wasn’t the problem. I just simply didn’t check the bottle before we had left.

We got there, and I tested before we went into the water. Three strips. One used, so I had two left.

I checked after swimming and bathing. Two strips.. one used, one left.

We went out to eat and go to the restaurant. I knew I only had the one strip left, and I could have gone off my CGM, but it has been so off lately, I didn’t want to trust it. Plus, my BG was really high because I decreased my basal too much while we were on the beach. AND, with dinner being my hardest meal to bolus for lately, I certainly did NOT want to start off on the wrong foot with an assumed number. So.. One strip… one strip used, none left.

photo (10)

We were invited to stay the night because of how late it was after we finished dinner. Plus, I don’t get to spend much time with them, so it was an added bonus to get to stick around for a while.  But I was out of strips. Me. The girl who has been double, if not triple, packing everything for the past few years in the event there could be an apocalypse of some sort and I wouldn’t be able able to live past a few days until I could get more supplies type of girl. I wanted to go home and get them because, honestly, the cost of one vial out of pocket is freakin’ outrageous.

BUT! I had seen these little meter combo thingys that other people had purchased on their trips. See, most meters you buy off the shelf now do not include the standard 10 sample strips like they used to. I hate that meter companies are doing that now. I would rather buy a brand I trust and that would use the strips I currently have in my drawer now verses some off the wall brand that I’ll probably never buy strips for again. Anyhow, I told the hubby we needed to get to a CVS so that I could get the little kit to get me through the night.

So, along with a few other essentials, I purchased the cute little meter and used it until we got home. I appreciate CVS for having this available for people who do impromptu trips like this one and accidentally leave strips (or meters) behind.

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First Impressions: Contour Next Link USB Meter

Friday at lunch, I came home to a surprise. Minimed shipped out the new Contour Next Link USB meter that they have available. I’ve been waiting for over a month for this little thing. Just so happened that Friday was also site change day, so I put away my Ping and pulled out my Revel so that I could do a run with the full experience.

First thoughts was that this little meter is sleek. It can easily fit into my “meter-case” section of my wallet (VERY important to me… because I LOVE that wallet!) Color screen is cool, and just the fact that the meter is now like the baby of the Contour Link and the CareLink USB device… it’s all-in-one. This same meter that you check your sugar with is used to upload your pump into CareLink. How cool is that? No extra dongle or wires to keep up with.

Setup was easy and just like any other meter – entering in the time, date, etc. No big deal. The screen is bright and, to me, easy to read. Charging it is simple. Just plug it into the charger that it comes with either directly or use the supplied cable to attach it if needed. I ran a few tests against the Verio IQ since I know a lot of people who use that meter, including myself. It tends to read much higher than other meters such at the OneTouch Ultra-family and a few others. And, truth be told, the Link was lower than the Verio, but it seemed to be a consistent amount:

Checking is simple – insert strip, apply blood, and wait. After this, you can tag before or after meal or choose not to have a tag at all. You have the option of including notes that include “Don’t feel right”, “Sick”, “Stress”, and “Activity”. You can even note how long after the your meal this test was.

The pros of this meter (to me) are that the strip goes in on the side. I hate a meter that has a bottom-loading strip. Sure, I could just turn the darn thing around, but still… for some reason, it’s a pain-in-the-butt to me. My hands shake when I try to do little things like lining up my finger to a strip end and it just makes more sense to put the strip on the side or top.

It’s small, compact, and yet still does a lot. It’s, as I said before, a marriage of the meter and upload dongle for the Minimed pump, so less stuff to have to keep up with. The strips for this meter are A LOT less and still fit the newer guidelines for accuracy. These, for 100, average about $75-80!! They’re even less than their prior strips, which were about $110 per 100. (whereas ones for like the Verio and iBG Star are more around the $140-150 range for 100. Trust me… I bought a 50 count bottle of iBG Star ones OUT OF POCKET and the ticket was $72. NOT COOL. I bought a 50 bottle of these and paid only $43.) Why buy them out of pocket? Well, because I like to have more than just 25 strips to test with to “try out” a meter, and I don’t want to go through the hassle of asking my doctor for a prescription for strips for a meter that I’m going to stop using in a week or so anyway. Which this one I may use anyway – Revel or not. I like it. More than the Verio because it’s just hard to get used to the higher numbers of the Verio when this one does read higher, but not as high. It’s sort of middle-ground.

I also like the Glucofacts software that’s on Bayer’s site. I’ve uploaded to it a couple of times and it’s pretty neat. Not perfect, but I like it a lot better than some out there. Oh, and the meter charges while you upload!

And this is where the “cons” I was speaking of in my last post comes in: There is a light around the strip port. But it’s not there to help you see where to put the strip in in the dark. It’s there to show you that the meter is charging. The light flashes as it’s being charged, and stops when it’s done. I think they could have done a better job at making it multi-functional. (ACTUALLY – The port-light can be activated before inserting the strip by double-tapping the power/menu button. Thank you for the comment, Emily!!!) The second “con” is that this meter is only available as a Minimed “Link” meter, not a stand-alone USB like the original Contour USB, and only available through Minimed. This is a great meter (in my opinion) and to be strictly for Minimed sucks because I think a lot of people could benefit from it functionally and cost-effectiveness if they were able to market it to more than just MM pumpers. There is the Contour Next EZ meter, but it’s the bottom-loading disk-shaped one. It is affordable at about $10-ish dollars, but it’s no USB with color screen, and you would have to have a special cable to upload it.

I think I might stick with this meter for a while. I really do like it. I like that I don’t have to use it with the MM pump (I can turn the Link function of it off), and if in a bind and Wal-Mart has an issue getting my strips as they’ve done in the past – I can pay out of pocket for another bottle of these easier than I could for ones for another meter.

 

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Accuracy: Should It Matter Right Now?

Right now, there’s a lot of people testing and trying out new or different meters and choosing one over the other saying one seems more accurate than the other. And while this may be true in some cases, there’s one fact that still remains:

The FDA still has the same standard across the board – They must test within ± 20% of the YSI method for fingerstick analysis if the glucose concentration is above 75mg/dl.

New Freestyle (not Lite) test strips.

VerioIQ Accuracy results

Well, I don’t know about you, but I don’t like to stay around 75mg/dl too long. My comfort zone is 85-125 (YDMV). So that means that outside of that, my readings that come back on my meter are allowed to be ± 20% of that number. So, it’s allowed to be 100-150mg/dl if my actual blood glucose reading is 125.

Thankfully, though, a lot of companies are actually closer to ± 15%, meaning that I could be 106-144, which still isn’t much when you think about it, and still doesn’t seem like much even in the higher numbers:

Actual BG    ± 20%         ±15

300            240-360     255-345

Even still, if I were to choose the VerioIQ over my Freestyle, then “technically” there shouldn’t be a difference, right? Since 98-99% of the tests are within the ± 15% accuracy range?

And yet, we still see pictures of them being so far off. Or were they? Maybe our bg’s were smack dab in the middle and one read the higher end of the spectrum verses the other reading the lower?

I just don’t know if griping over accuracy should matter any more. Not until requirements are tightened up to maybe 100% of tests being within ± 10% or even ± 5%, which would be a dream! Granted, I probably just made a few of you mad by saying that, but it’s true. What’s the use in fussing and raising Cain if the FDA refuses to tighten up on what’s “acceptable”? You can go check your sugar on ten different meters and all of them will come up with a different result, even more so if you use various brands. They all differ from one to another.

Accuracy isn’t any less important to me than it is to you. I still have to treat based off of the result that’s given to me. What we need to do is find a way to more effectively reach out to the FDA to petition for tighter allowable ranges.

I want to do something about this. I want to make a difference. I want our voices to be heard about this issue that is so important to all of us, and I want to do it in an effective way. The problem is, I just don’t know where or how to start.

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