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Blood Glucose Monitors

Frequently Asked Questions (FAQs)

 

What type of blood glucose monitor / meter would some folks here with Diabetes recommend?

I would recommend the FreeStyle InsuLinx.

This meter is programmable, and can be connected to your computer to download your blood sugar logs. One can enter different insulin/carb ratio's for different times of day. My son uses this meter to help calculate insulin requirements for his meals & snacks. It is used for Type 1 (Juvenile) Diabetes. It is a very useful tool for MDI (Multiple Daily Injections) which is often a stepping stone to the Insulin Pump. We have had good results with it. You also use less blood to test than the other meters we have used. We have never received an "apply more blood" message with the InsuLinx.

 

Why hasn't a wearable glucose monitor (similar to Fitbit) come to market, despite several promising research projects?

This question needs to be put into the context of what the Fitbit device(s) are, which are devices designed for users to monitor their fitness, and how they fundamentally differ from glucose monitors used in medical applications.

Monitoring distance, calories burned, steps taken, and similar metrics are the focus of those who are interested in general health and fitness. The addition of glucose levels to the portfolio of parameters that various Fitbit devices can monitor is in attempt by Fitbit to add additional data in the stream to fitness users. From a practical standpoint, the value of glucose levels is as an indicator of their overall health and metabolism, and may be useful as a screening indicator of impending diabetes. Certainly, this is a valuable piece of information, but it is fundamentally different than both the other information provided by Fitbit devices and the information that diabetics need to effectively manage their conditions (whether Type 1 or Type 2 diabetes).

To be clear, the glucose monitoring that diabetes are fundamentally interested in is blood glucose levels, which indicates the circulating glucose the body needs to function. Above or below normal levels, which are affected by insulin, activity, stress, carbohydrate levels, and other factors, problems can occur from the acute to chronic. From a short term consideration, hypoglycemia, or low blood glucose, is the major risk, since this can lead to shock and death in a short time if not addressed. Therefore, diabetics need to frequently test blood sugar using finger sticks to draw blood and test the glucose concentration directly. It is my suspicion (though not my certainty, since I have not found the evidence from Fitbit, yet) that the Fitbit method of monitoring glucose is actually by measuring the glucose levels in interstitial fluid as an indirect measure of blood glucose.

Many -- and I mean MANY -- alternative methods are being developed to provide diabetics with accurate, reliable and less painful ways to monitor blood glucose. These include measuring blood glucose via imaging technologies (near infrared), secondarily monitoring glucose in other tissues (tears, interstitial fluid, etc.) that do not require blood to be drawn. (These also include the contact lens being developed by Google to monitor blood glucose.) Thus far, these secondary analyte tests, however less invasive than finger sticks they may be, are not as accurate as direct blood glucose tests, since they must involve extrapolations of the data combined with algorithms to translate the non-blood glucose levels to what the true blood glucose levels are.

The major medical technology behemoth Medtronic has already gained approval for a continuous blood glucose monitor, but as an early generation device, its value leans more toward clinical research (e..g, tracking diabetics' blood glucose patterns over typically five minute increments) that will augment the development of both future continuous blood glucose monitors and the utlimate "closed loop" device (also often called an "artificial pancreas") that is not, as mentioned by another poster, just a glucose monitor but a glucose monitor combined with an insulin pump to autonomously regulate a diabetic's blood glucose by linking the device's blood glucose readings with insulin basal rate (steady infusion) and bolus (infusions to match the burst of carbohydrate intake).

In short, the value of glucose levels in the nondiabetic is minor other than for long term screening to reveal emerging diabetes, which creates little drive for glucose to be in a fitness-based device, while the drive for a noninvasive glucose monitor for diabetics remains HUGE.

 

Diabetes: What are the best selling and most widely used blood glucose monitors?

I used to consult for Roche and they have a range of excellent meters. However, after I lost my 4th meter - I bought a Bayer Contour Ts and am delighted with the simplicity and the ease of operation. I am not a big fan of OneTouch - but thats just me being opinionated and I will add the disclaimer that I haven't used it in years. It may be just equally as good.

Apart from ease of use - there are is a whole ecosystem of supply et al. When I used to live in UK - the patients didn't have to shell out money for the strips or the lancets. In other countries, including developing countries, there is no NHS like org to foot the bill - so availability and cost of these consumables is another set of consideration. Which makes Bayer attractive for me as well.

Worth noting that the companies manufacturing these make more money from strips and lancets that the meters themselves.