Monday, July 30, 2012

Here's to ushering in the era of the "Smart Meter." In the last few years, the market for sleeker, fancier meters and spiffy smart phone apps has moved faster than Willie Nelson running from the IRS, all with the purported aim of...
What, exactly?

I don't know. I mean, theoretically, it should be to create meaningful data patterns so that we can use the information to make changes in diabetes management. That's why the Verio IQ seems like such a great idea. Lifescan’s new meter is touted as the "first ever that automatically alerts you to patterns you might not even know were there.”  Essentially, it alerts the user to repeated patterns of high or low blood sugar.

Great idea! But the execution? Ummm...well....

Let me begin by saying that I landed the meter for free, which is cool. I like free stuff, generally. And the meter is slick. The screen lights up nicely, and I appreciate any meter that illuminates the spot for the test strip. (Why this is not a standard feature in all blood glucose monitoring devices actually kind of baffles me. A midnight hypo is so much more fun when I get berated by my spouse for turning on every light in the bedroom trying to check the BGs, right?) Much appreciated.

But the hallmark of this device is that "pattern alert technology," and the idea that the user can make adjustments based on quality data. That "quality" piece is critical. Meters are FDA approved with the idea that they can have a margin of error up to 20%. I'd heard from others that the Verio IQ seems to read on the high side, which can cause one to over-correct a perceived low blood sugar. I had no such issues. The meter was accurate to both my Accu-Check and Freestyle meters. The problem, then, was not with the readings, but with the data collection. Allow me to explain...

The pattern alert technology is predicated on time, clumping numerical data in a two hour window. If you are typically high in the window between 6am and 8am, you'll get a fancy message letting you know that this is, well, typical. Nice. Except, that's useless. I mean, not totally useless. My diabetic mother did pretty much the same thing every day of her life. Me, though? Not so much. I got up this morning at five, for example, and went for a run. Tomorrow, I will get in some intervals on the bike after work. Wednesday, I have a group ride scheduled with my friends starting around noon...
Do you see where this is going?

The data would be most useful if it were based on the tags and not on day part, with custom tags like, "Before Run" and "After Run," or even generic tags like "Post Exercise." That kind of dynamic data collection could be really insightful. I could see, based on the averages of the tags, what my blood sugar was doing pre and post workout or, more specifically, running versus cycling. Or when I race. Or during illness. But the Verio IQ allows for only two tagging options: "Before Meal" and "After Meal" which are really for your own reference only. Everything is averaged based on time of day, and the "Before Meal" or "After Meal" tag is just used by the Verio to populate the initial data. That makes the "pattern alerts" kind of irrelevant. Knowing I'm often low at 2:00 might be attributable to something...or it could be a function of coincidence. Numbers, taken in isolation and paired with time of day are, well, just numbers...generated not unlike every other meter on the market. Sure, sure, those others meters are lackluster in their marketing and don't look nearly so fancy, but in terms of function, they are pretty much the same. Unless, of course, you are my mother.

If you really want to take those numbers and make them contextual, you will still have to have the fancy app on your phone, or go old-school and keep a log. I suck at tracking, so I do neither. I just test often, correct as needed, and hope for the best. It's worked pretty well so far.

All that aside, The Verio test strips are formulary with my insurance, and I prefer the size of the meter to my current insurance approved option. I also liked the display. I may switch. After you get over the hype of the "smart meter" and the "pattern alert" business, it is kind of cool and feels nice in the hand, and is easy to read and tote from place to place. Good enough. 

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