Alternative Prickers

Talk about cool packages arriving in the mail: last week, I got a surprise from Can-Am Care, in the form of a test unit of the company’s new Renew lancing device.

Who would have thought that anything could make drawing your own blood more fun? This system really is pleasant to use.

Renew_fingers

A quick overview of my experience with Renew:

PROs -

* handy and “fun” design

* easy to advance and “cock” (ahem…)

* virtually painless (for real, I hardly felt a thing)

* no loose needles, no need to carry or replace them

* you’re using a clean, fresh needle each time (how important? no idea, but nice to know)

CONs -

* very low pressure: I found I had to crank it up to the highest depth and mash my finger up against it to draw any blood at all

* if you “miss” and don’t draw blood, you still have to advance to the next of 20 microlancets stored on the cartridge. In other words, you waste one.

* it doesn’t fit in your standard glucose meter carrying case, so yet another med-gadget to schlep around separately

* price – the base unit is only $11, but each set of 5 cartridges (good for 100 pricks) will set you back another $12. I’m lousy at math, but it’s pretty obvious this is a lot more expensive than most systems we’re using now — where your insurance sends you buckets of lancet needles and you can use each one for, well… far too long ;)

Anyone game to try getting their health plan to cover the Renew system? I suppose you’d need proof that it’s “medically necessary” over older, cheaper lancing devices.

On that note, a number of readers have called my attention to the Pelikan Sun, a very sleek-looking and supposedly painless electronic lancing device from a very ambitious company here in Palo Alto, CA (they just secured $69 Million in VC financing).

Pelikan_sun_2

This little gold box uses proprietary “state-of-the-art miniaturization and automation” to make a lancet that you don’t feel at all. At least what the kids say in the videos. I’m inclined to believe them.

A mother who reads this blog wrote me:

We just bought the device for our 10-year-old. I don’t know if you have actually tried one yourself yet; it really does work without pain, AND does a better job of getting an appropriate amount of blood on the first attempt. We’ve frequently had to choose between one painful fingerstick we know will draw blood (and keep bleeding) or multiple attempts on a lower setting. After just three days of using the device, he’s no longer tensing up to test because two minutes after testing, he can’t even find the spot again because there is no residual pain. They also claim it creates less scar tissue, and since he is just 10, we are in this for the long haul.

I’d say this is that rare ‘pain-free’ technology that does have value. At $200, it isn’t cheap, but we just tell Max that college is overrated : )

Gotta love her! Yup, $200 is no small sum just for a lancing device, not to mention the $15 for each set of replacement cartridges (50 pricks on each, so 100 total). The company says the Pelikan is covered by insurance like any other lancing device, but I’m guessing it’s ditto on my comments above. Still, I think if it were my child getting poked all the time, and I could afford it, I’d buy this thing out-of-pocket in a minute.

Now I’m just so darn curious: What kind of lancing device do you all use? What are the PROs and CONs?

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25 Responses

  1. riva
    riva January 24, 2008 at 7:50 am | | Reply

    I was in the trial for the Pelikan Sun and it’s fantastic. True to it’s word it’s just about painless and much easier to get just the amount of blood you need from each finger, which varies. You do test more often because it’s no fearsome thing anymore.

    I don’t know whether insurance will really cover it, but I do hope so. I’ve already been to college but I’d rather not spend my retirement savings on lancets. But horribly the thought of going back to the everyday painful lancing is really unsettling.
    riva

  2. Kathy
    Kathy January 24, 2008 at 8:03 am | | Reply

    Sigh. Would someone *please* invent a cure (or at least a better closed loop system) instead of another ‘mousetrap’? Sorry but I’m getting tired of waiting…25 years is a long time.

  3. Matt M.
    Matt M. January 24, 2008 at 8:31 am | | Reply

    I just use whatever device comes with my Ultra One Touch meters, but more to the point, it’s been years since I’ve pricked my finger in the service of blood glucose monitoring. I use my arms – upper and lower – exclusively. I find that mostly this is painless, but I guess that could vary from person to person.

  4. Chris
    Chris January 24, 2008 at 9:01 am | | Reply

    I also use whatever device comes with the OneTouch. I am all for less painful testing but not at the price of $200.00 and then for the refills. Plus good luck getting it covered by insurance for quite some time. If you have to fight tooth and nail for a proven device to help Diabetics (CGMS) then I would think it would take an act of God for them to cover a device that is already packaged with every BG monitor.

    Cool devices though

  5. Ed
    Ed January 24, 2008 at 9:51 am | | Reply

    Does the pelican thing also serve as a meter or is it just a $200 lancet device? I couldn’t figure that out on their website – if it’s just a lancet device that is retarded.

    I use the accu-click softclix, hardly any pain and my fingers heal pretty well, cost $9.

  6. Bernard Farrell
    Bernard Farrell January 24, 2008 at 10:02 am | | Reply

    Interesting. These types of devices really take a little off the rough edge of living with diabetes.

    I use the BD lancet that came with the BD meter that I got several years ago. I hated the meter, but I love the lancet. It’s a very fine gauge and (to me) is almost painless.

    I’m curious about the gauge of the ‘micro-lancets’ in the Renew product. I wish they’d specify it on their site.

  7. Larry
    Larry January 24, 2008 at 10:09 am | | Reply

    I use Accu-Chek Multiclix, which comes with a five-lancet drum, on my outer palm. This is virtually painless if you change the lancet periodically. After 48 years of testing, I find this the best so far. And Accu-Chek Aviva is good for poor eyesight.

  8. Barbara
    Barbara January 24, 2008 at 10:40 am | | Reply

    As a T1 for 45 years and a CDE, I use and often recommend the Accuchek multiclix. The technology is different from the usual devices that are spring loaded and actually twist a bit with the puncture. I haven’t been testing my blood sugar for 45 years, though, because we didn’t have the technology then (1963). We peed in a cup, used an eye dropper to measure out 5 drops, added 10 drops of H2O, added a clinitest tablet and watched it boil….and got questionable information that was at least 2 hours old…we also boiled glass syringes and non-disposable needles (and sharpened them from time to time on a file)…so while I love new technology and long for a cure, I don’t get too excited by a finger stick. Try boiling glass syringes in a college dorm kitchen and have people mess with your stuff while waiting for it to cool down…

  9. Cara
    Cara January 24, 2008 at 10:45 am | | Reply

    I did use the lancet device from my BD meter. It was great. But then I discovered the Accucheck Multiclick. It is even better (in my opinion). There is hardly any pain and it is something I will keep using, even if I change meters.

  10. Kristin
    Kristin January 24, 2008 at 11:53 am | | Reply

    I use the Accu-Chek softclix as well. It is wonderful– I rarely have pain (and I change the lancet only every few months). I can hardly find any evidence of the finger stick. Compared with the ones that come with Freestyle or OneTouch meters, I much prefer it. As far as testing on the arm, it was hard for me to get blood and I heard that it is less accurate than finger sticks, but I don’t know if that is true.

    It’s funny to me that companies would think that we would want to change lancets every finger stick?!?! I would not want to pay extra for that!

  11. Thomas
    Thomas January 24, 2008 at 12:53 pm | | Reply

    I use the Accu-Chek stabbers too: having tried all of the others (Autolet, BD, One Touch, Abbot etc) it is the most gentle on the market.

    As for the lancets, you mean you can change them? ;-)

  12. Sarah
    Sarah January 24, 2008 at 2:06 pm | | Reply

    Very cool devices, and I would use them for sure if they were given to me free, but…

    “69 million” in investment assets is given to a lancing device company?!

    What?! Why is it that when someone has a Type 1 diabetes “CURE breakthrough” like Faustman, she has to struggle to raise a measly $10 million. But a company has no problem wasting almost 7x to make a lancing device that really does nothing in and of itself to improve control.

    While I think it’s important to test often (even better the less it hurts), and some of us MUST to stay out of a coma (moi), this and of itself does nothing to justify the cost or amount of investment. IMHO, it’s another money-making scheme that may go the way of Exhubra. You can’t put financial gains over your customers.

    I use the FreeStyle Mini (Flash in the US), and the “poker” that came with my free Precision X-tra. It’s the best one I’ve ever used, and it was FREE. And it works on both my calloused (Type 1 for 24 years) AND sensitive fingers.

    I don’t know how many of us would be willing to spend $200 on a lancing device, aside from young children and those who play the piano professionally.

    More concerning, are we not looking to move ahead PAST requiring a blood drop for testing? Are we giving up on that route, or are they “milking” (pun intended) every last drop out of home monitoring with fingersticks?

    Cool technology, but save that for cars and videogames. When it comes to diabetes, I want a cure, not a better mousetrap.

  13. Larry
    Larry January 24, 2008 at 2:06 pm | | Reply

    Regarding the helpful post by the T1 for 45 years, I did not mean that I was blood testing for 48 years. Anyone remember Benedict’s solution, which had a great turquoise color until you had to boil it with some urine in a test tube?
    Useless by today’s standards, but that’s what I did in 1960.

  14. whimsy2
    whimsy2 January 24, 2008 at 8:12 pm | | Reply

    I use the adjustable depth poker that came with my Ultra meter, set at the lightest setting. I poke about 10x a day and there’s no pain at all. After 10 years of poking 10x a day, I must admit I’m getting calluses on my fingers, though.

  15. Phil K
    Phil K January 24, 2008 at 9:46 pm | | Reply

    Wow – only one comment so far asking “you mean you actually change your lancets?”? I probably use a new lancet about 2-3 times a year. Maybe less.

    I’ve also been using the same three fingers (on my right hand, no less) for about 18 years. Its hard to change now that I have all of those calluses.

  16. JasonJayhawk
    JasonJayhawk January 24, 2008 at 10:22 pm | | Reply

    I think the Peklikan Sun will go out of business. They can’t possibily have the reps to sell this to the endocrinologists to sell to the patients. The insurance companies will see it as too expensive, especially with “replacement cartridges.” I would figure that a laser would provide unlimited usage, so I’m not sure I understand the replacement cartridges for it.

    Ah HAH! Upon checking their press release, it looks like they’re going into blood glucose testing markets. I wish all the luck to them; the more competition out there, the more pressure there is to keep prices fair for any cash-paying Type 1′s test strips.

  17. Kevin
    Kevin January 25, 2008 at 5:39 am | | Reply

    Hands down (fingers down?), the best lancet device I’ve used is the Accu-Chek Softclix (sic). It’s compact (much more so than the Multiclix that has received so much attention), virtually painless, and can be “cocked” and fired single-handed. I’ve bought Accu-Chek meters JUST FOR THIS LANCING DEVICE.

    How messed up is that? A meter with lancing device often sells for less than the lancing device on its own. Pretty wasteful, I know, but I’m just responding to the basic price incentives.

  18. Dan Fahey
    Dan Fahey January 25, 2008 at 6:28 am | | Reply

    I’ve never found the automated lancet devices to be worth it.
    If someone tests often, one’s fingers become quite callused, so it’s hard to imagine being able to use the “lightest” setting and have that consistently work.
    To me, lancing is the least of the issues for a diabetic.
    I probably use one lancet for 2 days [or about 30 "stickings"].

  19. Kelly Kunik
    Kelly Kunik January 25, 2008 at 8:40 am | | Reply

    To be honest, I don’t use a lancing devise,I just prick myself with the lance. I don’t have time for one.
    I take at least 10 blood sugars a day and dealing with yet another piece if diabetes hardware is one more thing I have to carry.

    Call me crazy, but it’s true!

    Still – both devices are nice looking, if my doctor gave me samples of each, I might try them.

    Thanks for the heads up!
    Kelly K

  20. Lauren
    Lauren January 25, 2008 at 7:37 pm | | Reply

    Kelly, you are brave. When my lancing device broke and I was forced to stab my finger with a naked lancet, I had to work up the courage each time.

    I have so much respect for those “diabetes veterans” who were diagnosed in the years before glucometers. (My type 1 aunt is one such person — she is now pushing 60.) I remember learning about Benedict’s test in my biochemistry class, long before my own diagnosis, and thinking how archaic and wildly inaccurate it seemed. Thank God for the technology we do have. Without the tools we can now avail ourselves of, I wouldn’t be able to cope with the demands of diabetes and medical school.

  21. AmyT
    AmyT January 25, 2008 at 7:53 pm | | Reply

    Hey Guys,

    I always tell the newly diagnosed that the one extra thing they should always carry when traveling is a 2nd lancing device. What else are you going to use to poke yourself? A safety pin? Yuck! I need something more “clinical.” :)

  22. MagicJ
    MagicJ January 26, 2008 at 10:18 am | | Reply

    One thing that the Pelikan Sun and the Renew device (although I’m less sure about the Renew device) are trying to do is eliminate the re-use of lancets.

    Today’s lancets are EXTREMELY sharp, and a new one will make a nice clean cut. But they dull quickly. Over several repeated uses, that nice ultra-pointy tip will have bent over and turned into a barb.

    If your goal is low pain lancing (on average because of course some sticks hurt worse than others at the same setting) and better wound healing, starting out with a fresh lancet every time will give you the best chance for success.

  23. Florian
    Florian January 27, 2008 at 3:31 pm | | Reply

    I’ve been testing since the early 80′s when I got my first glucometer so its been a long time. Now I just have to squeeze the end of my finger for a microliter of blood and I’m good to go. Only kidding.

    I use the BD Ultra 33 Lancet by itself no spring loaded lancet device. I test at least 10 times a day, not to see how I am doing but to find out if my pump is delivering insulin and holding my blood sugar steady and near normal.

    Many have mentioned calloused finger tips. I believe that is from using dull lancets (which happens quickly) and having to set and keep the depth of penetration too deep to puncture the skin and score blood. The lancet hits the finger tip with a lot of force leaving a minor bruise and lots of skin damage.

    My fingers (I use the side tips) are in excellent shape with no bruises or callouses.

    Florian (T1, dx 1967)
    Animas 2020 + Apidra

  24. Suzy Smith
    Suzy Smith January 30, 2008 at 11:53 pm | | Reply

    “If your goal is low pain lancing (on average because of course some sticks hurt worse than others at the same setting) and better wound healing, starting out with a fresh lancet every time will give you the best chance for success.”

    I was about to mention this. I have noticed that if I change the lancet every time it is much less painful, and I have extremely sensitive fingertips to the point that I have to force myself to hit that damn button, every single time of the multiple times a day.

  25. Scott Powell
    Scott Powell April 3, 2008 at 4:10 pm | | Reply

    I think I might give this a try. I agree whole-heartedly with the “I want a cure, not a better mousetrap”.

    That’s great…but a cure is still a LONG ways away. In the meantime, I’ll take the better mousetrap.

    IMO,
    Scott

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