Ask D’Mine: Dueling Glucose Meters

Welcome back to our weekly diabetes advice column, Ask D’Mine — with host veteran type 1, diabetes author and educator Wil Dubois. This week, some of our readers are pondering some specific glucose meter models and the function of control solution, and naturally, Wil has some advice based on his own experience and a keen eye on the meter market through the years…

{Got your own questions? Email us at AskDMine@diabetesmine.com}

Joe, type 2 from Florida, writes: Hey Wil, I’m thinking of changing from the Contour meter to the Breeze 2, just for ease of use. Long story short, got a Breeze 2 meter and tested my glucose with it, and then used the Contour to compare readings. The Breeze gave me 111, while the contour gave me 85. What gives with the discrepancy? Bayer makes both, so I called and was given the run-around by an extremely heavily accented customer service type person. Got nowhere and am frustrated as hell. Oh yeah, I did do the control solution readings with both meters, and both were within range.

Wil@Ask D’Mine answers: The Breeze meter (and its kid, the Breeze 2) sounds like a cool idea. A meter you don’t have to put strips in. The Breeze uses a foil disc of strips that reminds me of the old disc film back in the 80s. Really, it’s a more current version of the old Bayer Ascensia Dex (no, not Dexcom) glucometers that used the same kind of foil disc. You just slap in the disc, and when you need to test, the disc spins and the meter disgorges a test strip. After testing, you can eject the strip over a trash can.

Sounds great, huh?

Not so fast. There are drawbacks. The meter is big and bulky. It looks like a first-generation Soviet cell phone. And it’s an ooooooold meter. Like Moses old. It got its 510(k) approval back in 2006. So you know the technology itself is much older. But that’s only the beginning.

Of all the meters I’ve been exposed to, I find the Breeze to be the least accurate. And I, too, found it tended to report quite high. Back when I first started at the clinic, Breeze meters were the first ones I was able to score samples of, and we had a disaster with them. Everyone was having higher blood sugars than their A1Cs would suggest. Then we had this poor fat kid. What? No. I’m not being rude, I’m being accurate. He was a low-income very obese pediatric patient. He had a family history of diabetes and was having some symptoms of hyperglycemia. The family couldn’t afford the necessary labs, so we decided to give him a meter and let him test his blood sugar for a week. The poor kid came back in tears. His sugars were awful. At this point, the family ponied up for all the necessary labs and he turned out to be sugar-normal.

WTF?

That’s when I tested the Breeze on myself. Test after test, it was heaps higher than the readings I was getting on my meter—at the time a CoZmonitor using FreeStyle strips.

The next day I threw all the Breeze meters in the dumpster.

That said, my personal experience aside, I didn’t find much griping about the Breeze online, which surprised me. Most folks talking about their Breeze meters seemed pretty happy with them. Oh. Except this guy, who filed an Adverse Event Report with the FDA after a chain of hypos that resulted from giving himself insulin corrections for what he alleged were false highs from the Breeze. Oh, and this lady here, whose family filed a similar report. In her case, the Breeze meter had her at 146 mg/dL, but she was showing signs of being low. The paramedics ended up clocking her at 30 mg/dL. And they weren’t using a Breeze, either. But wait. There’s more.

Of course, all meters are not as good as we wish they were, and I suspect if you spent any time at all looking, you could find some bad news on any model.

But me and the three folks above aren’t the only ones who suspect trouble with the Breeze. Shortly after my clinical misadventure with that meter, I was chatting with a doc who runs a diabetes treatment clinic in our capitol. She, too, had noticed issues with the Breeze and called Bayer. She’s a stubborn woman, to say the least, and she worked her way up to someone in authority who finally admitted that Bayer felt the Breeze product was best suited for patients who don’t require a great level of accuracy.

What?!

“And who would that be,” snorted Dr. Stubborn, “patients I don’t like?”

I’m not sure what transpired in the phone conversation after that…

Now, as to control solution, I’m convinced that the creation of this product is a conspiracy to force us to waste an extra strip every now and again. A dollar here, a dollar there. It really adds up when there are 23 million people using your product.

In theory, control solution is like Halloween vampire blood. It’s fake blood that’s supposed to have a controlled amount of glucose in it. If you test your meter with the vampire blood the meter should be able to identify the amount of glucose in the fluid, and this will tell you if your meter is working right or not. Sounds good in theory, but something is rotten in Denmark.

Looking on a vial of strips for the much-praised-for-accuracy iBG Star, I see it has control solution range of 95-145, a 50-point spread. This means that if I waste a strip on control solution and get a result anywhere between 95-145, I should sleep well at night knowing my meter is working right?

I don’t think so. This meter boasts being accurate within 10%, of a reading, but it can “test” up to 21% off and still be working right. Not something I’d put my faith in at bedtime.

Lastly, as far as the “heavily accented customer service type person” is concerned, I’m fine with that. Diabetes is a global epidemic. If that heavy accent comes from the country I suspect it did, rest assured they collectively have more diabetes experience than anyone else in the world. Sure, that’s no reason for him to give you the run-around, but what else can he do? The product he’s representing is out of date, and for many people, inaccurate. He probably knows it, but has a job to do.

My advice? Skip the ease of use and stick with accurate results.

Carol, type 3 from Texas writes: My husband is a heart patient, since he had a massive heart attack 2 years ago. Now his sugar is really changing. Our doctor wants him to keep track of it in the morning and two hours after dinner. With a doctor’s note, is an iBGStar meter in any way covered by insurance?

Wil@Ask D’Mine answers: The iBGStar is a very fine meter indeed. It’s accurate, convenient (if you have an iPhone or iPod Touch), and very cool.

But it may or may not be the best choice for you. Go to your purse, get out your insurance card, turn it over, and call the toll-free number on the back. When you eventually weed your way through the computerized menus and get to a real person at your health plan, ask them what the plan’s preferred glucometer is. Also ask them how much the co-pay for strips is, and what the procedure for getting a meter is.

In the olden days, a couple of years ago, a doc could just write a prescription for a “blood glucose meter and strips” and you were good to go. Oh, quick detour. Meters and strips are NOT prescription devices, but many insurance plans require a doctor’s prescription for reimbursement. The worst thing you can do for your pocketbook is to run down to the local drug store and buy one. Anyway, back then, you took your script to the local pharmacy and they set you up. Sometimes they’d even show you how to use the damn thing.

But nowadays, many health plans will only cover one brand, or in some cases, only a single model of meter. Other meters might not be covered at all, or if they are covered, they’re covered at a much higher out-of-pocket cost for you. I’m also seeing a lot of plans refuse to pay for the meters themselves at pharmacies. Instead, once you have a prescription from your doc you have to FAX it to a “meter center” contracted with the plan, and they’ll then send you the meter.

Could they make life any more difficult? This makes me see red because it can mean weeks of delay before someone newly diagnosed can start testing.

But I digress.

Back to insurance-preferred meters vs. patient-preferred meters. For those cases where a brand you might want costs more, sometimes the maker of the strips you want will have a co-pay card to help level the playing field. In the case of the iBGStar, go here to get details on their program. In some cases these cards will make the strips you want the same price as the ones your insurance will pay for, but in most cases you’ll end up paying more.

Only you can decide if it’s worth the extra money for you. No one ever said life with diabetes was a breeze.

Disclaimer: This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.