Bayer Contour USB meter big step forward for design
Bayer USA sent me one of their Contour USB blood glucose meters to review some time ago. For me the summary is easy: this is a great meter with slim design that's easy to use. I like it a lot. Read on for the details and lots of pictures.
LifeScan created a buzz when they released the OneTouch UltraMini a few years ago. Given their sizes, looking at the two meters together is a good way to get a quick comparison point. In the picture both meters have a strip inserted and are prompting for a blood sample. Note the Contour uses standard strips that need a 0.6 microliter drop of blood, by comparison the OneTouch needs 1.0 microliters. Both meters provide results in 5 seconds. The Contour meter is auto calibrated with each strip, while you have to calibrate the OneTouch meters each time you get a new batch of strips.
I'm comparing the readings with my WaveSense Jazz meter, and they are usually within about 10% of each other. So I believe the Contour USB accuracy is good. I need to use the meter over several A1C tests, to do a real comparison.
The color is really eye catching, and the text is very readable. Here's a picture of the Contour USB meter showing a low blood sugar reading of mine.
The designers have used this high resolution screen and color very effectively. When your BG is lower or higher than a range that you set, the result is displayed in an salmon color.
One the right hand side of the meter are three buttons, in the picture above they're between the column reading Reminder|Notes and the Bayer symbol. You can press the button to set a reminder for a later test, or to add some basic notes from a small selection list.
The next picture shows the meter immediately after you apply a blood sample. You're prompted to mark the reading as before or after a meal, or just to continue on to the results. While you're doing this, the result is being calculated. So this step makes the whole thing seem faster.
And don't worry, if your blood glucose is out of range the meter won't wait longer than 5 seconds (time to calculate result) for you to make a choice, it will just display the value.
In case you're wondering where the USB part of this meter is, here's a picture.
The meter has a rechargeable battery that gets powered up whenever you connect it to a standard USB port. They also provide a standalone charger you can plug into an standard outlet (which also works for charging an iPod).
One last picture. If you're testing in the dark, it's really easy to see the results on the screen. But you know how difficult it can be to get the strip into the meter and a sample on the strip. If you click the button at the top of the meter (not visible in my photos) twice, then the area to insert the strip lights up. Note I deliberately took this picture in low light conditions to show you the overall results.
Bayer arranged for me to talk with Rick Case, the project director, and Eric Nelson. These folks were leading the design team, which was completely within Bayer. We had an interesting discussion about product design and some technical issues.
Their target audience for this meter was people in their late teens or early 20s. (Which means that folks like Bennet and me can't get too excited about it!)
They wanted to get the product into the market, so initially it's only in black. But they're considering different meter colors and hope to have these available before too long.
If you use the GlucoFacts software that's provided on the meter itself, it doesn't actually remove the readings off the Contour USB. As the meter holds 2000 readings, you'll get almost a year's worth of readings if you're testing 6 times a day.
You can register at the Bayer site and download a different version of the GlucoFacts software that does take the readings off the meter. The built-in software doesn't allow you to manually enter new values, or A1C readings, but the installed version does. Both pieces of software are written in Java and run on Windows and Mac operating systems.
Because of speed to market, they purchased an off the shelf charger. When you use it, the meter is facing away from you, a minor annoyance. They plan to fix this in later models.
They are reading the sites of many diabetes bloggers, so they're taking note of suggestions and complaints for future versions of their products. One suggestion from me is to enable me to download the readings in some standard format (CSV), so I can look at them using other software. I hope the next version will also include an ability to upload readings to a central server like the MyGlucoHealthMeter.
For the first meter from this team, I think Bayer have done a superb job, and I'd recommend having a good look at this meter.
Recently I was given the MyGlucoHealth blood glucose meter for review. It's made by Entra Health Systems a new entrant to this enormous market.
I considered giving a summary up front, but it’s not that easy with this meter. It has some good points and ways in which it can be improved, I don’t think a summary would do justice to these.
The meter arrived in an elegant white box somewhat like an Apple product. I was really pleased to see the meter picture on the front had a blood glucose reading of 157 mg/dL. Finally, a manufacturer that’s not scared to show a more realistic reading.
The box contained the meter and the usual accessories (lancing device, lancets, some test strips, a carrying case, a USB cable, and an instruction manual). Two AAA batteries were included. I'm glad to see that is uses these instead of the more expensive button batteries used on many other small meters. The cost of this kit is $89.95 on the http://www.myglucohealthstore.com site. I was also given 50 test strips, which are worth an additional $49.95.
While small, the meter is not compact. Here’s a picture of the myglucohealth meter (on the right) beside a OneTouch UltraMini (on top), a WaveSense Jazz on the left and a Bayer Breeze2 Meter in the middle.
From this picture you can see that the blood glucose readings are large and easily readable. Unfortunately there’s no backlight, so using the meter in low light levels is really not an option
The strips require a 0.3µL drop of blood and results are shown in about 3 seconds, which is fairly standard features on the better meters available today. The meter is self coding, when you insert a strip the code is read off it and displayed, so you save a little time on each new vial of strips.
You can use the meter straight out of the box, though MyGlucoHealth strongly suggests you read the manual. I didn’t do this and wasted several strips until I talked with MyGlucoHealth support. Here’s the problem, after you insert the strip and the code is displayed you have to select an activity code before you can add a blood sample. This is not obvious and completely different to the many other meters that I’ve used.
Even after learning this I continued to waste strips because I’d apply blood after the code disappeared but before I chose an ‘activity’. There are four activities to choose from: before a meal; after a meal; after sports; after taking drugs. This is a very limited set of options: what about sickness or fasting options? What if I didn't want to add an activity code?
I think the need to choose the activity before testing is a poor design choice and I’m surprised this wasn’t fixed when the meter was being field tested before release.
The meter has a neat little slider at the top which makes it easier to extract the used strip.
The supplied kit also comes with a 3-month MyGlucoHealth.net subscription. This is the site where you can upload your readings, add other health information and share these with your healthcare providers. I don’t know what the annual costs are for an ongoing subscription.
I did hit a snag when trying to upload readings from my meter. I had chosen a password that contained invalid characters, so it wasn’t accepted. Unfortunately I didn’t get a warning about this and had to contact MyGlucoHealth support to resolve this problem.
To upload readings you create an account, logon and press the big blue Get Readings button on the home page of the web site. This launches an application from the web site that asks you to connect your meter. (Firefox users, you’ll need to install the Microsoft .NET Framework Assistant before doing this.)
The first time you do this, you’ll need to fill in a short form so this application can connect with the web site to send the data from your MyGlucoHealth meter.
Then go back to the Meter tab on this application
Now you need to connect your meter. You can either plug in the standard USB cable that’s provided, or you can connect directly if you’ve got Bluetooth on your PC. I tried both approaches and they worked equally well.
After all the readings are downloaded the Meter tab will change to show the most recent blood glucose reading. You can add a comment to go with this reading, or use the arrows to add comments to any other readings. (You can also add comments to readings on the web site.) Press the Continue button and all your data is on the MyGlucoHealth.net website.
On the website you can view your readings as a chart
Or as a table
You can also add other readings, such as my HbA1c line in the middle of the above table. And you can export your readings to an Excel spreadsheet from this page
If your doctor is registered on the MyGlucoHealth site then they can review your readings and exchange messages with you through this secure site. It’s not clear to me how healthcare providers register, currently there are less than 30 doctors listed on the My Doctors tab.
The site allows you to set reminders when your testing frequency is below a specified level, or when the supply of test strips is below a certain amount, and other options. You can also setup alerts when your blood sugar is out of range and have these sent as email or text messages to several people.
Summary
For the first meter from a new company in this space I think the MyGlucoHealth meter scores about 70 out of 100. These days I assume that meters will be full featured and well designed, unfortunately the meter doesn't score top marks for either of these.
It can calculate averages, store up to 250 results, and remind you when you need to test. But the lack of any backlight is surprising. The user manual is barely adequate and really needs improvement. For example the explanation for setting alarms and average results were very hard to follow.
The ability to upload readings directly to a website is innovative. With electronic health records (EHR) and personal health records (PHR) I think many new meters are going to have a feature like this. This is forward thinking.
The Bluetooth connectivity and the use of a completely standard USB cable is nice (WaveSense take note). However you need to install a serial driver if you’re going to use the USB cable, which is irritating even if other meter companies do the same thing.
The website is nicely interactive using Adobe Flash technology appropriately. But the upload software is Microsoft .NET based, so I don’t think it will work on non-Windows machines. These days, all diabetes device makers should be building software that runs on Windows, Mac OS and Linux.
There’s no way to take readings off the meter without the software from the website, which means you need internet access to use the meter effectively. I’d believe there should b separate download software than can be used without the need to be online, but I know this won't be important for everyone.
I hope that Entra Health Systems succeeds with this meter and the website, so that more manufacturers follow this integrated approach.
Vista Therapeutics has licensed some Harvard University technology that uses nanowires to look for proteins in your blood. These are small wires, about 10,000 could fit inside a hollow human hair.
According to TR this is initially targeted at inpatient use and it's very early in development. Eventually they may be able to create implantable glucose sensing devices...but don't hold your breath.
We finally have a replacement wireless meter for the Minimed Paradigm insulin pumps. The new model is the OneTouch UltraLink meter.
It uses existing OneTouch Ultra test strips, with 5 seconds before you have a reading. The meter lets you flag readings as before or after meal so you can get these averages. It stores up to 500 readings and runs on 2 AAA batteries. For more details read the 90-page user's manual (PDF).
The meter is now being shipped with new Medtronic Paradigm insulin pumps. Those of you who already have a Paradigm pump will have to wait a little longer.
... we plan on sending U.S. customers who own a MiniMed Paradigm 512, 712, 515, or 715 insulin pump a OneTouch® UltraLink™ Meter at no charge later this year.
Minimed gives you a way to find out when you'll get your meter.
This meter is only available to US customers. Outside the US, the replacement meter will be from Bayer. Currently there's no word on the release date for the Bayer wireless meter.
If you have, or want to use, the OneTouch diabetes management software you'll need the latest version (2.3.2). You'll also need to download the newest meter driver to your PC so the UltraLink can be recognized.
Yesterday Abbott issued a warning for users of Precision Xtra, Optium, and other blood glucose meters. Apparently if the meters are dropped on a hard surface parts of the display may not work properly. They say the lot number or date information may not display correctly.
But I assume this also means that an 8 might display like a 7 or another number. If only some of the segments are wired properly then you could still think it's working when it's actually displaying false values.
So if you drop your meter, use the display check function to ensure the display is fully connected. On the Precision Xtra the display check is done each time you switch on the meter. It should look like the picture on the left.
If you see any part of the display is missing, then my suggestion is to contact Abbott at the number on the back of your meter.
According to a Medtronic press release, Medtronic and Bayer will work together to distribute a new blood glucose meter for Medtronic patients outside the US. Originally I missed the fact that within the US, Medtronic has made a similar agreement with LifeScan. Thanks Kevin and Amy for pointing this out.
The new meter for those in Canada and Europe will be based on the Bayer Contour and will transmit results to Minimed insulin pumps and the Guardian REAL-time CGMS.
The new US meter will be based on the OneTouch platform. I wonder whether they'll use a version of the more stylish OneTouch UltraMini, the Ultra2 or something completely new because of the need to include the circuitry for wireless transmission.
And once again, I hope that one or more of these three companies (Medtronic, Bayer, or LifeScan) will finally decide to work towards a standard format for representing diabetes data.
Since Amy posted her review of this meter, I thought you might be interested in seeing it in action.
So here's a short video of the meter being used to take a reading.
More about this meter next week.
Update: The meter is made by a New England company called AgaMatrix. I don't know how many insurance companies are covering it. I really like the styling overall.
What might this mean? Well here's the problem for those of us with diabetes.
How many diabetes data devices do you use? Glucose meters? Continuous glucose meters? Insulin pumps? Each of these typically collects some amount of data related to your diabetes treatment.
Have any of you got an easy way to collect this data into a single piece of software to that you can do some analysis on it?
Now imagine a future where all of the various pieces of software that come with your devices each exports the data in a common format. What might that mean?
If that format was shared and freely useable by anyone, then it allows different people to create software to collect the data and make logbooks out of it, or analyze it in different ways.
To get device makers to think about this, I've sent e-mails to various companies that are currently working on new blood glucose monitoring devices. Companies like Biosign Technologies who are developing a new wrist-worn monitor; and Nilimed who is working on a new continuous glucose monitor. I'm also trying to interest the Artificial Pancreas project in supporting standard data formats as part of that effort.
Would you like to get involved? If you've got any experience with programming, especially how to use XML and process XML, then you may be able to help.
Leave a comment, or send me an e-mail (mail address on the wiki), and I'll drop you a note.
Here's something that I just don't get -- and you can certainly call me naive.
<soapbox>
I test my blood sugar readings about 6-8 times each and every day. So over the course of a year I use between 2,200 and 2,900 test strips. At about $0.40 each (I'm being generous here), that means my meter maker is seeing sales of $880 to $1,160 each and every year. Over the last five years they've basically made over $5,000 just from me.
So why is it that they want to charge me $35 for a proprietary cable so that I can get the data out of the meter which might help me better manage my diabetes?
I've used blood equity, time, and money to collect that data. It belongs to me. Why can't I just get it?
I think I've finally realized that device makers don't understand the two ways I use their meters.
Clearly I use meter(s) to tell us what our blood glucose levels are at a given point in time. So I test before I drive, before exercising, before meals. That way I can tell: whether it's safe to drive; have I a good reading before I start my sumo wrestling match; or is it okay for me to eat right now.
But I don't think they understand how important it is for me to have the values for the last month, or the last six months, so I can understand how we're doing on a long-term basis.
Now makers may think that log books would be enough for that kind of tracking. But can a log book automatically draw graphs for me? Can I easily review a months worth of data by flicking through my checkbook-like logbook?
The way I see it these manufacturers are requiring us to spend our own money (because insurance doesn't cover it) to buy a data cable. By holding our data hostage what they're saying is that getting ready access to my data is less important to them than the revenue they receive from their cables.
The Diabetes Technology Blog is focused on using technology to live life to the full with diabetes. I review new diabetes technology including: blood glucose monitors; continuous glucose monitors; blood sugar meters; diabetes software and living with diabetes.
About Me
Name: Bernard Farrell
Location: Massachusetts, United States
I was born in Ireland and now live in the US.
I have had Type 1 diabetes for over 36 years. I struggle with my blood sugar, the same as most people with diabetes.
I wear a Cozmo 1800 insulin pump and a Dexcom SEVEN Plus CGM to track my blood glucose levels.
I'm blessed by God, and every day brings the possibility of a cure.
It uses existing OneTouch Ultra test strips, with 5 seconds before you have a reading. The meter lets you flag readings as before or after meal so you can get these averages. It stores up to 500 readings and runs on 2 AAA batteries. For more details read the 90-page 
