Diabetes Devices: Favorite Features
People with diabetes reveal the aspects of their devices that make the biggest difference in their diabetes management
We chatted with 11 people with diabetes about what they look for in their diabetes management tools—what works for them, what they love, and what they wish for.
Blood Glucose Meters
Blood glucose meters are one of the few tools that can be used by nearly all people with diabetes. From women with gestational diabetes and folks who have prediabetes to those who have lived with type 1 or type 2 for decades, everyone with diabetes can benefit from the information you can get from just a tiny drop of blood on a test strip. A meter can tell you a lot about how your blood glucose is doing at this very moment. With dozens of meters on the market, special features help set devices apart from one another.
Downloadable data: Wes Lyons, 33, of Valhermoso Springs, Alabama, uses Bayer’s Contour Next USB meter because of its download feature, which puts all of his blood glucose readings into a spreadsheet. By examining trends, Lyons learns what causes him to spike—and that helps him make healthier choices to control his type 2 diabetes. “It helps to compare what I’m doing versus what my levels were,” Lyons says. Using data from his meter and a calendar, Lyons is able to pinpoint what his schedule was like when his blood glucose spiked or dropped.
Tomiko Lane, 44, of Apex, North Carolina, also likes the download capabilities of her meter. Lane, who has type 2 diabetes, was given her Lifescan OneTouch Ultra by her doctor and says she’s a creature of habit, so she has kept up with it. “I like that it has the table that you can [use to] keep track and see trends,” Lane says. “That’s what my doctor also does. My insurance was trying to give me a new meter, and I was asking, ‘Does it have the tables?’ ”
Cost effectiveness: The one-time cost of a meter isn’t much compared with the cost of test strips, especially for folks who test many times per day. That’s why Charles Nokes, 43, of Nashville, Tennessee, has stuck with his ReliOn Prime meter since being diagnosed with type 2 diabetes in June 2013. Walmart’s house-brand meters and strips are readily available at the chain’s many locations for relatively low cost. “When my doctor first diagnosed me, he said he didn’t suggest me going out and buying something really expensive unless he felt [the inexpensive model] wasn’t doing the job,” Nokes says. “It was a little $15 meter, and then the strips [were] $9 for 50. Now they have a super pack with 100 strips, and it’s $17.”
Seeing the light: Kassie Tyvela, 34, of Bay City, Michigan, has type 1 diabetes and says her VerioIQ meter’s color screen makes seeing her results a breeze. But what really seals the deal are the meter’s test strip port light and two-sided test strips, which double the number of checks she can do with one pack. She likes this meter so much she had her pharmacy order it specifically for her.
Insulin Delivery Systems
There are several ways to deliver insulin. Insulin users can reach for traditional vials and syringes, insulin pens, insulin pumps, and—if it stays on the market—one inhaled product. Your type of therapy (basic or intensive), your insurance coverage, and your preferences are part of the purchasing decision.
Insulin pumps for tighter control: Alejandra Marquez, 36, of Greensboro, North Carolina, began using an insulin pump when she started trying to get pregnant. Before leaving her native Venezuela for the United States in 2010, Marquez had not seen many pumps. But here, as part of DiabetesSisters, a nationwide support group for women with diabetes, she says many folks she knows with type 1 diabetes are pumpers, like herself. “It’s easy for me to control with the pump,” she says. It paid off: After going on the Minimed Paradigm Real-Time Revel pump in 2011, Marquez is now mom to healthy baby Lucas, born in August 2014.
Pumps for constant control: Amanda Holmberg, 39, of Arlington, Virginia, loves that her Medtronic MiniMed 530G, like all pumps, delivers a constant programmed stream of background or basal insulin—except when it doesn’t. And that’s something she loves even more. The MiniMed 530G is the first device cleared by the Food and Drug Administration with Threshold Suspend technology, which stops insulin delivery for up to two hours if blood glucose hits a certain low point and the user doesn’t respond to the alarm. This feature is great for people who, like Holmberg, have hypoglycemia unawareness. “If I’m getting the low alerts and not responding, it shuts the pump off,” she says. “It has happened a couple of times overnight, and it’s probably saved me from an ER visit.”
Pumps for safety and simplicity: Tyvela runs a day care out of her home, so keeping sharps away from little hands is a must. “I like that I can bolus on the go,” she says of her Medtronic Paradigm 720. “I like that I don’t have to use syringes.”
Pumping tiny doses: Sylvia Bustard’s son, Johnny, was diagnosed with type 1 diabetes when he was just 14 months old. Because Johnny was so small, he often needed doses of insulin less than 1 unit—tough to deliver with a syringe but no problem for pumps, which can be programmed to deliver boluses in increments as low as 0.01 units. Now 4 years old, Johnny, who lives with his family in Southington, Ohio, still uses his Medtronic MiniMed Paradigm Real-Time Revel. “At the time, there were only a few pumps offering micro dosing, which is why we chose that pump,” says Sylvia.
Elsie Hunt, 3, of Goshen, Indiana, and her family also looked for micro dosing when selecting a pump. Elsie uses Tandem Diabetes Care’s T:slim pump. “We could only give as little as a half a unit of insulin with the syringes, and our usual doses were 0.25 or even smaller. So since we couldn’t give that little, her sugars remained higher as we would just wait until her sugar rose and correct it at a later time,” says her mom, Sarah Hunt. “With the T:slim, we can give [basal] doses as small as 0.001 units, so we get a more well-maintained blood sugar level.”
Inhaled insulin: Cynthia Rogers, 37, of Boise, Idaho, uses Afrezza, a new insulin delivery system that allows users to inhale, rather than inject, their mealtime insulin. (Whether the product will stay on the market or be withdrawn like its predecessor because of lack of sales remains to be seen.) A desire for non-needle delivery drove the product’s development, but Rogers found a personal benefit. She’s in recovery from diabulimia, an eating disorder in which someone with diabetes withholds insulin to avoid gaining weight, and getting the benefits of insulin without the sense of “units” is a big deal. “It doesn’t register to me as units,” she says. “I don’t feel like I’m injecting insulin and ‘getting fat.’ For me, that’s a great tool to introduce for recovery. It just seems different.” Keep in mind: Afrezza dosing may not be precise enough for people who require very small doses of insulin.
Pen/syringe combo: Juggling multiple kinds of injectable medications can be tricky, especially if you have poor eyesight, a possible complication of diabetes. Because insulin vials all look similar, it can be easy to grab your fast-acting insulin when you mean to grab your long-acting. And it’s easy to make mistakes with pens, too. That can be dangerous. So Asha Brown, 30, of Minneapolis, who has type 1 diabetes, takes Lantus by traditional vial and syringe and Symlin, another blood glucose–lowering injectable, in a pen form. “I have a really busy life, and this way it’s fairly effortless for me to never make that mistake,”she says.
Pens for on-the-go ease: Insulin pens are an easy and discreet way to keep both medication and device in one neat package. Lane uses pens to take Lantus and deliver Victoza, a non-insulin drug used to manage type 2. She says her doctor suggested pens to her as the simplest way to inject the drugs.
Continuous Glucose Monitors
By wearing a continuous glucose monitor (CGM) that uses a sensor to constantly track glucose levels, users get a complete view of how medication, food, and exercise affect blood glucose. While an unending stream of information can be too much for some—or be one too many items attached to their body, which Tyvela found to be true for her—others relish the potential goldmine of data a CGM provides. Here are just some of the reasons people use CGMs:
For peace of mind: Marquez loves how her Dexcom CGM gives her real-time trend data that she can see easily on the receiver without a finger stick, which she says was especially important when she was breastfeeding, which can cause blood glucose to drop. “With this sensor, it helped me to understand how my body worked with the food,” she says. “I can see, immediately, with the graphic, and I can figure out what I need to do.” But note: Meters and finger sticks are still necessary for checks done before giving boluses or correction doses, before treating lows (unless you have symptoms), and for calibration.
For staying accountable: For Rogers, her Dexcom CGM with data sharing software is a tool that helps her share her glucose readings with trusted sources. “I absolutely would choose my CGM above anything,” she says. “It’s the only way to know what’s going on. Somebody else has eyes on me; my husband also sees the data.”
For special features: Because all CGMs have similar accuracy, it’s the special features that really make a product right for someone. For example, Brown loves her Dexcom because its sensors, worn on the body, last for seven days, the longest of products on the market. And she loves that its color screen is super friendly to the eye—no black-and-gray screens here.
Open the App Store or Google Play on your smartphone and you might be overwhelmed by all of the health apps available to you. Some allow you to track blood glucose. Others track food intake or activity. Charles Nokes, 43, of Nashville, Tennessee, uses My Glucose Buddy. “I’ve tried several different ones, but I really enjoyed doing that one because it also had a way that you could [log] your A1C, your weight, your blood pressure, and everything,” he says. The app sends all logged information to a printable Excel spreadsheet, as well.
Asha Brown, 30, of Minneapolis, has been using the same Securitee Blanket vial protector, a cozy for insulin vials, for several years, and she says it’s still as good as new. The little sleeve makes insulin vials easier to see and hold—great for people with vision issues or with peripheral neuropathy.
Brown also swears by Dia-Pak Deluxe by Medicool, a travel case that holds everything from her meter to extra test strips, lancing devices, and glucose tablets. Though the Dia-Pak works for her, Brown suggests everyone with diabetes find a kit that carries several days’ worth of supplies and fits their own needs. “I’m never worried about running out of something,” she says of her supply kit. “If you want to carry all your stuff in a Ziploc bag, if that works for you, then do it.”
Talk to your doctor, but it’s fine to hold out for a product you really want. Stephen Shaul, 53, of Baltimore, has been using his MiniMed Paradigm Real-Time Revel pump to manage his type 1 diabetes for so long that its warranty has expired. But until he finds something new that meets his standards (and that his insurance will pay for), the Revel will have to do. “Maybe I’m too picky, but I haven’t found anything that really wows me,” he says. “I’m making sure I [buy] something I feel comfortable with for the next four years before [its] warranty is out.”
There’s no hard-and-fast rule on when you need to replace your diabetes devices, but Lisa Merrill, MS, RD, CDE, sees no harm in waiting for what you really want. “To me, if something ain’t broke, why fix it?” she says. “Let the bugs get worked out of new technology before getting something new.” But technology is constantly evolving, says Heather Free, PharmD, so it might be useful to talk with a health care provider about innovations that can best serve you.