Diabetes Forecast

A Mom and Dad Find Peace of Mind With a New Meter

By Hallie Levine , , , ,

Eric Hinders/Mittera

The Patient:

Alexis*, 7, who has had type 1 diabetes for three and a half years

The Diabetes Educator:

Janet Dominowski, RD, CDE, a certified diabetes educator and nutritionist at the C.S. Mott Children’s Hospital at the University of Michigan in Ann Arbor

The Backstory

Alexis has always used a blood glucose meter to stay on top of her type 1 diabetes. But her parents became concerned about the accuracy of her device. Its readings always trended higher than her continuous glucose monitor (CGM) and the meter used by her certified diabetes educator, Janet Dominowski, RD, CDE. “They’d check her blood glucose level on her meter, then compare it to her CGM and Janet’s meter,” says her mother, April*, who has type 2 diabetes. “While the last two were always around the same, Alexis’s meter was always off—sometimes by as much as 20 points.”

Though Alexis’s CGM doesn’t require finger-stick blood glucose confirmation, both April and Dominowski felt that she could benefit from using a meter. It was an extra layer of security when Alexis thought her glucose might be low or needed to deliver insulin.

The Choice

Alexis was limited in her selection of meters because of insurance. “I’ve been a diabetes educator for 20 years, and it used to be that you were able to prescribe the best meter for each patient,” says Dominowski. “Now you’re restricted to the handful that insurance will pay for.”

Dominowski’s first choice was a meter that was compatible with Alexis’s insulin pump. It had family-friendly features, such as a test strip port equipped with a light, making middle-of-the-night blood glucose checks much simpler for parents. The meter also allowed meal tagging, which lets parents count carbohydrates, proteins, and fats so that they can adjust mealtime insulin doses. There was just one problem: It wasn’t covered by the family’s insurance. Dominowski considered another, easy-to-use meter because it came with a lancing device that simplified blood draws. The lancets are loaded on a drum, so Alexis wouldn’t have to insert a new one with each blood glucose check. The grab-and-go nature is great for kids, Dominowski says; users just advance it with a click of a lever. But the meter had a major drawback. Its test strips were expensive.

The Decision

In the end, Dominowski recommended Ascensia Diabetes Care’s Contour Next One. Unlike Alexis’s previous meter, it requires less than 0.1 milliliters of blood for each reading, which makes collecting the correct amount of blood easier and quicker.

Dominowski also liked how small and portable the Contour Next One is. “Kids have to like the look of a meter because if it’s too big and bulky, they’re not going to want to pull it out and use it.” Even better, the meter’s USB port meant that Dominowski could plug it straight into her computer and download all of Alexis’s blood glucose information as pie charts and bar graphs.

The Result

Alexis now uses a Contour Next One meter. “The best thing about it is that it takes a lot less blood,” says April. “I don’t think that ever bothered Alexis, but it bothered me!”

Another perk: The meter allows up to 60 seconds to reapply more blood, which Alexis’s previous meter did not. “It’s a pain for the meter to error out, and then you have to start from scratch again, which isn’t fun if Alexis is tired or hungry.”

Alexis’s blood glucose levels are often in her goal range, thanks to the vigilance of her parents, but lows are a concern. “What always worried me about Alexis is that her blood glucose levels can dip very low—even under 40—and she won’t know it,” says April. With the CGM’s low-glucose alerts, April knows right away if her daughter is headed for a low. And she can use the new meter to confirm the readings when in doubt.

Why double check with a meter? Because CGMs measure glucose levels in the interstitial fluid, there’s a slight lag compared with glucose measurements taken from the blood. When Alexis’s glucose is changing rapidly, such as after a meal or when correcting a low, she and her family can check via her meter to get the most up-to-the-minute reading.

The meter also has an app, which April and her husband downloaded to their phones, making it easy to keep track of their daughter’s blood glucose levels. This is particularly helpful when the nurse checks her blood glucose at school. “When we’re at work, it gives us peace of mind to look at our phones and see from two sources—her CGM and her meter—that she’s doing okay,” says April. 

Another bonus: April uses the meter as well, checking her blood glucose levels once a day. “I’ve lost a lot of weight and am hoping to be able to stop medication soon, but it was always tricky to gauge accurate blood sugar levels on the old meter,” she says. “Now, I see that I’m on the right track.”

*Last name withheld to protect privacy

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