Blood Glucometer Consumer Sentiment
Consumer sentiment in the US and Canada in the last year towards the pervasive "finger prick" blood glucose monitoring (BGM) systems remain negative. The newly released flash monitoring systems, while they haven't eliminated all the negatives, have provided many benefits including enhanced security for the person with diabetes, providing opportunities for bonding other users, educating non-diabetics and providing real-time data trends for the person with diabetes. There are additional BCM's awaiting FDA approval that have the potential to make a considerable difference in diabetics bG management. The adoption of the monitoring apps have not had the expected uptake, but there are devices for the visually impaired.
- From scholarly studies, it is apparent the users' feelings toward using the standard "stick your finger and draw blood" test is negative overall. Researchers stated they knew that those tests are not always accurate and are often uncomfortable for patients.
- Another research report defined them as "invasive, painful, time-consuming, and a constant burden for the household budget."
- The Ontario Ministry of Health announced they would provide public funding for flash glucose monitoring systems under the umbrella of the Ontario Drug Benefit (ODB) program, effective September 16, 2019.
- Ontario and Quebec are the only two provinces to fund this type of system. This funding is good news as the ODB covers all senior citizens (65+) in the province. Senior citizens also pay a two dollar copay for every prescription.
- A new user of a continuous glucose monitoring device was very pleased with the result of her switch. "I've downloaded the FreeStyle LibreLink app on my iPhone and can check my glucose level on the fly whenever I want. The best part, though? No routine fingersticks! This is a game-changer in how I control my diabetes."
- Another user reported feeling like the weight of the world had been taken off her shoulders. "Hypoglycemic unawareness is still the main reason the information on my CGM screen makes me feel more secure because I can tell which way my blood sugar is heading in instances such as before bed, before exercise and before driving. After all, the number on my meter might be good for before bed if I know my blood sugar is stable or trending upward, but that same number might mean I need a snack if I see that I'm trending down. My CGM plays a big part in keeping me at my A1C goal for the last five years."
Bonding with other diabetics
- CGM technology is potentially visible if worn on the upper arm, which is one of the recommended areas. Its easily seen when short sleeves are worn and have prompted some bonding between people with diabetes. The conversation was published by the author of a diabetic living website.
- "The waitress came back over and brought our drinks. "I noticed your Dexcom; I wear one, too." Her face brightened. "Hey, that's awesome! I like it wearing it on my arm. But you know, sometimes I have trouble keeping the sensors stuck." We spoke in diabetes shorthand for less than a minute, comparing favorite adhesive overlay tapes and body real estate options. She pantomimed carefully putting on a shirt to show how sometimes her sensor gets stuck on the sleeve hem. I pantomimed pulling down a pair of pants by exaggeratedly stretching out the waist to show how to avoid pulling off the sensor from my thigh. She told me about the random guy at a bar who showed off his insulin pump after seeing her Dexcom sensor. We laughed at the absurdity of the whole robot-life thing. My daughter watched us, two strangers fluent in the same language."
- Another consumer shared how he engaged his non-diabetic friends on Facebook, giving them regular updates and encouraging them to place bets on his next meal. It appears to be an effective means of education.
- "I have come to think of the sensor device, in combination with the LibreLink scanner software on my iPhone, as a Friendly Robot Vampire who politely tests my blood glucose every minute or so and offers information and opinions. And if you don't think I'm over-the-moon happy with my Friendly Robot Vampire, just ask my Facebook friends. By the end of the first week, I had them placing "bets" about when various meals would peak my blood glucose, how high, and at what time."
Using tracking data
- The same contributor discussed how he never took his blood sugar because his A1C was low enough, and he didn't see any use. He would ask the doctor, "f I bring in the numbers, what are you going to tell me that you aren't telling me now?" His opinion has changed significantly.
- "I am now discovering the manifold joys of a food diary and medication log WHEN YOU ACTUALLY HAVE GOOD DATA TO CORRELATE WITH IT, and having a marvelous set of laboratory equipment to run tests on a population of 1, yours truly. (Oh, and the lab equipment volunteers super-useful information. Looks like I need to spread the carbs and calories around better after noon!) NOW I've got an answer to "what is testing going to do for me now?" CHANGE MY LIFE FOR THE BETTER.
Clinical Trial New Metering system
- New technology by Control IQ is expected to be available to the public by the end of 2019. "Because correctly dosing insulin is challenging, the automated features of Control-IQ are very appealing — the changes are designed to decrease the burden for people with diabetes and to improve blood sugar management. This system has been shown to reduce hypoglycemia (low blood sugar), increase time-in-range (70-180 mg/dl), and lower A1C."
- One of the members of the trial for the system had the following review "Life with diabetes was difficult and frustrating, but I kept an upbeat attitude and assumed everyone had rough days. After two weeks with Control IQ running at night, I realized that I'd been feeling BAD all those years, both physically, mentally, and emotionally. My brain, after two weeks of using Control IQ, felt like it was on overdrive just from getting the correct amount of fuel from consistent good nighttime bG levels."
Adoption of Monitoring Apps
- There are over 300,000 health apps for download, which are designed for a variety of needs from weight loss to the management of diabetes. The challenge in the marketplace is that these apps are not subject to federal regulation, and there are no medical guidelines in place to help physicians and patients select an app. Patients usually resort to the internet, but there is no definition of the critical features an app should have for it to meet the needs of a diabetes management app. Research has indicated barriers to usage include financial (no money), temporal (no time) and technical (Don't know how to use it).
- Despite the level of interest, the level of uptake has not been as high as expected, especially for those living with type 2 diabetes (T2D). Although no one is sure, the reason most often suggested is that without clear evidence of their benefit, there will be only sporadic adoption.
Challenges with Cell Phone Monitoring
- There are also unforeseen problems when using cell phones to monitor bG. A medical doctor posted the following tweet upon the announcement that no cell phones would be allowed into the concert. "@Madonna if my cell phone controls my insulin pump and reads my continuous blood glucose meter am I excluded from your show? Will you make exceptions for phones that function as medical devices? #T1D #diabetes-awareness #wearenotwaiting." Madonna has not answered.
People with diabetes with Vision Problems
- There is, however, help for people with vision impairment, which is a common complication of diabetes. Typical glucose monitors have relatively small screens. Now, meters with large screens and "talking" meters are available.
Research began with an analysis of studies completed in the last year on blood sugar monitoring. We found three articles published by the National Institute of Health and one in the magazine Science Daily. From there, we moved to the press, looking for information on Blood Glucose Monitoring. Because the client asked for information from Canada, we were pleased to find the announcement of a new policy of the Ontario government starting Monday, September 16, where the health care system will cover the cost of flash monitoring devices. Unfortunately, while we found many media articles about the cost of insulin across the United States, there were no articles referencing Blood Glucose Monitors. Instead, the coverage focused almost exclusively on the cost of insulin.
We then turned to social media, scouring Facebook Instagram and Twitter for comments on blood glucose monitoring. We found only one post on Instagram in the past year. Unfortunately, all the Facebook groups where users discussed diabetes were closed. An interesting issue on Twitter was also included in the findings. Finally, we researched numerous blogs to get diabetic's impression of blood glucose monitoring. We have included those insights as well.