The iTest (Keynote) vs The Contour

As a reward for my shiny A1C, I bought a new toy - the iTest meter, aka the Keynote Wave in the States. I was almost out of strips anyway, and since I have to buy some more, might as well get a new free meter to try.

This is the third meter I've tried. The first was a Breeze 1, which I didn't care for. The Breeze 2 is undoubtedly better than the 1 (smaller size, faster), but I just didn't like the packet of test strips concept.

My usual meter is an Ascencia Contour. It's a good meter, with a small sample size and nice speed. The iTest is supposed to use a different, more accurate calculation for blood sugar, which is one reason I chose it.

The Case:
My first thought when I saw it was 'wow, that's smaller'. The I Test carrying case is in standard black, and smaller than my Contour case. It looks less bulky as the fabric is a bit thicker. I'm not sure this photo shows off the difference well, but it's thinner and not as wide.

Unfortunately, the case doesn't have a belt loop, which is a small detail that I appreciated on the Contour case. If I'm not carrying a purse, it's nice to have the option of attaching it to a fanny pack or belt. However, the smaller size will make it far nicer to tuck into my purse.

The Lancing Device
The lancing device on the iTest is pen shaped, and I already like it better than the Contour lancet. It's far more natural to hold and push the button. The needle is definitely thinner, and it has depth settings going from 1-8, while the contour has 5. It makes a far smaller pinprick. I find on my fingers these means a lot more stretching/massaging to get enough blood to test. My fingers have lots of familiar smudges. If I prick closer to the nail it flows better, and this technique is helping me avoid bruising. I think as I continue to practice, it'll get even better. I haven't picked up my Contour lancing device once since I tried the iTest version.

The Lancets
The lancets are visually very different, and you get 100 with the iTest. Both are equally easy to handle and load.

I prefer the lancet cap on the Contour meter. The cap lays straight before I take it off, and sideways when I push the needle into it after use. I can instantly look at a lancet and know if I've used it or not, even if I've jumbled them together or dropped my case and sent some flying. I keep my sharps container at home, so it's not unusual to have a mix of lancets in the case.

On the iTest, the lancet cap goes on exactly the same way after you've used the lancet, so there's no way to really see that it's already been used. I tried pushing the cap on backwards, but it falls off pretty easily. The tiny needle just isn't strong enough. I've been mashing the lancets against the nearest hard surface to bend the needle. Once it's smushed, I'll never confuse a used one with an unused one.

The Strips
The iTest strips are smaller and seem more flimsy than my Contour Ascenscia strips. I accidentally bent the first one I picked up, so now I handle them more carefully. They slide into place without a lot of feedback. On my Contour, there's an audible beep when you insert a strip. On the iTest, you have to watch the screen, or bent strip! I'm sure once I get used to the new meter, it'll become a habit, but for now I'm really having to watch what I'm doing. At my pharmacy both strips are the same price.

The iTest also requires coding, which the Contour didn't. This hasn't made any difference to me. The number that automatically pops up has always matched the number on the vial.

I've also run across 1 dud strip so far (Error 1, "Wet, Used or Damaged Strip" on the meter), which has never happened with Contour strips. Maybe I dented it without realizing, or maybe it was just a bad strip.

Testing
The iTest uses 0.5µL and the Contour 0.6 µL. Somehow it feels like the iTest uses a considerably smaller amount. I think it's the smaller strips and smaller display window.

I also like the countdown better on the iTest. It's actually a second faster - 4 seconds instead of 5, but instead of a simple number countdown, it fills part of the screen with lines. Because there's always something moving on the machine, it feels faster. A second can seem really long when you're waiting for a number to flip. I really like that animation.

The Results
I expected the iTest to read higher than the Contour meter. Nearly every mention of this meter I've found online has talked about higher numbers. My meter is no different.

Here's a sampling of the differences I'm seeing:

iTest	Contour	Difference
6.0 (108)	5.5 (99)	0.5 (9)
5.6 (101)	5.3 (95)	0.3 (6)
8.7 (157)	7.5 (135)	1.2 (22)
7.9 (142)	6.0 (108)	1.9 (34)
5.4 (97)*	5.0 (90)*	0.4 (7)
5.9 (106)*	4.4 (79)*	1.5 (27)
5.7 (102)	5.4 (97)	0.3 (5)
*These four were taken at the same time.

Almost half the time, the iTest was more than a point higher than the Contour. Without a lab to verify, it's impossible to say which readings are correct. Certainly the much higher iTest readings aren't what I'm used to seeing, and my low A1C would support lower readings as well. And hey, we all want to believe lower numbers over higher ones, right? I'm out of Contour strips now, so there won't be any further comparisons, but I'd love to see this meter in a mixed meter clinical trial to see how it really lines up compared to other meters.

Another feature I am missing on the iTest is the 'bad reading' indicator. If I'm testing someone else (which happens occasionally), or I know a reading is crazy off, I can immediately mark it as invalid on my Contour, so it doesn't affect my average. The iTest does not have this feature.

Other Features
The iTest does have a bunch of features I haven't tried out yet, namely charts and graphs. It automatically organizes your results into breakfast, lunch, dinner and bedtime, and provides an average of each. I'm not sure if I like this or not. My fasting readings are being marked as breakfast, and I'm wondering if my two-hour post breakfast readings will show up as breakfast or lunch. The Contour has a simple post/pre meal flag, which I never used.

The iTest does come with six alarms you can set for any time of day. The Contour has a single alarm that you can set to go off 2.5 hrs after a test once you've marked the reading as 'pre meal'. I didn't use the Contour alarm, though I would have if I could have adjusted the default time frame to 2 hrs. I don't have a predictable schedule for most of my meals, so I'm not planning on using the iTest alarms either. I'm sure there are others who would use these alarms.

The iTest also calculates 14, 30 and 90 day averages, which I'm interested in seeing. The Contour has a 14 day average only. You can flip into graph mode on the iTest to see a simple chart showing your ups and downs, which also looks interesting.

Both meters have high/low summaries, but being a pre-diabetic, I never hit those ranges so I can't give an opinion. They also both count the number of tests you've done.

Finally, the iTest comes with a "Zero-Click" software package via USB cable. I haven't hooked it up yet, but from the screen shots on the website, it looks more updated and shinier than what I downloaded from Ascencia. Once I've got a few more readings in the meter, I'll take it for a spin.

Conclusions

So, my first impression is fairly neutral. There are a few things they've really done well, and a few important details I feel they've missed. I like the smaller meter, smaller case, smaller blood samples and pen style lancing device. I miss the auditory feedback, belt loop and 'bad reading' settings my Contour has. I'm really liking the "waiting for results" animation, but fairly concerned by the higher readings. I don't care for the iTest lancet cap, but that's something I can get used to. Once I've got enough data to graph, I can start evaluating the software.

Once I get close to the end of my strips, I'll post again to give a second opinion.