Japanese UG-201 Meter - No Blood Required

Well I've been saying how much I want a non-invasive blood sugar meter. And I've finally found one coming on the market. The UG-201 doesn't require any finger pricking. It uses innovative pee on a stick technology.

Ick!

On the one hand, this meter has a lot of really good ideas. The sensors can be reused 200 times (ick!) and will cost about ¥6,000 or $56 Canadian Dollars. That's about a quarter a test - I pay seventy five cents now. Yay for cheapness. Huzzah for the environmentally friendliness of a re-usable sensor. They've got to be able to come up with this for blood.

They're working on a separate USB memory system that the results are transmitted to via infrared. This idea I love. Meter testing should be separated from meter results. Work together closely, yes. But I want whatever is holding my results to plug in to any computer and give me instant access to the data. No downloading software, no installing. I want something that I can take with me on vacation, use at work, or kill time with when I'm on a plane. There's no mention of any software like this in the article, but it seems like a good first step to me.

So two really good things. Then there is the downside.

Personally, I'd rather live with a tiny pinprick than have to run off to the bathroom every time I need to test. There's a three minute wait between tests as well. That's a long, uncomfortable time hanging around a bathroom if you need to re-check the numbers. Plus the fact that you don't always have to go to the bathroom, and that bathrooms are not always immediately available.

A huge issue is also accuracy. If testing on your arm is 10-15 minutes delayed from your finger pricks, how out of date is your blood sugar number going to be when it has time to affect your urine? The system also needs to be re-calibrated weekly which adds to the inconvenience.

And did I mention the whole Ick factor? The idea of carrying around a sensor, using it, rinsing it off, and tucking it into my purse seems so unhygienic. Somehow a tiny drop of dried blood on a test strip doesn't bother me at all.

Still, this will probably be a popular product. They've been selling a non-portable version since 2004, and this announcement is for the release of a portable model. I wonder what other diabetes technology is being developed in Japan?

Australian Meter/Game System: Glucoboy

Found another new meter, unfortunately only available in Australia right now. The Glucoboy is made Guidance Interactive (I can't find any other meter products by them) in partnership with Nintendo, and is targeted at children. Apparently this became available in November or December 2007 after several years of development. I'm not aware of any other meters specifically designed for juvenile diabetics, and I think it's a great idea.

Aside from the standard meter functions, the Glucoboy has a bunch of built in games that offer reward points though 'GRiP', a guidance reward platform. This includes an online community to help encourage good diabetes management. It sounds like testing regularly earns you more points, which are then spent inside the games or on the website.

The Glucoboy requires you own a Nintendo DS or or a Gameboy Advance to play the games - You plug it in as if it were a Gameboy cartridge to play. The device itself is designed in white and bright orange, and looks very kid friendly. It retails for $299.00 AUD, so it is quite expensive for a meter or a game (Though I don't know how other meters compare in Australia - in Canada meters run about $50 CAD, though you never have to pay for them). The strips are bright orange, and retail for around $31.30AUD for 50. They're planning a lot of accessories to go along with this meter as well.

I'm not Type one, so I have no experience with being a child with diabetes, but I'd like to think this device is a good idea. It seems like a way of making all the unfamiliar changes that come with a diagnosis a little easier to learn by putting it in the familiar context of video games. I would think one of these would be 'cooler' to take to school.

Of course, any child is going to get tired of a game after a while (or at least I always do), but it might be a good way to form the habit of regular testing. Of course, it would be great if Nintendo continued to put out games, or found a way to link the incentive points with their regular offerings.

Any Type 1's or Type 1 Parents out there care to give an opinion in this? I'm really interested in hearing a thought from the inside.

A Pretty Concept Meter - Ninos

Concept art for diabetes products seems to be a new trend. On the one hand, it'll be great if any of this stuff actually hits the market. On the other hand, these concepts always seem to be promotional pieces for designers with little chance of actually getting picked up by an equipment manufacturer.

The one that caught my eye today was a dual concept study called the Ninos As & Ninos GL. They are very stylish, very pretty in modern black and silver.

Reading the story though, I wondered how much research had been done. The Ninos As is an insulin inhaler concept. As sleek and streamlined as it is, I'm not sure how valuable a concept it is when Inhaled Insulin has been linked to Lung Cancer.

The blood meter concept (the Ninos GL) looks a lot like a cellphone. It has a shiny touchscreen and all the charts and graphs you need built in. I love this concept.

However, the concept meter uses a "bloodless glucose measurement system". Apparently you're just supposed to press your finger against a notch in the top. Again wonderful, if the technology existed. As far as I know, it doesn't. The first meter that doesn't use test strips is going to have millions of people flocking to it.

I haven't been able to find much about these concepts - most of my searches online have returned reprints of the same article, often written as if these were actual, available devices. I think they may be German, from squinting at the photos provided. I don't know if there part of some contest or just a designers portfolio.

Love the prettiness of these, but I do wonder about the science behind them.

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.

More on the Non-Invasive Front - Breath Testing?

Ran across an article today on a new new theory in blood glucose testing.

The gist of it is this: Dr. Pietro Galassetti at the University of California is the guy in charge of the study. They've found that the concentration of a certain gas (Methylnitrate) in the air you breath out is related to blood sugar levels. When the kids they studied had high blood sugars, that had more methylnitrate too.

There's also an interview with Dr. Galassetti, that goes into more detail. I love what he says about finger pricking:

"The prick is not very painful, but doing it five times a day all your life becomes very obnoxious."

It's clear this a very preliminary concept. Dr Galassetti talks about '5 or 10 years down the road' and needing to develop a profile of gases related to blood sugar. But it's nice to see research being done on alternate methods.

Edit: Jeff @ Go Do A Test! pointed to me to an older article on the study, with more specifics on the experiment.

The Holy Grail

Okay, right, a cure is the real holy grail. But a cure is going to take time, and money, and skill, and probably a zillion more mice. They're getting really good at curing mice these days.

But for my day to day life? The holy grail is blood sugar testing without blood. No pricks. No way to skip out of tests because I 'forgot' my meter or I'm nearly out of strips. No stopping what I'm doing to go to the washroom to test - in case someone in the office doesn't like seeing blood. Fingers than don't get sore. Of course, I'd like some consistency and predictability, and an A1C that always matches what my meter's telling me too.

But I'll settle (for now) for losing the blood. There's a new non-invasive blood measuring device I just read about, the Echo meter. Early tests are positive. It's the sort of thing I take with a grain of salt. Early tests new stuff always seems positive, or it would never make the news. And then there's the whole "We need millions more dollar to develop this" gotcha.

If I ever win the lottery, I'm donating to this kind of research. Devices and technology that improve our day to day. Yes, we need a cure. But we also need quality of life.