Is it hyperbole to call the two newest blood glucose meters revolutionary? Not if you ask the people who use them.
Both meters have been on the market for only a couple of months. They are so different that you could even say they are complementary. And they both are generating considerable excitement.
The race is over.
One of the new meters, the AtLast, is the first truly painless blood glucose meter, long considered the holy grail of testing blood sugar. In November 1997 Diabetes Wellness Letter reported on the literally dozens of companies that were in "The Race for a Painless Monitor." Now, several more meters are coming down the pike, but the race is over.
The other meter, the In Charge, is the first home meter that tests not only blood glucose but also frutosamine, which measures your average level over the past two or three weeks. The February 1999 issue of Diabetes Wellness Letter reported on the forerunner of this meter in "Better Control with Fructosamine." That meter is no longer sold for use by people with diabetes.
The AtLast Meter
At Last, more than 30 years after the first blood glucose meter, we've finally got one that is ouchless. Its manufacturer, Amira Medical in Scotts Valley, California, has appropriately named it the AtLast meter.
Monitoring your blood glucose with the AtLast meter isn't much different from using older meters, with one big exception. The exception is that the blood sample you use for testing will come from your forearm, upper arm, or thigh, instead of from your fingertips. The testing sites that the AtLast uses are less sensitive than your fingertips, so you will rarely if ever feel any pain or discomfort.
The design of the AtLast also differs from conventional meters. Amira calls it an "all-in-one" design where the lancet holder is built into the meter.
No other meter currently available uses less blood, 2 microliters. It gives the result it 15 seconds or less.
The meter has a high level of precision and accuracy. The U.S. Food and Drug Administration last year approved the marketing of the AtLast meter on the basis of Amira's data, including a report on the AtLast's precision and accuracy. That report is available on the company's Web site, www.amira.com.
The meter stores the last 100 test results with date and time information. However, you can recall only the last 10 results, and they lack date or time information. The meter will also display your average test results for the last 14 days.
"We are currently designing the software for downloading," says Bill Feagin, Amira's director of marketing. "But it will likely be June before the product is available."
The AtLast sells for $62.95, including 25 test strips and 25 lancets. The cost of additional strips and lancets is similar to the cost of those for conventional meters.
The AtLast should be especially interesting to anyone who tests often for tight control. Children also seem to appreciate the AtLast. In fact, anyone with sore fingers seems to go for it.
"I went to a diabetic meeting last night," Fran wrote on a mailing list, "and to my surprise the AtLast rep was there. I really liked it and am going to try to get my insurance to cover the strips. Anyway, she tried it on me and it was completely painless, although she had to try twice on my thigh to get the blood out. I like the convenience of it. And besides, my fingers could use a rest from 10 stabs a day."
Lori in Meadville, Pennsylvania, wrote on another mailing list that she had just received her AtLast meter. "It was fun!" she wrote. "It didn't hurt me at all, and as far as blood, only a tiny bit comes out, and it's all you need."
Later Lori was still enthusiastic about the AtLast meter, but thought it had two drawbacks. The first is that the meter doesn't yet have software to download test results.
"The only other drawback is that sometimes I don't get enough blood out of my arm," Lori told us. She had missed one sentence in the user's manual that recommended switching to the other lancet holder that Amira provides with the meter if you have difficulty getting enough blood.
That seems to be the biggest challenge that some users have had with the AtLast. "People should try using both lancet holders to see what works best for them," Amira's Bill Feagin says.
The In Charge Meter
The other new meter, the In Charge, could hardly be more different from the AtLast except for the fact that both meters test blood glucose very quickly. In fact, the In Charge, made by LXN Corp. in San Diego, is the fastest such machine on the market, telling you your blood glucose level in as little as 9 seconds with a six microliter drop of blood.
The In Charge is the only meter marketed to people with diabetes that tests fructosamine as well as blood glucose. The fructosamine test takes four minutes and a 15 microliter drop of blood.
Blood glucose tests are essential, but they only measure how you are doing at one point in time. Another important test, hemoglobin A1c, will tell you your average blood glucose level for the two to three month half-life of this blood fraction.
The fructosamine test, which LXN calls GlucoProtein, has the advantage of measuring a shorter window than the hemoglobin A1c test. Its clinical significance is profound, believes Dr. William T. Cefalu of the College of Medicine, University of Vermont in Burlington.
"Frequent testing (recommended once per week) may yield data that reveal recent changes or trends in glycemic control that would otherwise not be observed," he says. Testing fructosamine, he believes, allows for earlier and more efficient intervention and better glucose control. While fructosamine test variability is inherently greater than glucose test variability, the key is the trend.
Another endocrinologist, Dr. Steven V. Edelman, the founder of the Taking Control of Your Diabetes conferences, is an enthusiastic advocate of the In Charge meter.
"I like the meter very much," he says. "It is small, light, and put together well. I love the GlucoProtein test, because it empowers the patient in a major way."
Karen Wheelock in Colchester, Vermont, says she loves her In Charge meter. "Their customer service is wonderful too. They were ever so helpful when I had a problem with my mail-in prescription company finding test strips for me."
The In Charge meter lists for $79.95 including 25 glucose test strips, four GlucoProtein test strips, and an auto-Lancet with 30 lancets. However, LXN offers a $20 rebate and $45 trade-in allowance. The suggested list price for 50 glucose test strips and four GlucoProtein test strips is $36.95.
Right now the In Charge stores the most recent 200 glucose test results and 50 fructosamine test results with the date and time. By the time this article is published LXN should have completed beta testing of it glucose management program on its Web site, InChargeNow.com. This software will let you automatically upload and chart your test results—both glucose and fructosamine—without any software on your computer. No other meter can do that.
In fact, no other meter can match these meters in several respects. That has to mean that calling them revolutionary is no overstatement.
This article originally appeared in Diabetes Wellness Letter, May 2000, pp. 1-3.
In 2002 Roche Diagnostics bought Amira Medical and discontinued the AtLast meter.
Likewise, LifeScan bought LXN and discontinued all of its products including the In Charge and Duet meters. It also recalled all GlucoProtein (fructosamine) test strips because they may produce false highs.
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