Tag Archives: product review

The Freestyle Libre (part 2): Final Analysis.

Disclosure first: I was given the Freestyle Libre continuous glucose monitor to try at home. Abbott is covering the cost of the device and two sensors. I am not being compensated in any other way. All opinions on my brief experience with this device are my own, as always.

My trial run of the Freestyle Libre CGM was pretty smooth sailing.

There are a number of things I should cover, so let me give you the rundown of what I’ve observed:
 
 
– First of all, as I mentioned earlier, the sensor warmup period is a lengthy 12 hours. It’s great that there are no finger sticks involved, but there certainly are when you have to wait 12 hours for your first CGM reading. You still have to know what’s happening with your blood sugar over the course of 12 hours. So even though I’m not using them to calibrate (the Libre is self-calibrating), I’m doing a fair amount of fingersticks during that 12 hour warmup period.

It’s been mentioned elsewhere that the warm up time in other countries is significantly less than 12 hours, so here’s hoping that gets ironed out soon (also, more on the “careful” versus “full gusto” submission processes with FDA below).
 
 
– Unlike what I’ve been reading from others who have been doing the same trial, the numbers I saw from the Freestyle Libre were almost always higher than what I saw from my Dexcom or my Accu-Chek Guide meter. When my numbers were lower, they were pretty much in sync, single digits separating the numbers on the screens. When the number got over, say, 140 mg/dL, the numbers on the Libre were higher.

In these situations, the Dexcom always showed the lower number, and the Libre the higher number. The number from my glucose meter was somewhere in the middle. Like this:

Obviously, I don’t know this for sure, but to me, this would indicate not a failure, but a difference in how the glucose data is being interpreted by each individual CGM. As many will tell you, it’s not usually the number, but the trend that’s important. Plus, if glucose is being interpreted a specific way on a regular basis, it’s easy to account for that, or at least understand when to do a BG meter check to make sure.
 
 
– The size of the sensor is very small compared to any other CGM sensor on the market (for those of us in the USA, about the size of a half dollar). Insertion was easy (don’t forget, my user guide was in Spanish, so I did my insertion based on online tutorials). The comfort level wearing this on my upper arm is without compare. And it stayed on, without the need for extra adhesion.

This might be a factor to keep track of down the road… If they get enough competition, I can foresee Dexcom breaking the mold, so to speak, and speeding up work on a smaller sensor and transmitter option.
 
 
– There is certainly a convenience factor in being able to take the reader, scan it over the sensor on your arm, and see a new reading instantly. Even less than a minute apart. For the record, Dexcom gives you a new reading every five minutes.

This is not a big deal to me, but I have to admit that sometimes, I found it easier to have the reader next to me when I slept, and instead of reaching for my phone and getting the number in the middle of the night, I just scanned and saw the number on the Libre reader.
 
 
– That said, I have my phone with me throughout the entirety of my waking hours. To roll out a medical device in this day and age, and not have a Bluetooth/Mobile option of some kind attached to it is a real shortcoming. Especially considering the reader options are significantly limited. There is a mobile app for Freestyle Libre available in other countries (known as LibreLink), but not yet in the USA.

I get it… Abbott either wanted to make sure they got the Freestyle Libre approved as a standalone without having to get the mobile app approved at the same time, or they couldn’t get it approved right away and went instead for just the sensor and reader. They’re probably working feverishly to get the mobile app okayed as soon as possible. I’m only speaking for myself here, but that’s a dealbreaker. Double dealbreaker if the mobile app eventually comes out only on an Apple platform (LibreLink is available in other countries on Android, so yay).

You might wonder why, in this case, I seem to be holding Abbott to a higher standard than maybe I held Dexcom a few years back. Why? Because it’s 2018. In case you haven’t noticed, we’re in a digital, mobile-manipulated world, and yes, I’m expecting industry to keep up with the times. Is that asking too much?
 
 
– One additional item: There have been rumblings about the lack of alarms with the Freestyle Libre. That’s true in a sense, because alarms are not part of this package, unless you’re actually scanning the sensor. You, as an individual user, will have to figure out whether that’s important to you or not. I’ve also heard a lot about alarm fatigue from the Dexcom, so I will leave it up to you to decide what is best for you.
 
 
Overall, I think the Freestyle Libre is a good option for People With Diabetes. The cost is less than the Dexcom, the readings are accurate enough for this cowboy, and you can’t beat the size and comfort of the sensor. I also think this might be a super option for some (if they can get it approved by insurance), because of the longer sensor life (10 days versus 7 days for Dex), and the fact that finger sticks are not required (other than sensor calibration, finger sticks are not required for Dexcom either).

Bottom line: For now, I’m not moving away from my Dexcom. If there’s a mobile app that allows me to see the reading on my phone, and helps me share data? Then I’ll be happy to take a second look.

Again, and I don’t think I can say this enough, it is wonderful to have an additional CGM option, and one that isn’t forced to be linked with a specific insulin pump. There are plenty of reasons to like the Freestyle Libre, and only a couple of reasons for me to hold off on a full throated endorsement (for now).

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Review: The Accu-Chek Guide.

Full disclosure: I was sent a new Accu-Chek Guide by Roche so I could try it out. I was not asked to write about it. All opinions, good and bad, are my own. Read on for my thoughts.

I’ll be honest… I’ve been a fan of the Accu-Chek glucose meters going back to the Accu-Chek Nano (which I still have two of and still use), and I’m about to tell you why. In fact, there are three reasons why I’ve liked these meters for years.

1. Accuracy. Since my first Accu-Chek Nano, the readings I’ve received have been something I could rely on. Even after beginning on my Dexcom continuous glucose monitor, I’ve noticed that my results are almost always within 10 mg/dL of my Dexcom readings. Actually, they’ve been nearly always within 5 mg/dL of my Dexcom readings. Hard to get more accurate than that.

2. Consistency. Those accurate readings have remained, no matter how long I’ve used a meter. It’s really great when you have a feeling that your meter will give you result that you can count on, even if it’s high or low.

3. Improvement. Even though my Nano was pretty good four years ago, my Aviva Connect meter, which I received just about a year ago, has been great too. It’s also been something that’s been able to be synced with mySugr and Tidepool accounts, and believe it or not, there aren’t a lot of meters that are doing that, or doing it with Bluetooth technology.

While I can’t say I know a lot about the company, I can say that I’ve been happy with what they’ve produced for a number of years. So… how does this new Accu-Chek Guide measure up? Here are the pros and cons… since I like happy endings, I’ll give you the cons first.

Cons: Actually, the only con I can think of (feel free to add your own in the Comments section, if you have one) is the marketing of the new container for strips. It’s true that when you open a brand new container, the strips are neatly lined up and easy to access, and they don’t spill if you turn the container upside down. Once you’re about halfway through though, it’s easier to knock one or two (or a few) out of place and then they’re much more likely to fall out when you don’t want them to. Still, it’s not like the previous containers were that great. They went for an improvement, and I think it is an improvement, just not as good an improvement as they’re touting.

Pros: See my notes above about accuracy, consistency, and improvement. In addition, probably the biggest thing that makes me a fan of this meter are the strips themselves. The strips have a flat surface, meaning that instead of having to get blood on a narrow part of the strip to get a proper reading, you can actually get the blood on any part of the strip to get a proper reading.

Check this out (video courtesy of me):

When I saw that for the first time, I was hooked.

Now, let’s talk about price. Not the meter price, because you know glucose meter makers will make their meters extremely inexpensive in order to get you to buy the strips, which is where the real money is made. Roche, makers of the Accu-Chek Guide, is doing something different when it comes to pricing on strips. For people who have trouble affording the expense of strips, they’re implementing something called the Simple Pay Savings Program.

Here’s how it works:
You can get a savings card from your doctor, or from Roche. With the savings card, the first vial of strips would cost $19.99. Each additional vial after that, for the same prescription, is an additional $10.00. That means that two vials (100 strips) would cost $29.99, three would cost $39.99, and so on. You can use the savings care to get up to 12 vials, or 600 strips, per prescription.

All in all, I find this meter another compelling offering from a maker I trust. You might have noticed that I’ve almost entirely stopped reviewing products here, mostly because I get more offers to review things than I have time to write, and also because I want to only endorse things I truly believe in. Take this with a grain of salt if you must, but I really like the Guide.

Please remember that other than the meter and 50 strips, I’m not getting anything for this review. If you have a different experience with the Accu-Chek Guide or other meters from Roche, let me know in the comments below. As always, your experience may be different, which is just one of the reasons why we should communicate with one another.

I should also mention that Diabetes Mine did a fabulous and more detailed review of this meter last week. CLICK HERE to check it out.

Finding diabetes devices you can rely on is a tall order sometimes. Personally, I’m glad to have another meter I can count on.

Level Foods Review and GIVEAWAY!!!

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UPDATE: Our giveaway winner (according to random.org) is latanya!

Latanya, you have 24 hours to send me your mailing address (e-mail me using the E-Mail Stephen link on the left of this page). Once I get it, I’ll send out your Level Life Box ‘O Goodness. If you don’t get back to me by 12:00 noon EDT on Sunday, I’ll go to the next person on our list. Thanks!
 
 
Life is full of firsts. At least I like to think so. I think there are firsts that happen for us all through our lives. Today is one of those for me. It’s our first giveaway!

I’m going to try to do this justice today, but I know you’re just dying to get to the bottom of this post and find out how you can win some Level Life goodies for yourself. If that’s the case, skip to the end and then come back up here and check out my review of Level Foods’ snack bars and protein shakes.

I’m not always the best person to ask to review things, because for me, it goes like this: If I like a product/book/website, I’ll talk about it. If I don’t, you (usually) won’t hear anything from me. Why? Because it’s hard to put yourself out there, whether you’re posting a video online, writing a book, or developing products that are both tasty and helpful for People With Diabetes. So if I have criticism at all, I generally keep it to myself, or keep it just between myself and the person it’s directed at. On the other hand, if I like something, I want the whole world to know.

Ethan Lewis is a Type 1 and founder of Level Foods. In the past few years, his efforts are coming on strong in development and release of several products that are high in protein and low in carbs, designed to help you keep your BGs level as much as possible (get it? Keep the BGs Level? Level Life? Ahem… moving on…).

Ethan was kind enough to send some samples my way recently, and I had a chance to try out snack bars and shakes carrying the Level Foods brand. For me, they have been exactly as advertised. I tried the Caramel Chocolatey Peanut bar and the Chocolatey Crisp bar, (carb counts: 17g and 18g each, respectively), and both the Vanilla and Chocolate shakes (all Level Life shakes are 10g each). The main takeaway for me was the absolute remarkable feeling of being full after enjoying each of these items. In fact, I had to start drinking only half a shake at a time because I would feel too full if I drank the whole thing at once.

They’ve been good pre- and post-workout snacks for me… making me feel full, but giving me enough fuel to feed my muscles, whatever muscles I have left. My favorite? The Caramel Chocolatey Peanut bar. That seemed to be the big hit overall at our household. They went pretty fast.

So now I have to go get more. The good news is I can get more online at levelfoods.com, and I can go to Target if I don’t want to wait for delivery (it’s okay… I pay cash for nearly everything anyway). Ethan even has a $4.00 USD off at Target coupon offer on the website.

Now, let’s get down to the giveaway. I have what you see in the photo above: A four-pack of both the Strawberry Crème and Rich Caramel shakes, plus a box each of Chocolate Peanut Crunch and Double Chocolatey Chip snack bars. Also included are Strawberry Banana and Mandarin Orange (my favorite) glucose gels (15g of carbs each).

To be eligible to win, just leave a comment below telling me you’d like to win. I’ll accept entries through Friday at midnight Eastern Daylight Time. Then I’ll put everyone’s name in one of those random-generator things and pick a winner, so look for the name in an update on this post Saturday morning. Good Luck!

Disclosure, just in case you didn’t catch it above: I was sent samples of Level Foods products to try. I was not asked to write about them, and I was not paid anything to write about them. I have no working relationship with Level Foods at this time. But I’m happy to give some of my goodies away!
 
 
 

Medtronic and Dexcom in a good light.

Tuesday’s post covered a couple of potential issues with devices made by Medtronic and Dexcom. And I seem to remember a similar post that included Medtronic a couple of months ago.

Taken just as they are, these posts might give you the impression that I have a problem with Med-T and Dex. Trust me… I do not have an axe to grind. I really do try to be fair and balanced. Not fair and balanced like a certain news organization here in the States that eggs on congress to repeal the Patient Protection and Affordable Care Act (the house voted against it 37 times already), then champions House Speaker John Boehner when he states that “…creating a better environment for jobs has been and will remain our top focus”. But I digress.

What I’d like to do today is talk about the things that I really like about the Medtronic pump I have, and the Dexcom continuous glucose monitor (CGM) I’m using as part of a clinical trial. M’kay?
 
 
First, Medtronic.

The single best thing I can say about my MiniMed Paradigm® Revel™ insulin pump is that it’s reliable. It has never once failed me. Oh, I’ve gotten a motor error or two now and then, but I was always able to overcome that without too much difficulty. By “without too much difficulty”, I mean within five minutes.

I’ve also dropped my pump several times over the last three and a half years. I’ve scratched it. I’ve let it get dirtier than a medical device should ever be, and it still keeps going. It’s been on bike rides and runs and through airport security more than a few times. No problems here… still pumping.

And when it comes right down to it, what I want most out of a medical device designed to help keep me alive is reliability. My pump has that in spades.
 
 
Now, Dexcom.

There’s a lot to like about the Dexcom G4™ continuous glucose monitor. To begin with, the insertion process is simple, smooth, and often completely painless. For the study I’m participating in, I’m required to wear the sensor on my belly only, so I haven’t had a chance to try it anywhere else. But I really like the fact that I can get the sensor in easily, and that once it’s in I almost never feel it.

Since it’s not integrated with my pump, the Dexcom CGM has its own display device. Much has been written about how 21st century and sexy this little thing is. I mean, it is kinda nice, and it looks a lot like other electronic devices we all carry around every day. But I really dig two things about it. One, it holds a charge for a loooong time (and recharges quickly). And two, the range on the device is pretty good. I’ve gotten into the habit of reminding myself to put it in my pocket every time I stand up now, so I don’t leave it on a table or on my desk at work. But if I’m in a meeting in a big conference room, I can leave it on the conference table and get up to walk around the room without worrying about whether I’ll be out of range. At home, I can sit it on the front steps while I mow the front lawn (I have a small yard, but it’s big enough to be out of range for other CGMs).

Finally, I like the Dexcom Studio™ software used to track all of the data from the CGM. Lots of user-friendly, understandable graphs, charts, and other features that help me understand my glucose trends better. I could go into detail, but if you’re really interested in finding out more about it, you should probably check out the information on the Dexcom website.

I haven’t tried a lot of continuous glucose monitors (just Dexcom and Medtronic), but my impression of the Dexcom G4™ is that it’s the Cadillac of CGMs right now. If you disagree, feel free to let me know why by leaving a comment.
 
 
So you see, it’s not all bad. If you think about where we were twenty years ago, there really has been a lot of hard work done and progress made on insulin pumps and CGMs. I hope that in future years, Medtronic and Dexcom will be able to keep the best features of their current products, and improve and enhance the worst. Our lives, and the quality of our lives, depend on it.
 
 
 

A new favorite.

I have a new favorite juice:

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I was treating a low last night and opened this bottle of Ocean Spray® 100% Juice Cranberry-Pomegranate juice. It‘s been made by the Ocean Spray® people since 2009. And it’s delicious.

Don’t let the label fool you though… this “Cranberry-Pomegranate Juice” is actually a mixture of grape, apple, and plum juice from concentrates, plus cranberry and then pomegranate juice from concentrates. In that order. At least here in the USA, that means there’s more grape, apple, and plum juice in there than cranberry or pomegranate. But it still has the cranberry-pomegranate taste, and for me, it’s still all juice (with a little fumaric acid and ascorbic acid—vitamin C—in there). It’s still tasty, and that’s what matters in these moments.

It’s got a higher carbohydrate count than the average orange juice from concentrate. OJ generally has about 29 grams per 8 ounces. This stuff has 34 grams per 8 ounces. So if you can stand to have just about 7 ounces instead of 8, you’ll get right around 30 grams of carbs.

Whatever. I like it. Ocean Spray® makes a point on the FAQ page of their website that “Ocean Spray® Light Juice Drinks are appropriate for people with diabetes”. Well, maybe, but not if you’re treating a low. When I need to get my BG up in a hurry, this stuff is my new favorite juice.

I’m Stephen, and I approved this message. This just means that I like the product, not that anyone is giving me anything for saying I like it.
 
 
 

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