Editor’s Note: Chris Stark is a long-time advocate for increased access, universal design and true inclusion. He is an AEBC member living in Ottawa, Ontario.
It seems to me that the older I get, the harder it is to be independent. While my specialist and hospital clinics communicate with me by email, Health Canada and its agencies do not. Canada Pension Plan will, but I have to call and then wait three weeks. The Ontario government is no better in providing accessible information. I do get pills in bubble packs, paid for by the pharmacy/government, with the packs containing the correct doses of medication for each time of day for a week. This means I can avoid taking the wrong pills in the wrong amounts at the wrong time. Recently, I was asked to monitor my blood glucose level. Here, I outline the research I did on talking blood glucose monitors.
Finding information about products that can be used by persons who are blind is not always easy. As a first step, I spoke with a number of people who are blind, and received a great deal of useful and practical advice. I strongly suggest that others do likewise.
The Canadian Diabetes Care Guide website (http://www.diabetescareguide.com/en/monitoring.html) was helpful in learning about blood-glucose monitoring. While the United States continues to use imperial measurements (milligrams/deciliter), Canada began using millimoles/litre in 1967. Make certain the device you choose can give readings this way.
An article I found particularly useful was “Evaluating Glucose Meters: Talk is Cheap, But Access is Golden” (http://www.nfb.org/images/nfb/Publications/vod/vod_24_1/vodwin0910.htm). Published by the National Federation of the Blind (NFB) in the United States, it says: “The contemporary meters are smaller, faster, and much less expensive than older choices, require only a tiny drop of blood, and are easier to use. However, buyer beware! While these meters are being aggressively marketed to blind and low vision users, only the Prodigy Voice is totally accessible. Despite the hype, you will find that you need sighted assistance to use essential functions such as time and date, and memory review on many of these products.” Another NFB article is “The Talking Blood Glucose Monitor Revolution” (http://www.nfb.org/Images/nfb/Publications/vod/vod215/vodwin0707.htm).
Present choices for talking glucose monitors include Prodigy Voice, Prodigy Autocode, Oracle, Advocate, Redi-Code, Companion, Embrace, Clever-Chek, Smartest Smart Talk, and the Accu Check VoiceMate. I have tried the Prodigy Voice and the Oracle.
There are basically three activities involved in monitoring your blood sugar level: pricking the skin with a lancet from an applicator; getting some blood and putting it on the test strip; and having the blood glucose monitor read the result to you. Also, in my case, doctors want to see the record of readings.
Both the Oracle and Prodigy monitors come with manuals in audio format. While I found each manual adequate, the one for the Prodigy contains a chapter on carrying out a blood sugar test as someone who is blind, which I found useful.
Each talking glucose monitor comes with lancets and lancet devices, but it appears that it doesn’t matter which ones you use; there are universal lancets available that fit most lancing devices. The test strips used for each monitor, though, are specific to that product. Once you decide on which monitor to use, the correct strips have to be purchased. The talking monitors are usually free or very low cost, but the test strips are fairly expensive. The Prodigy I use requires the Prodigy Voice strips.
Both the Oracle and Prodigy come with software to install on a computer to record readings. Each has an internal memory to keep track of about 400-plus readings. While the Oracle software is not accessible without using a mouse, the Prodigy software is supposed to be accessible, though it was being updated at the time of this writing. The company did acknowledge that the software would be reviewed by people who are blind to make sure it continues to be usable.
I personally find the Prodigy more user friendly than the Oracle. It is easier to get blood onto the strips and get a reading, and the review and settings functions are totally accessible. While I can control the Prodigy independently, sighted help is required to alter the Oracle’s settings and read the history of results. The downside of all of this is that neither device is available in my province and test strips have yet to be approved for use. Therefore, you have to order the devices from a supplier.
The Prodigy can be ordered from several U.S. places, which ship it as “Medical Supplies for the Blind.” They go right through customs, but you should check on regulations (Canada Customs: English: 1-800-461-9999; French: 1-800-959-2036). Future Aids/The Braille Superstore is a Canadian company that sells the Prodigy in provinces where the device has been approved for use (Toll Free: 1-800-987-1231; Email: sales@FutureAids.com; Website: www.braillebookstore.com).
As a newbie, I found it challenging to tell if I had punctured the skin to get enough blood to test. But as the Prodigy manual says, “Don’t give up, keep trying and practice, practice, practice.” And though I shouldn’t be, I’m appalled at the lack of locally available, useful information. Diabetic organizations and most pharmacies had no information for people who are blind. The only device they knew about, and could get, was ten-year-old technology, the Accu-Check VoiceMate, in which the audio is an add-on. It is the most expensive of them all, costing $400-$500.
Compared to when I was younger, the same old problems persist–lack of resources and lack of accessible information, not to mention people who know nothing about blindness except perhaps pity. This has motivated me to outline my impressions and experiences as a new user, hoping to help others who find themselves in a similar situation.