Ready, Aim, FIRE!
Note to readers Real time research is the best approach since time will pass by this snapshot in time.
Introduction:
Recently, I have been asked to monitor my blood glucose level. This article outlines the research that I undertook, and what I found out about the two glucose monitors for measuring sugar in the blood, the Oracle and the Prodigy, which I have evaluated for potential use.
I am by no means an expert in this field. There are persons who are blind who know a lot more than I do on this subject. As a first step, I spoke with a number of people who are blind. I received a great deal of useful and practical advice. I strongly suggest that anyone wanting to learn about this matter consult persons who are blind who use glucose monitors.
Here are a few resources I found along my learning journey, which may be of assistance, and may save some frustration. Finding information about products that can be used by persons who are blind is not always easy.
The Canadian Diabetes Care Guide website was helpful in learning about the monitoring of blood glucose. Below is the link to the sites homepage as well as a direct link to the monitoring blood glucose page.
Homepage:
Canadian Diabetes Care Guide Link to Monitoring Blood Glucose Page:
www.diabetescareguide.com/en/monitoring.html
Canadian Diabetes Care Guide
Phone Number:
416-690-4871
Mailing Address:
Sampling Canada
33 Wheeler Avenue
Toronto, ON
M4L 3V3
The measurements for glucose levels in Canada changed in 1967, while the United States continues with imperial measurements, using milligrams/deciliter, as we used to, and we began to measure in Millimoles/Litre. I believe the conversion is to multiply by 18, not difficult, but a needless “pain in the neck and makes the thought process more of a challenge if you are dealing with a physician who is younger than I am!!! However, there should be no need for this, as I know the Oracle is metric, and I believe the Accu-check is also compatible with the voice box as well as the Voice, Prodigy. If you are converting check the conversion factor with a medical professional first.
When looking at glucose readings, it is patterns and trends that are important, not an occasional reading that is out of the ordinary.
NormalRange of Glucose
Before Meals: 4-6 mmol/L
2 hours after a meal (from the time you started): 5-8 mmol/L
Target
Before Meals: 4-7 mmol/L
2 hours after: 5-10 mmol/L
An article I found particularly useful was published by the National Federation of the Blind (NFB) in the United States. It is entitled “Evaluating Glucose Meters: Talk is Cheap, But Access is Golden”. It can be found at the following web link:
http://www.nfb.org/images/nfb/Publications/vod/vod_24_1/vodwin0910.htm
The article mentions that in 1997, the NFB called on meter manufacturers to make their meters speech accessible. Since then, and especially in the past few years, a number of talking blood glucose meters have been introduced. These new 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.
With advances in technology, adding speech to a meter can be accomplished at a low cost—talk is cheap. And more talking meters means more choices for people with visual impairment or for those who appreciate multi-sensory testing. However, manufacturers need to realize that adding limited audio to a meter may
meet the needs of some people with minimal vision loss, but it is not adequate or appropriate for people with moderate or severe vision loss. They need
spoken access to all meter operations to ensure independent use—access is truly golden.”
Another article from the NFB, is entitled “The Talking Blood Glucose Monitor Revolution” at the following web link:
www.nfb.org/Images/nfb/Publications/vod/vod215/vodwin0707.htm –
It describes the two varieties of talking blood glucose monitors. The first uses a standard off-the-shelf, blood glucose monitor and adds a piece of hardware which converts the displayed text on the screen to audible speech, such as the Roche Diagnostics Accu-Check VoiceMate. These are generally more expensive and more bulky. The newer varieties fall into the second group, such as the Prodigy Voice, and the Oracle. They have speech built directly into the monitors; no additional mechanism is required. This makes them much more convenient to carry when you’re on the go.
There are now several choices for talking glucose monitors, including Prodigy Voice, Prodigy Autocode, Oracle, Advocate, Redi-code, Companion, Embrace, Clever-Chek, Smartest Smart Talk, and the Accu-check VoiceMate
I have been trying two of these – the Prodigy Voice and the Oracle. Here is some additional information on these two devices.
1. Prodigy Voice:
Prodigy Glucose Meter Contact Information
Toll Free Phone Number: 1-800-366-5901
Mailing Address:
Diagnostic Devices, Inc.
9300 Harris Corners Parkway
Suite 450
Charlotte, NC28269
Email: intlsales@prodigymeter.com
Prodigy Glucose Meter web links
Link to the US website:
The Prodigy Voice and other Blood Glucose Monitors, lancer and test strips can be purchased at:
Maxi-Aids – Products for independent Living
Toll-free: 1-800-522-6294 TTY: 1-800-281-3555 Fax: 631-752-0689
Item#: 151900
Your Price: $84.95
Future Aids – the Braille Superstore.
Email: sales@FutureAids.com
Toll Free: 1-800-987-1231
Item Number: 2973
Title: Prodigy Voice Kit
Talking Blood Glucose Monitoring Kit for the Blind
Price: $74.95 But I was told that they can not sell it yet because it is not approved for use in Canada and assured me that approval was pending.
PRODIGY VOICE – The Talking Blood Glucose Monitoring System
“Total Independence for the Blind Diabetic”
• Audible test results in only 6 seconds
• Audible instructions and meter status
• Tactile buttons for easy identification of functions
• Auto Turn-on – just insert a test strip
Prodigy Complete Starter Kit includes everything you need to start testing! Glucose meter, control solution, 10 Prodigy™ strips, 10 sterile lancets, lancing
device.
Audible blood glucose monitoring system specially designed for the blind. The updated features were developed with the help of National Blind Associations
and Certified Diabetes Educators.
Audible prompts talk the user through all set-ups, step-by-step, including audible test results, meter status, averages, and memory records with date and
time.
Easy-to-identify buttons have raised tactile markings, including directional arrows and letters to allow the blind user to easily locate and operate them.
For greater comfort, Prodigy® Voice offers you the option to test with blood from your palms, forearms, upper-arms, thighs and calves, which have fewer
nerve endings than your fingertips.
Smaller Blood Sample Required – requires only a 0.6 micro liter drop of blood – smaller than most meters available today. This allows you to use extra
fine gauge lancets and significantly reduce your pain and discomfort.
Audible Memory and Data Management stores up to 450 audible test results with date and time, and gives 7, 14, 21, 28, 60, and 90-day audible averages.
Prodigy’s FREE software allows simple downloading of test results to your computer helping you and your Diabetes healthcare professional to track changes
in your blood glucose level over time.
REPEAT button allows the user to check and hear the last message or test result. No coding necessary – simply insert the test strip and the meter turns
on automatically. You get safe accurate test results every time. Eject Button safely ejects the used test strip with a push upward. Built-in earphone jack
for privacy (earphone not included.) Powered by 2 AAA Batteries (Included.) Size: 3.5 in. L × 2 in. W × 0.81 in. D. Weight: 1.86 lbs. 1-Yr. Limited Mfg.
Warranty.
2. The Oracle Talking Blood Glucose Monitor
Contact Information
Toll Free: 1-866-829-7926
Mailing Address:
Tremblay Harrison Inc.
1684 Dufferin St.
Toronto, ONM6H 3M1
Email: info@oraclediabetes.com
Website: www.oraclediabetes.com
Information from their website.
The Oracle Glucose Monitor is the ultimate in home blood glucose monitoring. It combines simple operation with the most advanced features available.
Your Oracle Glucose Monitor has ALL these features ;
• Talking Function – either English or French
• No Coding
• Alternate Site Testing; allows sites other than your fingertips for testing.
• Tiny Blood Volume
• Simple Single Button Operation
• 7 Second Results
• 450 Memory events; Keeps track of date and time with 7,14, 21, 30, 60, and 90 day averaging
• Computer Downloadability (Computer download cable is sold separately)
• You or your health care professional can download your results to a computer
• Ketone Warning
• Automatically comes on when your blood glucose is above 14.3 mmol/L
EZ Health® Oracle Test Strips ;
EZ Health Oracle Test Strips come in boxes of 50 or 100 for your convenience. There is no need for coding or calibration of any kind. Your meter automatically turns on when you insert a strip and automatically turns off after use.
There is a website to download audio versions of manuals for the Oracle Blood Glucose Monitor, and how to use the test strips, lancets etc.
www.oraclediabetes.com/index-7.html
Analysis:
There are basically three activities involved in monitoring your blood sugar level: pricking the skin with a lancet from an applicator; Getting some blood, putting it on the strip; and having the machine read it to you.
Also, in my case, the doctors want to see the record of readings. Both the Oracle and Prodigy come with software to install on a computer to record the readings. They both have internal memories which keeps track of about 400 plus readings.
The Oracle software is not accessible without using a mouse. The Prodigy software is suppose to be accessible, but it was being updated, at time of writing. They did acknowledge that the software would be reviewed by people who are blind to make sure it continues to be usable. Both the Oracle and the Prodigy come with manuals in audio format. The Prodigy sends a c.d. containing the manual, while you have to go to the Oracle website and download their audible instruction manual. The Oracle manual was not as professionally done as the Prodigy’s manual.
Although they were both adequate, the Prodigy manual contained a chapter on carrying out the process, as a person who is blind. These tips were useful to me. It would appear that it doesn’t matter what lancet device and lancets you use for pricking the finger. The local pharmacy gave me one with a drum of ten needles in it, but I don’t like it because of the difficulty in knowing how many needles are left in each drum.
Both the Oracle and the Prodigy come with lancets and lancet devices. You can also get a box of universal lancets, which fits most lancing devices. The strips used for each device, though, are specific to that device. Once you decide on which device to use, then the correct strips have to be purchased. The devices are usually obtainable free or at a very low cost, but the test strips are another matter. They are fairly expensive. In the Prodigy’s case, there are strips available for the audio device and the Prodigy Autocode. The Prodigy I use requires the Prodigy Voice strips.
I personally find the Prodigy to be more user friendly. The strips are easier to get blood onto, and to get a reading from. The review function and the settings functions are totally accessible. While I can control the Prodigy, the Oracle says that sighted help will be required to alter the settings on the device and to read the history of results. The down side of all of this is that in my province, neither device is available, and the strips have yet to be approved for use. Therefore you have to order either device from a supplier. In the case of the prodigy, you can order it from several places in the United States. They will ship it as “Medical Supplies for the Blind” and they go right through customs. However, you should check on the customs regulations first.
Customs Canada Contact Information:
Service in English: 1-800-461-9999
Service in French: 1-800-959-2036
Email: CBSA-ASFC@canada.gc.ca
Business Hours: Monday – Friday, 8:00 to 16:00
Several other talking blood glucose monitors are also available, but I have not tested them. MaxiAids sells a new one called the Embrace, which they describe as follows:
NEW! Embrace Talking Blood Glucose Monitoring System: Bilingual English/Spanish
“Announces Results in Only 6 Seconds”
Item#: 150201
Your Price: $24.95
• Announces results in English or Spanish in 6 seconds
• Voice guidance through entire test process
• Small sample & alternate site testing reduces pain
• Uses 2 AAA batteries (included)
• Includes lancing device, lancets and carry case
The Embrace Talking Blood Glucose Monitoring System was designed to deliver an accurate reading of your blood glucose level in 6 seconds. You may have test results announced in either English or Spanish. Plus, this model provides maximum accessibility to blind and low vision users by offering voice guidance to talk you through the testing procedure. (Note: The talking feature can be turned off if not wanted.)
Embrace requires a smaller blood sample and offers alternate site testing (fingertip, palm or forearm), so you can expect faster, easier testing with less
pain. Uses 2 AAA batteries (included.) Portable, lightweight meter weighs only 2.3 oz. with batteries installed. Color: Grey. Manufacturer’s Limited Lifetime
Warranty.
Other Features:
– Stores 300 test results with date and time stamp.
– 7,14 and 30-day averaging and test results can be downloaded to your PC via USB connection and available software.
– Large display makes seeing results easier
– Auto power off after 2 minutes preserves battery life
Package includes:
Meter
Lancing device
Ten lancets
Quick reference guide
Instructions in both English and Spanish
Log Book
2 AAA batteries installed
Zippered storage/carrying case
Product dimensions (imperial): 0.78 inch H x 3.90 inch L x 2.11 inch W
Product dimensions (metric): 20 mm H x 100 mm L x 54 mm W
NEW! Embrace Blood Glucose Test Strips: 50 Strips
“Use with Embrace Blood Glucose Systems”
Item#: 152010
Your Price: $15.95
These Embrace Blood Glucose Test Strips are for use only with Embrace Blood Glucose Systems. Package contains 50 Test Strips.
There are also a number of glucose monitors available with large print, but I did not look at them, as they would not meet my needs.
For a newbie like me, it is quite challenging to get a handle on the process. Particularly for me, I found it challenging in telling if I’ve punctured the skin to get enough blood. As the Prodigy manual says, “Don’t give up, keep trying and practice, practice, practice.” It is the approach to be used.
The surprising thing to me was the lack of locally available, useful information. Diabetic organizations and most pharmacies had no information for people who are blind. The only device that they knew about and could get was ten-year-old technology, the Accu-Check VoiceMate, in which the audio is an add-on, and it is the most expensive of them all, costing $400-$500.
Accu-Chek Contact Information
Toll Free Phone Number: 1-800-363-7949
Mailing Address:
201 Armand Frappier
LavalleQCH7V 4A2
Website: www.accu-chek.ca
The information abyss is what has motivated me to write these few thoughts, outlining my impressions and experiences as a newbie, hoping to help others who find themselves in a similar situation.
Empowerment, self-advocacy voting, elections and people who are blind, shopping and blindness, access to information for people who are blind, consumers who are blind, disability,,rights, self help health care when you are blind, medications and blindness, health care and blindness,