Help with University research for Product development

[Thechai]

Hello to all,

I am working with a group of engineering students to aid research into the development of a new blood glucose testing device from a more user orientated prespective. We have managed to get hold of some of these devices, and have personally tested them, however our views would very likely be different from yours.

I would like to ask for some help from anyone who uses current Blood Glucose Monitoring device to answer some open ended questions. It would be really appreciated if you can answer in as much detail as possible.


1) What blood glucose monitoring device do you own? If you do not own one, why not? Can be either provided by the NHS or personally purchased.

2) How often do you use it over a typical day?

3) How satisfied are you with the device?

4) Describe examples of problems you have encountered while using it?

5) What improvements would you like to see in future monitoring devices?

Feel free to post up your answer as a reply, or you can email them to me at kwang.chai07@imperial.ac.uk

Thank you for your time

Best Regards,

Andrew

 

[Northerner]

Hi Andrew,

1. Accuchek Aviva, Nano and Optium Xceed
2. Around 6 tests per day
3. Fairly happy, except there can be a variance in readings of +/- 10% so not highly accurate which can be a problem when you are actually lower than it says.
4 and 5. Please read this blog post from a Canadian blogger - these are the problems and we can't buy the product that she uses as her solution - to have it in-built would be good (or just the stick-on to adapt existing meters!)

http://canadiandgal.blogspot.com/2010/11/light-bugs.html

 

[novorapidboi26]

Hey,

1. Abbot Fresstyle Lite, and the previous model.

2. Test between 7 - 10 times a day

3. Very satisfied, probably just used to it and could be open minded when it comes to using different brands and functions.

4. No real problems, sometimes struggle to get the sample onto the test strip due to the carry case zip being in the way.

5. I would like to see a more environmentally friendly way of testing. ie. the need for test strips should be eliminated (wishful thinking) and maybe a universal digital result format that can be downloaded and displayed for all to see including NHS diabetic teams...

 

[Northerner]

...5. I would like to see a more environmentally friendly way of testing. ie. the need for test strips should be eliminated (wishful thinking) and maybe a universal digital result format that can be downloaded and displayed for all to see including NHS diabetic teams...

The software could certainly be improved - meter companies seem to be years behind in technology generally - it's only recently I've been given a usb cable for my accuchek even though usb has been around since the mid-1990s, previously I had a serial cable. The software still doesn't work with Windows 7 so I have to use it on my very unreliable XP machine. I doubt software etc. would be free if it didn't tie you to one particular company's meters though.

 

[Steff]

hi

1)Abbotts freestyle freedom lite

2) test 3 times a day

3)More then satisfied had the same meter nearly 2 years it has never let me down.

4)Main problem for me is sometimes i dont get enough blood and then i have to prick my finger again and it hurts. 🙄

5) cant think of any at the moment

 

[martindt1606]

hi,

1. optimum xceed - supplied by hospital
2. minimum 6 tests per day - most ever in 1 day 10
3. device is fine and pc software that supports download of readings provides some good views. Main issue with device is that the clock seems to lose a minute a day....Note I have not used any other device to provide comparison.
4. no real problems although does time out occaisionaly when I am struggling to get a drop of blood out of my finger.
5. Improvements: - an end to the need to stab my fingers 6 - 10 times a day would be the best improvement. Also given the amount of technology you can get in something the size of a monitor I'd like to see an integrated device that records the blood and allows you to enter the amount type of insulin injected and record the meal / carbs eaten. There are web sites, phone apps, paper diaries, spreadsheets....they all fall down because its not all recorded in one place at one time. You could then go one step further and recommend the insulin dose based on the recorded blood sugar level and the input carbs for the proposed meal based on an historical analysis of previous readings....

Regards

Martin

 

[shiv]

1) Bayer's Contour USB. Just a note - some people with type 2 diabetes are given them by the NHS, others are told not to test and therefore have to buy or get hold of their own.

2) I test around 8 times per day.

3) Very. Sleek design, easy to use, software is very good

4) I want a better strip port light so when I'm testing in the night I don't need to turn on a light. The Freestyle Lite managed this - I don't see why other machines can't.

5) This machine for me would be perfect if I could log carbs and insulin along with it, as well as better tagging (ie more tags). Also if it had that damn port light!

 

[everydayupsanddowns]

Martin - you might be interested in the AccuChek 'expert' handset which is based on the Roche pump-wizard and allows you to add carbs/activity info. additionally it will then suggest an insulin dose based on your ratios.

Can't say how good it is yet, but I'm due to be picking one up from my DSN later this month.

 

[martindt1606]

Martin - you might be interested in the AccuChek 'expert' handset which is based on the Roche pump-wizard and allows you to add carbs/activity info. additionally it will then suggest an insulin dose based on your ratios.

Can't say how good it is yet, but I'm due to be picking one up from my DSN later this month.

Thanks I'm seeing my DSN on the 20th I'll see if she's aware of it.

 

[shiv]

Martin - you might be interested in the AccuChek 'expert' handset which is based on the Roche pump-wizard and allows you to add carbs/activity info. additionally it will then suggest an insulin dose based on your ratios.

Can't say how good it is yet, but I'm due to be picking one up from my DSN later this month.

Hiya

My DSN gave me one of these. I do like the fact it logs carbs, insulin etc and before I had the pump I used it to do the maths for me.

It is the exact handset that you would get if you had the Roche Combo pump.

I find it very chunky and not that nice to man handle. It's still behind the times in that you have to code your test strips.

Useful I think if you used it full time, but I don't use it anymore.

 

[Ellie Jones]

1, Accu-chek Nano

2, 5-14 times a day

3, NO

4, a, you can store carbs amounts, exercise or illness etc on it.
B, it keeps saying battery depleted when it isn?t, this is a know fault and it?s to do with design!
C, Sunlight makes the screen unreadable
D, Infer red communication is naff, difficult to align when transferring info, and again direct sunlight can cause problems

5, A, better screens
B, better electronic log books to store all you info in,
C, carb counter
D, better communication system, perhaps a dual method for easier use
E, better software which can compare carbs eaten to insulin used!


I can Accu-chek to day to enquire about the expert meter, seems though I?m using the spirit pump and to moan about the nano..
Nano is a design fault lose contacts after a while not good use

As to the expert meter, you?ve got to go through your diabetic nurse for a prescription for one, didn?t say why so not sure if this is cost related...
So Monday morning I?m going to give my pump nurse a phone to see if I can get one see what they say, fingers crossed I might get one..

 

[shiv]

As to the expert meter, you?ve got to go through your diabetic nurse for a prescription for one, didn?t say why so not sure if this is cost related...
So Monday morning I?m going to give my pump nurse a phone to see if I can get one see what they say, fingers crossed I might get one..

Is it because you've already got a prescription for one type of strips on there?

 

[Ellie Jones]

Shiv, no it's the actual meter I've got to get from the diabetic nurse... It uses the same strips as the nano and other aviva meters..

Perhaps it the actual cost, he did say if they DSN wasn't sure about the prescription order to phone them and they would say how's it's done.. So I'm going to have to have a word with my pump nurse at the hospital clinic, because somehow I don't think that my doctor one will be able to do it for me... She would if she could and very much suspect if no go with clinic, she certainly try to find a way around it hehe

 

[Twitchy]

Since sept:
1) What blood glucose monitoring device do you own? If you do not own one, why not? Can be either provided by the NHS or personally purchased.

Currently using the Accu-Chek Aviva Combo - it's both a blood glucose meter & the remote control for my pump.


2) How often do you use it over a typical day?

9-10 times (yes, I do get b******d by the dsn at my docs surgery, but I test the 'usual' 5+ times pre meals & bed & because i have to drive quite often in a day!)

3) How satisfied are you with the device?

At the mo, totally. I love that with the pump, you can record carbs eaten, bolus given, health notes, etc etc with better detail than on previous pumps I've used.

4) Describe examples of problems you have encountered while using it?
Sometimes it loses blue tooth connection to pump, but looking at it purely as a meter, no problems. Having to change the coding chip every time you change the tub of test strips is a minor irritation.

5) What improvements would you like to see in future monitoring devices?

Size ('chunkiness' reduced), automatic / no need for coding, good performance irrespective of temp extremes, ability to record in more flexible detail medical notes, carbs etc (at the moment most meters seem to just have a few limited drop down list type options).

Maybe one day Apple will decide to incorporate a meter into an iPhone lol! 🙄

 

[Northerner]

...Maybe one day Apple will decide to incorporate a meter into an iPhone lol! 🙄

You were saying?

 

[MCH]

1) What blood glucose monitoring device do you own? If you do not own one, why not? Can be either provided by the NHS or personally purchased.

One Touch Ultra Smart

2) How often do you use it over a typical day?

6-8 on a normal (if such a thing exists day) and 8 to 12 if I go to the gym or dancing

3) How satisfied are you with the device?

Very satisfied. It uses a small blood sample, can be programmed with the type of test, exercise etc and seems accurate.

4) Describe examples of problems you have encountered while using it?

a) When trying to carry out a blood test "on the move" it can be a struggle not to drop the machine, strips lancet, carrying case.....

b) The screen can be difficult to read. (Though that might just be me)

c) It is impossible to do a test in the middle of the night without putting on a light. If I put the screen light on, I get blinded and still can't see where to put the strip or aim the blood sample onto it because the light is not in the correct place to allow me to see the strip.


5) What improvements would you like to see in future monitoring devices?

a) a light to help as described above

b) a significantly smaller device (which would fit in a tiny handbag) which has the capabilities of the One Touch Ultra Smart in relation to being able to enter carbohydrate values etc.

 

[rossoneri]

Techai
I am on an insulin pump and my main meter also acts as a device for controlling the pump remotely. Some of my answers relate to this function in addition to its use as a BG monitoring device.

1. What blood glucose monitoring device do you own? If you do not own one, why not? Can be either provided by the NHS or personally purchased.
   • Accu-Chek Combo, used in conjunction with the Accu-Chek Spirit Combo pump
   • Optimum Xceed as back up and for measuring Ketones
2. How often do you use it over a typical day?
   • I average about 9 readings a day - this has risen by about 50% since going onto the pump regime
   • Used only very occasionally or when wanting to check for Ketones. This works out at about 2-4 times a month
3. How satisfied are you with the device?
   • It is ok. As a standalone BG meter it is the best I have used whilst the remote handling of the pump, especially the wizard for calculating the required Bolus doses for a given carb count; BG reading; time-of-day; health/activity combination, is extremely useful.
   • The fact that it measures blood Ketones is really good but apart from that I am not a fan of the Xceed.
4. Describe examples of problems you have encountered while using it?
   • With the Accu-Check: -
     • Getting enough test strips on prescription - although I have no trouble getting prescriptions my surgery only allows 100 strips to be a prescribed on a single form. At my rate of use this means I have to get a new prescription about once every ten days.
     • When doing a test my focus is primarily on getting the blood drop out and picked up by the strip. I therefore tend to get the blood into the strip before noticing if the meter is showing an error with it or if it is not yet ready for the blood sample (if I have to reinsert the strip after getting the drop). This waste of a strip can be very frustrating.
     • Last Saturday I attended a football match and wanted to take a reading at half-time. When I inserted the strip I got an error that the meter was too cold. Although it was cold this was also in England (the NW) in the daylight so it was at worst I doubt it was lower than -4C. 😛
     • Difficult to use on the move e.g. if jogging it is necessary to come to a standstill
     • Difficult to use in the dark
     • Overall I trust the accuracy of the meter but it gives the occasional bogus reading e.g. last week I had a reading of 18.7. I did not feel I was high and it was not too long since a reading of around 6.0. I took a second reading and it was 7.4! This can be quite serious given that a high reading can result in a significant 'correction' insulin dose being advised to the pump.
     • The Bluetooth connection to the pump fails quite often, I think mainly because the case that the meter is supplied with places the strip container in a position where it causes the most interference with the signal.
     • The supplied device for loading the results onto a PC is very cumbersome, and unreliable, based on an infrared connection between a third device with the meter (and also the pump) which is connected to the PC via a USB cable.
   • With the Xceed: -
     • Apart from the common problems I find with the Xceed that the strips are very slow at taking up the blood. This is despite the fact that I think the Xceed requires a smaller sample than the Combo.
     • The strips are all individually wrapped. They can be difficult to open at the best of times, let alone when you are having a hypo.
5. What improvements would you like to see in future monitoring devices?
   • I would like my device to provide Continuous Blood Glucose Monitoring (CGM)
   • No need to prick myself every time I take a reading. I have become accustomed to doing regular finger pricks but at 8-9 a day the fingers still get sore and occasionally bruised.
   • Cheaper test strips so that GP surgeries would be more generous in prescribing them!
   • As things stand there is still room to make the devices more compact. The best approach would probably be to supply a meter as a plug in device to a smartphone and then load the software for displaying the readings onto said phone. We nearly all carry a mobile around anyway so why not use it to provide the screen and software and let the meter just be a device for measuring reading off the strip?
   • Design the meter interface to behave more like a consumer device than a medical device e.g. you type in numbers rather than use up and down arrows.
   • More meters to measure both BG and blood Ketones so I am not obliged to use a meter I do not particularly like for the purposes of measuring the latter.
   • A clearer warning when a strip is inserted but the meter is not ready or able to take a reading from it - e.g. flashing screen or a vibration alert.
   • A small light at the end of the pump where the strip is inserted to aid nighttime readings
   • The ability to load the figures onto a PC using just a straightforward USB cable from the meter to the PC - similar to the Contour USB - and then simple client PC software for reading this data that does not require regular updates.
   • An indication on the meter screen of how much power is left in the batteries.
   • Better design of the supplied meter case so that it does not interfere with the device's functions.

Apologies for the length of the post, I have just indulged myself a little! 😎

 

[Thechai]

Thanks for all your replies!

A massive thank you to all your replies, they have been a great help!

From the problems that you have identified, we have developed a conceptual design idea of the potential product.

The idea is to incorporate all the apparatus included in a standard testing kit into a single device.

The device would be as small as possible, at the moment we are looking into a cassette tape style design.

The device would fit into a separate band and can be worn like an arm band on various parts of your body e.g. Arm, wrist, thighs etc... For home use or in the case of emergencies, this device can be dismounted from the band and used on the finger site.

A drum of a number of pre-loaded lancets and a reel of specially designed test strips would be fitted in the device. These would make contact with the skin through a small hole on the base of the device.

When used as a band, the device can be operated remotely by a provided keychain or any bluetooth enabled mobile phone. A button on the device would also allow you to operate it manually for finger tip testing. Test results would be sent to the key chain/mobile phone when complete. Everything would be designed to be automated, so you would be able to test in practically any situation.

This is all conceptual at the moment, final test strip and lancet numbers and how long you would expect to be able to use it for have yet to be confirmed.

Its a great time for your feedback, for we would still be able to make any changes!

Let me know what you think and voice your concerns!

Thank you once again

Andrew

 

[Robster65]

Hi Andrew.

I must have missed this first time around. Just to clarify.

Would we prick finger manually using a separate lancet. Then touch blood sample onto meter, which is worn somewhere on body. Then results are sent to bluetooth device for recording/analysis ?

Not sure if it's relevant for your project, but cost of consumables is a key issue in these times of NHS cutbacks. If you could make the tape cheaper per test than current strips, it would corner the market.

Best of luck with the concept.

Rob

 

[lucy123]

I totally agree with Robster, te cost cost of the tape compared to current test strip prices would be a big factor in whether it would be preferred or not. Good luck with the project.