Review: My Dario Smartphone Glucose Meter

I was recently given a Dario Smartphone Glucose Meter and some test strips to try from my friends at Perth Diabetes Care. I squealed with excitement at the prospect of taking that little orange device home with me, because I tend to get pretty excited about integrating my diabetes tasks with my screentime. There was no expectation that I would blog about the Dario, and all opinions expressed here are my own.

The Dario is a really nifty little device. I was surprised at Dario’s relatively low key launch into Australia, considering that many bloggers in the UK were given meters to try some time ago. If it weren’t for the odd sponsored post on Facebook or my perusing the Diabetes WA online shop, I wouldn’t have known it had hit our shores.

So, it’s an all in one glucose meter. Lancing device at one end, test strip vials stored on the opposite end.

For some crazy reason, I thought the whole device clipped onto the bottom of my smartphone. So there I was on the first night I brought it home, trying to attach the whole damn thing to my phone! Until I realised that only the little test strip port connects via the headphone jack.

You also need to download the Dario app to your phone, and register to get started. I was able to register with my Facebook account, which is a big plus in my book – one less password to remember! Once you’ve opened the app and connected the little test strip port, you can insert a strip and receive a glucose reading on your phone screen.

The Dario app also had features like a bolus calculator, food databases, data sharing and an estimated hba1c. The data entry screen shown below gave me plenty of time after testing to input carbs and calculate an insulin dose, so long as I didn’t press the tick to exit.

I didn’t really make too much use of the app because I use my insulin pump for calculations, but I imagine that if I were on injections this would be really useful.

How accurate are the strips? Although I felt extremely wasteful doing unnecessary tests for the purposes of answering this question, the Dario quickly proved to me that it was a reliable competitor. It held up extremely well against my FreeStyle Libre, my FreeStyle Insulinx, high blood sugar levels and in target blood sugar levels. From memory, most of my comparisons were within 0.5mmol – with the exception of my One Touch Verio, which tends to read slightly higher than my other meters.

I really wanted to like this device.

Unfortunately I just found it really tiresome to have to pull out my phone, open the app, eject the test strip port from the Dario, connect it to my phone, pull out a test strip and prick my finger for a result.

After a week I still felt kind of clunky using it. I couldn’t remember how to eject the little test strip port from the Dario, or which end was for lancing and which end was for test strips.

Although I had a box of test strips to play with, I didn’t use it as much as I thought I would. While I was out and about, using my meter was simply more convenient.

While I loved the idea of an all in one glucose meter, the reality is that I have to be prepared for my diabetes every time I leave the house. I already carry skittles, insulin and spare supplies to deal with a pump failure, that carrying a meter, test strips and a lancing device isn’t exactly a big deal.

That being said, I have only used this device for a week. It is a big change from using a traditional glucose meter for the last seven years, and perhaps I just needed some more time with it.

The Dario Smartphone Glucose Meter can be purchased online at mydario.net.au, and is also available through selected Pharmacies. The test strips are subsidised through the NDSS, and are sold through the Diabetes WA Shop here in Perth.

Foggy

I stirred in the darkness. I felt sticky. I could feel the dampness building around my neck and my thighs. I could feel heat emitting from the pillow where my stuffy head had been resting. Leaving the quilt on my bed last night was probably a bad idea.

I felt shaky. I could feel my entire upper body vibrating, as I lay there under the covers. Could I be?

But I didn’t want to open my eyes. I didn’t want move a muscle. I couldn’t gauge exactly why this was, but my brain couldn’t overpower my body that morning as I lay paralysed in bed.

BLEH BLEH BLEH BLEH…

No sooner than I had closed my eyes again, my alarm began to sound. It startled me. I couldn’t believe it was morning. I couldn’t believe I hadn’t registered the time on my clock radio when i stirred only moments ago.

I fumbled hurriedly for my phone, desperate to silence the blaring alarm. I felt disoriented. I felt weak. I switched on my bedside lamp, and reached for my meter.

2.6. My blood sugar was sitting at lowly 2.6.

I frantically got out of bed, pulled my retainers out of my mouth and fumbled around on my dresser for the ancient yellow-rimmed coffee cup where I could dunk them into.

I could still feel those shakes as I walked into the kitchen, like someone had frightened me. I poured milk into my coffee cup, and placed it into the microwave to heat up. Once the 45 seconds were up, I placed it under the coffee machine, watching the sweet brown liquid drip slowly into my cup.

I felt thirsty. I washed that coffee down my throat in big gulps, as a way to quench my thirst. I reached for biscuits. One of Nonna’s amaretti topped with a glace cherry, followed by a choc chunk cookie.

I wondered how long I had been low. I knew I had gone to bed sitting on a 4.9. I had eaten 3 skittles as well, which should have brought my blood sugar closer to 6. I hoped I hadn’t been sitting low for too much of the night.

As the shakes subsided, the brain fog began to set in.

As I went about my morning moving pallets and pushing trolleys, I could feel aches in my very weak arms and legs.

Those aches were a lasting reminder of that hypo.

Those aches left me feeling riddled with guilt.

Some added science from my friend Matt: Apparently your muscles are repairing overnight, and if there isn’t enough sugar for them to slurp on…ouch is incurred.

T1 Talk: Managing the Unmanageable

Welcome back to T1 Talk, a series of conversations between myself and Bec of Sweet and Sour Diabetes. We’ve started these conversations with the aim of highlighting how type 1 diabetes impacts two people of a similar age, who were diagnosed at slightly different stages of life. You can learn more about us in our first post here.

This T1 Talk is titled Managing the Unmanageable, and tackles the more technical side of management – from diabetes healthcare professionals to pens, pumps, fingersticks and CGMs. There are two parts to this T1 Talk. The first part is here, and the second part follows over on Bec’s blog at Sweet and Sour Diabetes.

The Australian health system is split into public healthcare and private healthcare. What do you use and why?

Frank: I began seeing a diabetes educator privately last year because I needed someone who had more time for me. The public system pushed me towards self management as soon as I was able, and diabetes education is something I genuinely missed for a few years there in the middle. I wanted someone consistent, someone who I could get to know and who I was able to contact inbetween appointments. I didn’t feel like the diabetes education I received in the hospital was personalised to my needs towards the end.

I see my allied healthcare professionals privately too, simply because it’s more convenient than going to the hospital.

I still see the endocrinologist publicly at the hospital. I feel like the endo is more strictly business. She refers me for all of my important check ups, reviews my hba1c and other pathology reports. I only tend to flag the more “medical” concerns with her. I’m happy seeing my endo publicly, and I don’t feel I could justify the cost of going private based on my experience here.

Bec: Your relationship with your CDE sounds brilliant!

When it comes to health system, I’ve sampled most of it. Currently my diabetes management primarily falls on two people, both private practitioners. My private endocrinologist is basically a whole healthcare team in one. She manages everything a diabetes educator would, as well as her usual endo role. This suits me really well and I feel very well supported in the private system. However, this was hard for me. I strongly believe in public health care being the best quality care. I believe you shouldn’t be able to pay more for better health care, it should just be a given. Unfortunately, the public system (whilst amazing as an early teen) was not the best fit for me as an adult. I see my allied health professionals in the public system, and everyone else privately.

Frank: Wow, the all in one sounds awesome. It sounds similar to endos I’ve read about in American blogs. It does sound expensive, though. 

Bec: It’s not too bad price wise considering it’s only once every 3 months. She’s very supportive by helping out between appointments via email, but I often feel guilty for asking for help when I’m not paying for it.

Describe the relationship you have with your Diabetes Educator and/or endocrinologist.

Frank: I see my diabetes educator once every three months. I’m pretty proactive with my management, so at the moment it’s more than enough. I’ve got her card and I know I’m welcome to call or email inbetween appointments if need be, which is comforting. It’s so good to have someone who dedicates that whole hour to you. She lets me steer the conversation, and I don’t feel pressured into anything I don’t agree with. I love that my educator also explores things like how I feel with my current level of management, or how I handle my diabetes around others. The price I pay is absolutely worth it.

Bec: I’ve always thought your educator sounded amazing. I remember mine at the kids hospital were brilliant. She sounds like she takes a real interest in your health overall, rather than focusing on just one part of diabetes.

My endocrinologist is quite business like and direct, but I like that about her. She understands my approach to my t1 and supports that, but she also tells me when to dial it back and give myself credit for what I AM doing for my management. She’s very contactable outside of the quarterly appointments via email which is very helpful for my management. I find that I’m not as self sufficient as you are Frank, and I need a bit of help working out what to do with my insulin rates. I think this might be because you’re not very self sufficient in the paediatric setting. I understand how everything works but still feel some hesitation making my own rate changes without confirming it with an endo. Plus, with work and uni and constant fluctuations in my sugars I need a helping hand to sort through the mess. So just like your educator, my endo is certainly worth paying for. I just don’t have the brain space to do it alone.

Frank: That’s fantastic. We’re under all this pressure as type 1s to constantly manage well, that along the way I think we lose sight of what an achievement this is in itself. So, I think it’s great that your endo gives you credit where it’s due. Basal rates are really tricky to work out, and obviously you need to allow time for them to kick in and sometimes it takes a lot of trial and error before you get them right. If you feel more comfortable making basal changes under the guidance of your endo, then I say good for you. I’m glad you feel supported in it.

What would you change about the system of healthcare in Australia?

Frank: Stop cutting resources in diabetes clinics! Stop pushing patients away! The number of patients in my diabetes clinic keeps growing, but over the years it seems the resources continue to be stretched thin. The wait time to see a diabetes educator is at least a month, and although I’m supposed to see the endo in 9 months, it will likely be closer to a year. Once upon a time, diabetes clinic was the only resource I relied upon to manage my diabetes. I couldn’t imagine where I would be today if I hadn’t diversified my investment chips into peers, websites, books, social media, private education and allied health professionals.

Bec: Excellent points there. So you see your endo less than once every 3 months? That makes sense considering the role your educator plays in your management. I agree that adult care needs to improve, which is something transition services such as Trapeze (a company I work for) is working toward. I left public health care because it just didn’t fit me or my needs.

The thing I would change is the idea that CGM is a luxury. It certainly is not. I can’t feel my hypos very much, and I tend to drop in my sleep. How anyone can consider an alarm system that keeps you alive a luxury is beyond me. Yes, it’s subsidised for those under 21 upon recommendation from their endo, but t1 has no age cut off. I’ve spent a lot of time contacting politicians to make a change. Just last week I sent a letter to my local member to bring the issue up again. Probably not effective, but at least I’m trying to do something about it.

Frank: I feel so guilty to whinge about CGM considering how lucky we are here in Australia, but yes I wish they were more accessible to me. While I’m so happy for the kids who will get one subsidised, I feel like our government has simply forgotten about the rest of us with type 1. I worry so much about going hypo unaware. I go through tonnes of test strips. I usually set an alarm midway through the night, just to make sure things are sitting steady. Good on you for doing something about it, I still haven’t gotten around to contacting my local MP.

Head on over to Bec’s blog at Sweet and Sour Diabetes to read the second part of this T1 Talk. We delve into pens versus pumps, fingersticks versus CGMs, and the challenges of making changes in our management. Catch you there!

That Time I Almost Ran Out of Insulin

The eighth annual Diabetes Blog Week took place last week, and today I’m jumping in late and answering the Wildcard prompt.

Whether you or your loved one are newly diagnosed or have been dealing with diabetes for a while, you probably realise that things can (and will) go wrong.  But sometimes the things that go wrong aren’t stressful – instead sometimes they are downright funny!  Go ahead and share your Diabetes Blooper – your “I can’t believe I did that” moment – your big “D-oh” – and let’s all have a good laugh together!!

One day, a good couple of years ago, I went on a day trip with my family to Rottnest Island. I’ll say I’d had diabetes for a year or two at the time.

In the beginning, I was just full of attitude when it came to my diabetes. I didn’t want to admit that my condition had changed me. I didn’t want to admit that it made me different. I hated the thought of relying on a meter, insulin or jellybeans as a just-in-case. It felt weak. It felt like I was giving into my condition.

So, you can only imagine how this teenager with attitude reacted to his parents nagging. Whenever we were travelling somewhere distant, Mum and Dad would nag me.

Have you got your stuff?

Frank, I’ve got a bag here if you want to put anything in it.

Have you got all your stuff?

You get the idea. Cue lots of eye rolling and humming over their voices.

So, we were waiting to board this ferry on a day trip to Rottnest Island, when I suddenly realised that I didn’t have much insulin left in my pen. It wasn’t empty empty, but there was probably only enough in there to cover a meal. I think I gasped, or made some sort of expression that made Mum and Dad aware of the situation. Aside from a few remarks of I asked you if you had all of your stuff!, I don’t remember them getting super mad.

We did have some time up our sleeve before we had to be on that ferry. Dad suggested that if I found a Pharmacy and explained my situation, I’d probably be able to get some insulin. Of course, yours truly stubbornly said that he’d be fine and make it last the duration of the day.

I remember stopping at Dome for a coffee when we arrived, and not having anything. After some wandering round, we stopped for some fish and chips at lunchtime. I knew that if I just ate the fish and left the chips, I would be able to get away with minimal insulin. Of course, yours truly decided to eat his chips as well and ride the minimal insulin and high blood sugars out until the end of the day.

I can’t recall my pen actually reaching it’s threshold that day. I do remember checking my blood sugar on the ferry ride home and getting something like 16. I do remember thinking about getting home and being able to give a correction, which makes me think that my insulin pen did run out that day. But then again, perhaps I was just too self conscious to inject a correction shot on the ferry. Who knows…

What I do know, is that this was the silliest and most irresponsible thing I have ever done with my diabetes. So many things could have gone wrong that day. The ferry could have broken down, leaving me stranded on Rottnest Island, or somewhere inbetween without insulin. The fish and chips could have sent me into ketones if I didn’t have the insulin to cover them, with limited medical assistance available to me while I was offshore.

But I also laugh at this story. Whenever someone tells me that they’ve left their insulin at home or done something irresponsible, I usually refer to this story. I remind them that they can’t ever be as irresponsible as I was that day. I hope I make them feel a little bit less guilty.

On a sidenote, seeing this prompt among the Diabetes Blog Week topics has had me thinking of this blooper all week long.

To read other responses to this prompt, click here.