FreeStyle Insulinx

Review: FreeStyle Insulinx Blood Glucose Meter

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This week, I’m on a mission to deplete my remaining supply of FreeStyle Lite test strips. My calculations tell me that they should be depleted by early Thursday. The one piece of motivation that’s getting me through these final days is the mental promise of a new FreeStyle Libre sensor at the end of it. As part of this final hurrah, I thought I’d take the opportunity to celebrate the ‘life’ of my FreeStyle Insulinx meter over the past two and a half years.

I was first given an Insulinx back in 2015 after I had reconnected with my diabetes educator to discuss insulin pumping. This was a meter with a built in bolus calculator that would help me to become familiar with counting carbohydrates, which is what I’d eventually have to do on an insulin pump.

I had been using the same blood glucose meter since the day I was diagnosed. I didn’t know too much about diabetes back then, or some of the more ‘modern’ options that were on the market. Or the fact that ‘free’ meters were so easy to come across, because companies actually make money from the test strips!

The Insulinx was my first ‘modern’ glucose meter. I loved the test strips that were conveniently stored in capped vials, rather than being wrapped in foil. The USB cable, which meant that I was able to upload the data to my computer for review. There was a backlight for testing in the dark. It also used a much smaller sample of blood, and gave you an additional 60 seconds to apply more blood. No more annoying strip fill errors!

As much as I welcomed these modern features, I didn’t really make much use of the bolus calculator function. Mostly because I wasn’t motivated to count carbs and log insulin doses at the time.

Fast forward to today where I’ve tried many more meters and am generally more switched on to what my blood glucose levels are doing, the FreeStyle Insulinx simply does not meet my needs anymore.

The ‘Lite’ test strips may require a smaller sample of blood (0.3uL), however I feel that it’s easier for any sweat or moisture on my fingers to affect the blood glucose reading. I’ve been trying to combat this by extracting a larger drop of blood from my finger and making more of an effort to wash my hands prior to testing. I also don’t like not being able to physically ‘see’ the blood going onto the strip like other meters do.

The bolus calculator on the Insulinx isn’t as comprehensive as the one you might find on a pump or smartphone apps such as RapidCalc. Little things like being able to adjust carb ratios while I’m on my feet at work are a big deal for me. During pump breaks and even while using the YpsoPump, I haven’t even considered the bolus calculator that’s contained inside my Insulinx.

All of these gripes aside, I simply haven’t found the results to be as consistent or as trustworthy as my AccuChek Guide. Just last week I had something like a 12.7, a 10.1 and then an 11.6 in a row with clean fingers. Alternatively my AccuChek Guide has chalked up impressive consistency, even when throwing some grubby work fingers into the mix!

Due to its bolus calculating capabilities, the FreeStyle Insulinx is only available from a healthcare professional. If you’re using a FreeStyle Libre, the same bolus calculator is also built into the reader. Just make sure to ask for the code to unlock the bolus calculator.

I’m mindful that I’m a huge adopter of diabetes technology. Perhaps that’s why I’ve gravitated towards wireless systems such as Contour Next One or AccuChek Guide that will sync readings to my iPhone via Bluetooth for instant review.

For people who do want something simple and may not have the latest whiz-bang smartphone, this could be the perfect option for you.

Which Meter Do I Trust?

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One of the more “fun” pieces I recently had the opportunity to cover for Diabetes Daily was meter accuracy.

“To be fair, all blood glucose meters will only be accurate to the nearest 1 mmol/L (18 mg/dL) of a laboratory result. Which explains why two simultaneous blood glucose checks will likely produce two different results.

Most blood glucose meters must have a mean absolute relative difference (MARD) within 15 to 20 percent of laboratory results. This standard deems these devices a reliable indicator of blood glucose levels and safe to dose insulin from.

Which blood glucose meter can I trust? I conducted an experiment of sorts at home comparing all of the blood glucose monitoring devices that I currently use.”

You can see the results of my little experiment for yourself in the full column at Diabetes Daily here.

Curse of the One Touch Verio IQ

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I first received a One Touch Verio IQ glucose meter when I started on my insulin pump in May 2016. As most diabetes sales reps do, I received a rave review about how it was one of the most accurate blood glucose meters on the market.

I was using the FreeStyle Insulinx at the time, which I absolutely loved for it’s ‘Lite’ test strips that only required a tiny sample of blood and weren’t wrapped in that annoying foil. Although I had no intention of switching from the Insulinx, I decided to place this meter in my travel case and use it as my spare.

To give it credit, the Verio is actually quite an attractive meter. It has a colour screen and a backlight that automatically comes on when inserting a test strip. The meter is a refreshing white colour, rather than the dull greys and blacks that I’m accustomed to. By far, my favourite thing about this meter was the plastic shell that holds the meter, test strips and lancing device, which makes it super easy to carry.

Unlike any other meter I’ve used, its also rechargeable. This is good in the sense that you don’t need to keep on buying batteries (which are expensive, mind you!), but also not so good in the sense that you need to remember to keep your meter charged up before leaving the house. As a travel meter, the battery life held up well and would typically last me a month.

Testing with this meter was tricky to get my head around. Unlike FreeStyle and AccuChek meters, the test strip port was situated at the top of the meter. Additionally, blood had to be placed on the side of the strip, rather than at the bottom.

My pet hate was getting strip fill errors if I didn’t get sufficient blood on the strip in one go. I had a lot of these in the beginning as I was getting used to placing blood on the side of the strip. This was extremely wasteful compared to FreeStyle meters, which would give me ample time to apply additional blood.

I also didn’t like the fact that the capped test strip vials only stored 25 strips rather than 50, and that boxes came with 50 strips instead of the usual 100. This was an unnecessary waste of packaging materials, and meant that I needed to buy double the number of boxes to get the same amount of test strips. Although the price was comparable to other brands, Pharmacies didn’t necessarily stock more boxes of Verio strips on their shelves.

However, the biggest dealbreaker for me was the accuracy of this meter. I have consistently found that the Verio reads 0.5 to 1mmol higher than each of my other blood glucose meters.

Of course when I raised this issue with Aussie distributor AMSL diabetes at the ADS-ADEA conference last year, I was basically told that it was the other meters that were wrong. The accuracy of this meter fell within the acceptable Mean Average Relative Distance (MARD) from laboratory glucose readings. It had also been recommended for calibrating readings with Dexcom, which is the golden child of Continuous Glucose Monitoring.

I’ve done a little experiment with some of my leftover test strips, comparing the Verio with my FreeStyle Insulinx, Accu Chek Guide and FreeStyle Libre. I washed and dried my hands prior to each test, as I’m well aware that any moisture or dirt on my hands can impact glucose readings.

To be fair, all meter readings are only accurate to the nearest 1mmol of a laboratory result. Two simultaneous blood glucose readings will likely produce different results. So how do I know which of these readings I can trust?

I’ve found myself feeling hypo on several occasions, only to test with the Verio and receive a reading in the 4s. Patterns as exhibited above are a regular occurrence.

I’m exercising my own judgement here, in saying that I simply cannot trust this meter.

An Insulin Logging Adventure

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My meter is a pain in the ass at the moment. Every time I’ve gone to use it over the past couple of weeks, I’m reminded of a promise I’ve failed to keep. A promise to my diabetes educator that I would log my insulin doses into the meter. I flicked past Monday, February 29 in my diary, where I’d reminded myself of that very promise.

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I feel so guilty that I’m not using this new, smarter device to it’s full capability. I feel like I don’t deserve the luxury of having a shinier, fancier looking meter that goes with this decade. I feel like I don’t deserve the smaller test strips that use less of my blood and make less of a mess on my desk.

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I’m slack. I just haven’t been bothered to do such a menial task, when diabetes is already so consuming in itself. It’s a task that seems so worthless when there are so many more important things to do in the grand scheme of diabetes. I’ve also been a bit worried that the numbers won’t live up to Gwen’s expectations.

But I’ve made the decision to switch to an insulin pump. For lack of a better phrase, I’m going to have to own the consequence of that decision. Carb counting. Logging my insulin doses. Sending the meter reports to Gwen, so that we can fine tune things and prepare my insulin ratios for the pump. If I want to maximise the benefits of insulin pump therapy, then this is something I’m going to need to make a habit of. And I need to stop obsessing over the numbers not being “perfect.”

Today marks day 4 of my insulin logging adventure. I’m no longer relying on 3 different meters stashed in lockers, desk drawers and satchels. I’m carrying my Insulinx meter around with me everywhere, which gives me no excuse not to log an insulin dose when I forget! I’m also hoping to be able to send off some data to Gwen before Easter next week (eek!). 

Four days in, and I’m already seeing benefits. I’m thinking more carefully about what I’m bolussing for. When I go to test 2 hours after a meal, I’m reminded of how much insulin is still on board in my system. I can see on the screen how much more of a drop I can expect, which has stopped me from my bad habit of over-correcting and ending up hypo later on.

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Despite being sick, battling stubbornly high BGLs, and being hypo more than two times in one week, I am powering through all of this. When I looked at my lunchtime reading yesterday afternoon, I kind of felt like I was kicking diabetes’ ass!

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The “Fill In” Endo

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I’m very protective over my diabetes. I share it with the people I can trust, and I do my best to shield it from people who aren’t going to be supportive. I can thank my very first endocrinologist for that.

Thankfully, the endo I have today is someone I can trust. Each time I go into diabetes clinic, I find myself able to share more and more with her. Which is funny, considering I only go in there twice a year. But still, I feel a certain level of comfort in front of her, that I don’t in front of strangers.

I’d been planning Wednesday’s appointment out in my head for weeks. I had a list of notes and questions in my diary to ask her. I was nervously anticipating my post Christmas hba1c result. Sidenote: I really need to get these done inbetween my 6 monthly appointments, so that I’m not playing guessing games or making excuses to slack off on diabetes management for too long! I knew exactly what I wanted to talk to her about. I even brought along my FreeStyle Insulinx meter and USB cord, ready to share my data with her. For me, that was a massive step, and a big vote of confidence in her.

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So, when a “fill in” endo came over and called me into the office, my guard was immediately up again. That trust was gone. I would have to tread water carefully, but I was willing to give him the benefit of the doubt.

However, he didn’t seem to be very knowledgeable around my questions.

I asked him if I would be able to get an endo’s sign off on the pump without coming in for another appointment. His response went something like “I’m not really sure. I imagine that we would be able to sign it without you coming in. Gwen will be able to tell you.” Gwen, being my fantastic diabetes educator, of course.

I also asked him if I could have a letter exempting me from limits on subsidised test strips. He responded with “I haven’t really heard of such a thing. It might be a better question for Gwen. There is such a thing as too much testing. Most people probably don’t need to be testing more than 4 or 5 times per day.” 

He also wasn’t very encouraging when we talked about my latest hba1c result.

It had gone up by half a point since last time, but it was exactly where I expected it to be after the past few months I’ve had. I expressed my disappointment, and my desire for it to be lower and more stable with a pump. “Your hba1c is around where we’d like to see it. It’s certainly a good range to be aiming for” he replied, suggesting that I didn’t need to be aiming any lower.

All in all, he left me feeling disappointed. I feel like I’ve come so far with my diabetes management. I’m so proud of the attention and interest that I’ve given to my diabetes in this past year. I had shared my perspective around my diabetes to him, looking for some support and some guidance. Yet some of his answers were so vague and wishy washy, that I seriously doubted whether he was an actual endo.

I got the impression that because my chart looked amazing compared to many of his other patients, he didn’t need to give me too much of his time. I’m not a qualified professional myself, yet I can see that there’s room for improvement. There is always room for improvement.

As I walked out of there with a doctor’s certificate dated from the 1990s in hand, I thought to myself thank goodness I’m seeing Gwen on Monday.

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Spare a rose this February, and give life to a child with diabetes in need. Visit sparearose.org.