Glucose Meter and CGM Choices with Diabetes

Happy Saturday, and welcome back to our weekly advice column, Ask D’Mine, hosted by veteran type 1, diabetes writer and instructor Wil Dubois.

This week, Wil reacts to a few device-specific questions — about the universally-frustrating issue of snagging insurance coverage for particular products, and whether continuous glucose monitors will be replacing fingersticks soon.

Joe, type 1 from Minnesota, writes: Hi Will, my superb insurance has dropped all coverage on any type of test strips or meter anyhow –in my opinion–one of the worst meters on the market: the Verio IQ and its ilk. I currently use the FreeStyle Freedom Lite meter and strips, which has worked well for me for the past 10 or more years.   Out of pocket those strips will probably run me at least over $2K a year like I test 3 times per day or longer when I calibrate my CGM. But since I will likely be paying out of pocket for evaluation strips what is the next best choice of meter?

Wil@Ask D’Mine replies: Funny. I rather enjoyed the Verio IQ when my insurance covered the strips, while I locate that the FreeStyle strips rather… lacking. I guess that just shows how much private variation there is in how well these instruments work. In a different example, I was totally jazzed when the Dario arrived at our shores recently. It’s the Swiss Army Knife of glucometers, with lancet, strip bathtub, and tester all wrapped into a clever package. I was frustrated when I started using it and found tests ranging a full153 points from precisely the exact same blood sample! Holy crap.

My Dario is at precisely the exact same drawer I maintain my Swiss Army knife. I loved the idea of the knife but found it too fat for my skinny jeans. A guy needs to be careful in where his pants bulge when he’s out in people, ya understand.

But back to the crazy wide range of results I obtained from the Dario strips. It appears my results were the outlier, because the majority of the blogosphere was abuzz with how accurate the strips were. WTF? My experience was the opposite. How could that be?

There has to be something distinct about my own blood.

And why not? I understand that it is unpopular nowadays–with our current degree of racial and ethnic strife–to say this, but we really are distinct. On the biological degree. While we all appear to become red-blooded, there’s more to bloodstream than meets the eye. Consider that the garden variety yearly complete blood count really looks at fully 13 distinct elements of bloodstream. My blood is not the exact same one year to another, so why is it similar to somebody from southern Somalia, northern Russia, Southern Chile, or even western Mongolia?

Where am I going with all of this? I can not tell you the very best meter for you because I don’t know which meter will probably be ideal for anyone besides myself. I guess that different meters work much better or worse for different ethnic and racial groups broadly, and drilling down farther, I would wager that within those wide groups there are individualized “flavors” of blood which respond better to one test strip compared to another. In addition, I guess that what functions great one year might not be so hot the following. Many of us have seen this happen and normally blame the strip manufacturer for slacking on production quality (which may happen) but it might also be that our blood has transformed.

Right now, for me personally, the meter and strip combo that is working well is your WaveSense Presto. Next year, who knows? Perhaps the Dario will begin functioning for me.

But should you get such bad results from the Verio strips which you have decided to spend yet another two grand out of pocket on your diabetes, why change from what’s proven to work for you for a couple of years? If I had been you, I would stick with the FreeStyle.

Nancy, type 1 from Florida, writes: I read somewhere that CGMs can now be utilized for insulin dosing. Does that imply fingerstick meters are moving away soon?

Wil@Ask D’Mine replies: So this summer, an FDA advisory panel urged that the agency alter the Dexom’s G5 labeling from an “adjunctive device” to a that treatment decisions may be created with. Activism on the portion of our network helped push this through, however unless I slept through it, the agency hasn’t acted on the recommendation.

I guess they will. But once they do, that is not the death knell for finger tests. First off, the G5 itself utilizes a fingerstick meter for calibration. Various businesses are working on CGM systems which don’t need fingersticks, but we are not there yet. And even once we reach that point, think about how few people with diabetes may get CGM now. While a great deal of type 1s utilize CGM, I doubt that we are near the halfway mark nonetheless (the companies are secretive about sales volume) and really, very, very few type 2s can get their insurance to cover CGM. Why? It’s better is not it?

Damn right it is better. CGM provides context to blood sugar details. It offers the blood sugar amount value. It may tell you not just whether you’re at, say 247, however that you’re going up. Or secure. Or dropping. If your insurance company wanted you to become as healthy as humanly possible with diabetes, they would want you to have CGM.

Of course, your insurance company doesn’t give a crap about whether you’re as healthy as humanly possible with diabetes.

They are just interested in keeping you from becoming terribly expensively sick. And they wish to spend the minimum sum of money from the practice of keeping you from becoming terribly expensively sick. CGMs cost more than fingerstick systems. A lot more. Plus, as I pointed out a moment ago, they would still need to cover a fingerstick system, also.

So I don’t believe the fingerstick meter is moving away anytime soon. But who knows? Perhaps they’ll cure diabetes and all this gear will get dumped into land fills and vanish in the dustbin of medical history.  

However, my money is on meters and strips being accessible for a long time to come.

Disclaimer: This is not a medical advice column. We are PWDs publicly and openly sharing the wisdom of our accumulated experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are just a little portion of your whole prescription. You still need the professional guidance, therapy, and maintenance of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For additional information click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn’t adhere to Healthline’s editorial guidelines. For more information about Healthline’s venture with Diabetes Mine, please click here.

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