Over the last couple of weeks I've had a chance to test drive one of the newest glucose meters to hit the market — the Telcare BGM 3G, the first wirelessly-enabled glucose meter, from the Bethesda-based company of the same name (which we introduced here). Telcare made their debut at the Consumer Electronics Show in January, and was a semi-finalist in the "Last Gadget Standing" competition, alongside some very cool new technologies from mainstream consumer giants Samsung and Sony. Needless to say, I was looking forward to trying out this meter firsthand.
For the most part, new glucose meters work almost the exact same way as old glucose meters. Kind of like insulin pumps. When you get down to it, glucose meters tell you what your blood sugar is, and insulin pumps deliver insulin. It's all the bells and whistles that make one more appealing than another. And I'll admit, the Telcare BGM has quite a few bells and whistles worth writing home about.
Personally, I've been using the same glucose meter, the OneTouch UltraLink, for the past few years because it wirelessly communicates my blood sugar reading to my Medtronic insulin pump (hence the "link"). So it's been awhile since I've tried another glucose meter that wasn't a OneTouch. Upon unboxing the Telcare BGM, the first thing I noticed was the size of the meter. The size issue was first pointed out by Wall Street Journal technology guru Walt Mossberg, in his review in of the Telcare meter, and he was definitely right! It is noticeably bigger and heavier than my UltraLink, and it's substantially larger than other meters I've seen, like the Freestyle. On the plus side, that also means that the screen is quite a bit larger than that of other meters. But the meter case it comes with is also a large, square black bag. So it's both big and unattractive. I also wondered how exactly my male friends would feel about lugging this thing around. Man-purse, anyone?
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My Test Drive
The instructions on the meter (printed on one of those sticky films that peel off) says to turn on the meter and wait 5 seconds. Yep, this meter has an on/off switch, although if you leave the meter on between tests, the meter does "go to sleep." Leaving the meter on does drain the battery faster, but you don't have to worry about eating up batteries, as this glucose meter is rechargeable and comes with a plug-in wall unit. Think of all the money you'll save!
Once the meter is awake (or when you've woken it by inserting a test strip), the testing procedure is fairly routine. The strips are no-code and require .8 microliters of blood (less than some strips, but more than some others). But there are a couple of quirks to the Telcare BGM. Plus, the test strip is much longer than other test strips and the test strip slot is not easily viewed at the top of the meter (see comparison picture). The slot can be viewed from the back of the meter, but not from the front.
Jonathan Javitt, CEO of Telcare, explained in an email that the added length of the strip is part of Telcare's autocoding feature.
The countdown time to receive your reading is 6 seconds, as opposed to the standard 5 seconds on other contemporary meters. When the result pops up on the screen, the meter immediately prompts you to select a tag. And you have to act quickly! The meter only gives you 30 seconds to make up your mind about whether this is After Lunch or Before Snack, and if you don't select a tag or if you accidentally select the wrong one, there's nothing you can do about it. Like Joanne at Death of a Pancreas, I found this very annoying. You cannot change the tag after you save it or after the meter times out, which is irritating if you're indecisive, are distracted, or have butter fingers like me.
Matt Tendler, VP of Telcare, explained that the tags were designed to be static because the FDA won't allow changes to be made to "clinical data." This would make sense if the meter were setting doses, or even offering suggestions for decision support, like the new Verio IQ meter, but when the patient is the one choosing the tag, shouldn't the patient also be able to change it? I'm not a clinician... I'm just a patient keeping records, right?
The big benefit of Telcare is of course their 3G connection to T-Mobile, which is provided for free and allows the meter to send your readings to a server, where it is made viewable using the MyTelcare website or the MyTelcare iPhone or iPad app. This is an incredibly handy feature for someone who doesn't like to log (read: me). Automatic logging? Yes, please! But that's only when the 3G network actually works... On more than one occasion the meter sadly told me I'd have to be patient and wait because the connection to the server wasn't available. Argh! So close, yet so far away. The readings are stored in the meter's memory (up to 300 readings), but you have to remember to sync them to the server once you're connected to the network again. The meter won't do that for you automatically, unless you specifically tell it to.
Using the Website and App
The "personalization of trends" is something I liked about this meter. That is, after a reading is taken, the meter can deliver personal messages (though you can also opt-out), like your average 7-day blood sugar for a particular tag or how your current 7-day blood sugar average compares to the previous 7-day average (so you know if you're trending up or down). Using the MyTelcare website, you can program your target blood sugar comparisons. If you're trying to test more frequently or think you might be slacking off, the meter can let you know how many tests you've completed.
The MyTelcare website and app are handy tools, but their logging choices are fairly basic. The site houses the entire history of blood sugars, an average of meter readings by tag, and an average of meter readings by the hour. It has one logbook, which breaks down readings by tag, not by the hour. So if you have a morning snack and an afternoon snack and label both as "Snack," they are both going to end up in the same column.
The MyTelcare app is actually both pretty and functional. The Statistics option shows today's history, plus 7, 14, 30 and 90-day averages, along with hourly averages, and a colorful pie graph breakdown of low, normal, high and very high blood sugars.
The website and app also allow you to send your logs to your endocrinologist, CDE or primary care physician. And parents, this is ideal for you, as you'll be able to log in to your child's meter's account to see what their last reading was... and when their last reading was!
Would I switch to the Telcare BGM meter? It's tempting. I do love the automatic record-keeping, and although it's not as detail-oriented as I would like, it's far better than what I've got right now (which is nothing, since I hate putting the effort into manual logging!)
In terms of lifestyle issues like carrying this thing around, the odd placement of the test strip port, and the need to access the buttons of the side of the meter to tag readings make using some of the more stylish carry pouches inconvenient. That means we'd be stuck with the manufacturer's plain black boxy carry case. Bummer.
Plus, the meter is still brand-new to market and hasn't been picked up by many insurance companies yet. It retails for $150, and the test strips are $56 a per bottle of 50 strips. If you sign up for a one-year contract, the meter is discounted to $100, plus $36 for a bottle of 50 strips. Despite the discount, this certainly adds up if your insurance doesn't kick anything in.
Once the Telcare meter is picked up by more insurancers, I see this being a big hit for families with T1 kids (that auto-logging and remote viewing is bound to be a lifesaver!) and for elderly folks who need a larger, colorful screen. The MyTelcare website and app are nice, although a little light on the features I'd personally want, but the company appears very open to patient feedback to help them upgrade their service.
Overall it's a nice and also innovative glucose meter, but I still feel it needs some work before I'd commit to a long-term switch. Has anyone else given the Telcare a go?