A conversation in the online community caught my eye the other day, focused on the question: "Which diabetes tech has had the biggest impact on your life?" Mulling it for a bit, I went through a laundry list of possible contenders -- traditional glucose monitors, continuous monitors, insulin pumps, pens over syringes, mobile apps for logging and sharing data... and so on. In the end, I circled back to one basic tool that has changed my life the most: the simple glucose test strip.

Allow me to explain.

See, I didn't read any judgment of "good" or "bad" into that question. Instead, I took the word "impact" at its quite literal meaning of influence, or effect in life -- whether positive, negative, or a mixture of both.

I also took a loose definition of the word "tech" in this case to mean any tool for treating my disease created by modern science.

And the fact is that fingerpokes and the resulting blood droplets that go onto traditional test strips -- no matter which meter brand or type -- are the tools that have had the most influence on my life over my 34+ years living with type 1, and I'd contend they still do today even with all the advances in tech and treatment.


A Lifetime of Glucose Testing

From the early days following my diagnosis in Spring 1984, glucose monitoring has been a staple in my life -- and yes of course, at times poking my fingertips with lancets has felt like being stabbed with a stapler. The sizes and models of meters and the particular little strips they use have evolved, but it all comes back to that key piece of D-data generated, dictating so much of how I feel and live, in so many ways:

  • Guiding my meal choices
  • Indicating how much insulin to take
  • Telling me when it's safe to exercise, or when I might need to take a break from playing little league or adult-era golf to eat a snack
  • Confirming why I was grumpy (thanks to a High or Low blood sugar), or why I felt sudden chills and body shakes (signaling a Hypo)
  • Starting conversations in the initial moments of any endo or clinical visit, when the staff pokes my finger to get a result for my chart
  • Determining whether I should get behind the wheel and start the car ignition
  • Clogging at least two vacuums and dust-busters at our house through the years after getting embedded in the carpet (and probably messing with my lower back muscles from all the leaning over to pick them off the floor)

Over time, as technology and the diabetes industry has evolved, test strips have also:

  • Been used to enter data into my insulin pump for calculating doses
  • Been used to calibrate my CGM devices for "accuracy" (despite the strips being ~20% off from clinical lab results)
  • Spawned advocacy efforts on "test strip accuracy" and why it matters so much (and why regulations and policies can't push for 100% spot-on results)
  • Made so many wonder and lament, "Why do test strips cost so darn much?!"
  • Sparked so many complaints and virtual shouting-matches with insurance companies and third-party suppliers over what's covered and "why I need more strips," or which brand is "preferred" by payers, despite what I and my doctor determine is best for me
  • Been the subject of numerous cartoons and memes, as well as D-peep stories about whether one prefers to "lick" or "wipe" to be rid of excess blood

I am not the only one who's spent a small fortune on test strips alone over the course of 30+ years -- not to mention the various products I've bought to help store and even dispose of those strips.


A Collection of Moments

Sure, a natural go-to response to "biggest impact D-technology" question in 2018 would have been to name an insulin pump, CGM, or mobile app. Science and product development have come a looooong way in just the past decade, after advancing slowly but surely in the decades since I was first diagnosed (in the early '80s).

It's certainly true that my life has been changed by insulin pumps. CGM has been a life-saver countless times. Data-sharing and all the new mobile apps (from commercial products to DIY #WeAreNotWaiting tools) have been a panacea.

But when I think deeply about this question at its core, it all comes back to that simple, indispensable glucose-number-in-the-moment that serves as a guide for everything, and often an explanation for why my life happens to be taking the crazy turn it is at any given time.

In other words, while test strips only give us a quick snapshot of our BG in the moment, the point is that life is made up of moments...

Traditional glucose test strips have had the most impact in my life in various ways, as my personal D-math proves:

  • 34+ years with T1D
  • 17 years from diagnosis using only injections and meters, before my insulin pumping days began
  • 15 years of insulin pumping,with some brief scattered breaks during those years
  • 6 years or so of using a CGM (again, with various hiatuses over the years)
  • 4 years of data-sharing via Nightscout / #WeAreNotWaiting technology
  • A few recent years in using mobile apps specific to my diabetes

Even though the newest FDA "no calibration required" designations mean we PWDs (people with diabetes) don't need to use as many daily fingerstick tests to reset our continuous monitors, the fact remains that test strips are still a staple, used multiple times a day every day by so many of us. Maybe its just my generation, but I personally will probably always have difficulty trusting continuous monitors 100% of the time, so I don't see test strips exiting my world any time soon.

So this is why I say that test strips have had the biggest impact on my life to date. Whether that changes is TBD, because none of us have a crystal ball...

But I for one remain thankful for this now-basic diabetes tech, that remains at the nucleus of my PWD existence.