This is our third in a series of reviews of diabetes tech tools that also offer a coaching service connecting patients with certified diabetes educators (CDEs). We previewed a trio of these new products last Fall -- and recently published detailed reviews of the mySugar and Livongo offerings. Today, we're thrilled to have our correspondent Wil Dubois share his thoughts after test-driving One Drop.
I wake up every morning thinking that if I read about one more company offering an all-in-one diabetes solution, I’ll barf. That said, on the surface the new One Drop Premium appears to look pretty darn useful.
What is One Drop? It’s a new system that brings together a package of dedicated gear, software, and “live” help from CDEs right through its app -- all without a prescription, but with the FDA’s blessing, and all for a price that’s actually affordable out of pocket.
Sound too good to be true? To find out, I took One Drop Premium and Expert for a test drive to see if it lives up to its promise.
The Gear & Mobile App
The engine that drives the One Drop system is the app. Available for iOS, Apple Watch, and Android, the app lets you log blood glucose, meds, food, and activity. It also contains a robust food library and lets you share your data with a larger community if you choose to. It serves as the portal for reminders and support. It tracks your sugar and provides feedback on your control.
Ho-hum, you say. We’ve seen all of this before...
Not like this, you haven’t. Because the One Drop comes with two defining features: a truly innovative meter and case, and the real, live CDE help that comes with the system.
The One Drop Chrome glucometer is Bluetooth-enabled, so it automatically feeds BG data to the app in order to save users the untold hours of manually entering blood sugar readings. Equally important is the fact that the meter is powered by the highly accurate AgaMatrix test strips of Presto, Jazz, and BGStar fame.
Finally, an innovative system built around a test strip we can trust.
I won’t spend too much time today on the meter aesthetics, but suffice it to say that it’s Applesque. Clearly a lot of time went into its design. The meter is small, thin, and sexy. All your main pieces for using it -- the test strip vial, lancing device, and meter itself -- are black and shiny chrome, which is appropriate as that's the name of the device: The One Drop Chrome.
Also worth a shout-out is the carrying case, which is totally innovative, and unlike anything you’ve ever seen before. Gone is the worthless black zippered nylon bag with mysterious elastic loops that never seem to match the proposed contents. One Drop has created a wallet-like open-topped carrying case that keeps all the components together and makes rapid access a breeze. While best suited to purses, sport coat pockets, or cargo pants, the case can actually be carried in the back pocket of a pair of jeans more comfortably than you’d imagine by looking at it.
Now on to the other defining feature of the One Drop platform: The live CDE coaching that comes with the system and is packaged as One Drop Expert.
Certified Diabetes Educator in My Pocket
One Drop advertises that subscribers get 24/7 “in-app support” from CDEs who are available to “guide you, support you, and celebrate your accomplishments.” One Drop offers a 9-week diabetes education program through the app, and/or “on call” text-based one-on-one Q&A with a CDE also through the app.
This is where the rubber meets the road on this whole system as I was concerned, and I wanted to push it to the limit to see how much help a text-based CDE would be in the nitty-gritty gutter of real-world diabetes. I couldn’t wait to put my One Drop CDE through the ringer with a long list of quasi-fictitious difficult questions culled from my 12 years of clinical experience.
The CDE assigned to be at my beck and call at all hours, to answer all my questions, serve as my coach and motivate me was Rachel Head, RD. As soon as her face popped up on the app, I knew I was in trouble. You see, I’ve known Rachel for years. We’ve even eaten Cajun food together. Last I knew, she was running the diabetes program for Phoenix Children’s Hospital.
So much for being undercover: Her first text to me was: “Hi Wil! Long time no talk! It’s great to have you here!! :-)” I responded by telling her I’d recently been forced out of my clinical job, which is true, and how should I bolus for binge drinking? Wouldn't you know? The clever gal sent me a link to my own article telling teens how to drink safely.
Over the next few days I peppered her with questions ranging from carbs in bourbon to vaginal dryness. And from wheat crackers to depression. How were her answers?
They were typical CDE answers, well-crafted, but a hair more general than I would have liked. Of course, this is also true of most brick and mortar CDEs. For example, when asked if Tresiba or Toujeo is better, she took the safe neutral ground of, “ask your doc.”
Still, her tone was positive and always supportive, and I suspect if I were being serious (and truly needed help) it would be possible to develop a positive and productive working relationship with her through the app.
To me, however, one of the best services she could offer would be help in troubleshooting insulin-carb ratios and correction factors as the app records all BG tests, and if the user enters it, food, activity, and more. But can she? Sadly, no. These CDEs have access to the data, but “specific recommendations regarding medication adjustments and dosing” must be referred back to a provider. This is typical of all the new "remote coaching" programs.
But, she says, she can “help with pretty much anything else.”
I texted her at all times of the day through the app, and generally got answers back within a few hours. So while it's not technically a "real-time" service, it is quite fast. And in all fairness, if you placed a call to a brick and mortar CDE, how long would you wait for a reply? And how many CDEs will offer you unlimited texting?
Rachel tells me the One Drop Experts “definitely” respond to all questions within 24 hours, and “usually” within 12 hours, and sooner if they can. “We realize how important these questions and answers are to our users’ health and well being, so we try to be as responsive as possible," she says.
Overall, do I think this coaching part of the One Drop program is helpful? Let me put it this way: If you find visits to a CDE helpful to your diabetes, you are going to love having a CDE a few taps away. If you find CDE visits an empty experience, you’ll get nothing out of this. Not surprising.
Rachel tells me the most common questions they get “revolve around food, carb counting, and low carb recipes.” Interesting, as One Drop is quite proud of their food library which features:
- Quick changes of serving sizes that automatically adjust the carb count
- An OMG-fast barcode reader that uses the phone’s built-in camera
- Real-world serving sizes, not ounces and grams
- Automatic adding of meal components
Quality questions for a CDE, to be sure, though noticeably whiskey-related questions about the food database didn't seem to make the cut. Oh well.
An Offer You Can’t Refuse
One Drop isn’t covered by insurance. The One Drop Chrome meter kit will set you back about a hundred bucks (though there's an online store discount for $79.95). A subscription to One Drop Premium costs $39.95 a month -- $33.33 if you pre-purchase for the year. The subscription includes unlimited access to a CDE (you always get the same person so they can learn about you and you can get comfortable with them) and unlimited test strips.
You heard me.
Unlimited. Test. Strips.
If you test 15 times a day, they’ll keep ‘em coming to you at no extra cost. When you do a test and it automatically sends the result from meter to the app, it also tells you how many strips you have left, based on your last order. So, maybe you can't share strips with your D-pals without messing up the strip-count, but this is a seriously good deal. It’s less than many well-insured D-peeps pay for lesser quality strips. For the price of a copay -- or less, depending on your insurance -- you get an awesome, accurate meter, all-you-can-eat test strips, a robust and user-friendly food library, and free, unlimited access to a CDE.
What’s not to love?
My Final Verdict Is...
Color me impressed. I think One Drop will do a lot of good for a lot of people. It’s an intelligent, easy-to-use app powered by a reliable and accurate test strip that uses a modern, sexy meter that’s a joy to look at and use. The system is affordable, doesn’t place limits on strips, and has the added benefit of quick answers from medical professionals in a world in which getting ahold of your own team can be difficult. CGM data can also be synced to the app
The only thing really missing from the app that would make it perfect IMHO would be an insulin calculator and tracker, similar to RapidCalc. I’d love to see these two companies get together. Then we really would have a no-barf, all-in-one diabetes solution.
So will I keep using it myself?
Frankly, no. Like my T1 colleague Mike here at the 'Mine, who recently reviewed the competing Livongo system, I'm not a fan of apps in general and feel like I have enough diabetes stuff nagging me on a daily basis. So I can’t see myself using this one either, although when I run out of my current stockpile of strips, I’ll probably subscribe just for the affordable, reliable strips. And for the cost of those strips, I’d also have an experienced CDE like Rachel in my back pocket!
For those who do want to be nudged on testing, and regularly have questions for CDEs, the One Drop system is looking like it really can't be beat.