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For the first time, people with diabetes who don’t want to carry a separate finger-poking device and test strips along with their glucose meter have an option — with the world’s first and only all-in-one automatic fingerstick glucose meter.

The device is called POGO Automatic, made by Silicon Valley’s Intuity Medical, and it became widely available in the United States in September 2021.

While any sort of traditional glucose meter requiring fingersticks may not seem like novel technology at a time when continuous glucose monitor (CGM) is becoming widespread, the one-push-button POGO is an alternate option that cuts down the hassle for people not using CGM. It’s been a long time coming.

The POGO system has been in the works for more than a decade, including over 5 years since it first received Food and Drug Administration (FDA) clearance in 2016. It took several more years of updates and subsequent FDA nods, quite a bit of fundraising, and a scaling up of manufacturing to move it forward. The COVID-19 pandemic also pushed back the launch for an additional year. But it’s finally available for sale.

“Most meters make you manually do the work, but with the POGO Automatic we do all the work,” Intuity Medical’s CEO Emory Anderson told DiabetesMine. “I use the analogy of cars, where you had manual transmissions when cars were first introduced in America, but now they’re mostly automatic transmissions. That is the potential here, with the POGO Automatic being the first in its class… taking us to a different, more automatic type of glucose meter than we’ve had before.”

Carrying around a traditional fingerstick meter means you also need a separate lancing device to poke your finger, as well as a vial of test strips. That means most users need to carry a whole case of supplies.

POGO, on the other hand, combines lancing and blood collection into a single, replaceable 10-test cartridge — so no more need for loose lancets or test strips.

This added convenience helps remove barriers to testing one’s blood sugar, Anderson tells DiabetesMine.

He also points to POGO’s all-inclusive design as being safer than a traditional meter from the standpoint that you don’t have any bloody needles or strips lying around or going into the trash bin. There is no contact with the used supplies, and that makes it a safer product, he said.

“A majority of people are still using glucose monitors, not CGM. Patients want choices and there is no meter like this, as a one step all-in-one automated product.”

Here are the unique features of the POGO Automatic (short for “press once and go!”):

  • smaller than today’s latest iPhone models, but with an additional “bulge” at the lower front
  • has a color screen with backlight, and a port light near where the needle and strip are located
  • uses two AAA batteries
  • requires the smallest blood sample size on the market at .25 microliters
  • each cartridge houses 10 individual test ports, each one with a lancet and test strip inside
  • has an “add more blood” feature, allowing an additional 90 seconds when more blood is needed
  • is FDA cleared for users 13 years and older (the company plans to request expanded labeling for younger ages down the road)
  • available by prescription for insurance reimbursement, as well as available over-the-counter in certain pharmacies in the United States

To use this meter:

  • Press the power button, causing the cartridge to open and rotate to a new test position and automatically provide a fresh needle and strip.
  • Put your finger on the blue-lit round test port and it senses the pressure and a short countdown appears.
  • When the test is done, the lancet and strip do not come out; they stay within their single testing cell, which is retracted and disabled so it’s impossible to use again.
  • After all the 10 tests are done, the whole cartridge comes out with the lancets and strips contained inside; a window shows how many tests are left in the cartridge and when replacement is needed.
  • The meter always shows how many tests remain, time and date — even when the meter display is off.

As part of the POGO package, the meter connects automatically by Bluetooth to the Patterns mobile app, which is available for free on both iOS and Android devices.

The app has a colorful screen showing trend graphs and a big display of your latest blood sugar reading. Features of the app include:

  • You can log blood sugars, food, insulin, and activity data, as well as mood and other psychosocial aspects that might impact diabetes management.
  • With high or low blood sugars, you can program the settings to automatically send an alert with tips on suggested actions for treatment — such as drinking juice or eating fast-acting glucose and then testing again 15 minutes later.
  • If you don’t respond, you can also allow the Patterns app to send a text alert to any emergency contacts, including a GPS locator function so they can find you.
  • A nutrition database is included, that uses the same in-app system as WW.
  • Text and email reminders can be set up for things like re-testing after a high or low, and daily, weekly or monthly reports you can share with your healthcare team.
  • The app integrates with other devices and data platforms, including Apple Health, Garmin, FitBit, and the diabetes device platform Glooko.

Patterns also includes optional one-on-one diabetes coaching with a certified Diabetes Care and Education Specialist (DCES). That involves personalized support and a management plan tailored to your needs, as well as in-app and texting communication as needed. The coaching starts at $25 a month and can be added on to the POGO supplies purchased.

As of September 2021, POGO is available in Walgreens pharmacies across the country and is rolling out in CVS stores nationally.

If purchased directly from the POGO online store, this reusable meter costs $68, and a pack of 5 cartridges (each containing 10 tests) is $32.

Intuity also offers a subscription model where you can select a larger number of cartridges based on your blood sugar check needs, and those supplies can be shipped to your home each month.

Right now, the POGO is the only meter of its kind available in the United States.

However, some may recall that the Dario meter is also touted as an “all-in-one” fingerstick meter, even though you need to follow several steps before being able to use it. First cleared by FDA in 2018, the little rectangular Dario meter contains a built-in lancet poker at the bottom of the device, and also houses 25 test strips in the container located at the top. Unlike POGO, though, you still need to take out the meter part and plug it into your smartphone, and then correctly insert a test strip before using the Dario lancet piece to poke your finger and apply a blood droplet.

In other words, that meter makes it easy to carry all the items you need, but they are still distinct pieces that are used separately.

For that reason, Anderson believes Intuity has a more revolutionary product.

“We are the only one that’s truly automatic,” he told DiabetesMine. “If you look at POGO, all patients have to do is push a button to test their blood sugar. There is no fumbling with lancets or test strips, and then having to put the blood to the test strip. We don’t see Dario in the same space, as it’s really more of a packaging design versus a technology breakthrough.”

DiabetesMine has been watching the POGO development since our first glimpse of the concept back in 2011. By the time Intuity gained initial FDA clearance in 2016, we were skeptical that the product would ever come to market.

Interestingly, what held this product back in large part was the FDA’s skepticism about people using lancets more than once. At one point, the federal agency even proposed reclassifying lancets in order to require more regulatory review, but that never materialized.

Intuity spent the year of 2017 making the product Bluetooth compatible and finally received a second FDA clearance. Then, they made subsequent improvements and got yet another regulatory OK in 2018. Along with those updates, Intuity spent time scaling up their manufacturing process and connecting with an outfit called Foxconn to manufacture the meters at large scale. They also spent time raising money in order to prepare for a large-scale launch.

Intuity began a limited launch in the United States in early 2020, just as the COVID-19 pandemic was beginning. That pushed back launch plans even more, and it wasn’t until 2021 that the company was able to fully launch the product to customers at pharmacies as well as the POGO online store.

DiabetesMine asked Intuity’s executive team about plans for improvements or updates to the now-available POGO meter. Two points stood out:

Voice chip. In developing the POGO Automatic, Intuity built in a voice chip for the device to eventually be able to offer voice activation and commands. That isn’t utilized in the currently approved version, but Anderson says that voice tech is a big issue they want to address going forward, since most meters and diabetes devices to date are not adequately designed for people who experience vision complications.

More than 10 test cartridges. When asked about the possibility of a cartridge with more than 10 strips inside, Anderson said that they’d discussed that before and decided against it. Mainly, that was because they felt it was more important to keep the meter small and compact. Another issue was prescriptions and insurance reimbursement, which often fall into multiples of 50. So, they package 5 cartridges with 10 test strips each, in a “mini Pringles can” style container.

“What we’ve really tried to do in design is make this very portable, recognizing that patients need to be out and about,” he said. “We tried to find the right combination with this integrated cartridge and number of tests, to still make this device portable without needing a bulky carry case. What we’ve accomplished with 10 tests per cartridge is a miniaturization that’s been a huge breakthrough.”