30 Seconds To 0 – 20 Years of Blood Glucose Monitors
30,29,28,27,26,25…
For as long as I can remember I have been able to count backwards from 30. Not forwards; backwards.
The screen would beep, you’d hear the spring go then feel a sharp pain in the side of your finger as the blood pooled and dropped onto the strip. And then the countdown began…
24,23,22,21,…
The machine was a blood monitor (or BM Kit) and as a child I had to test at least 5 times a day. Of course at the age of 2 it wasn’t me doing the testing - it was my parents. Today I test 10-15 times a day but instead of blood, a temporary sensor sends the data straight to my phone continually. Much easier and less painful!
At 15 months old I was diagnosed with type 1 diabetes. It gave my parents quite a fright to put it mildly. I almost died. So now I need to manually regulate my blood glucose levels. You can’t calculate the right dose of medicine if you don’t know where you’re starting from. That is where blood glucose monitors come in and they have come on such a long way in the 20 years I have been using them!
One of the first BM Kits I had was about the size of a small bag of sugar. You held this huge spring-loaded contraption up to your arm and it would prick you to make you bleed and deposit the blood on a sensor which would then translate the chemical result into a number on a screen. These were meant to be the ‘child friendly’ painless contraptions. That was not the case. Thankfully by the 1990s we had some pretty nifty smaller versions as well which, while being more painful, were less intimidating.
20,19,18,17,16…
My parents were assisted by the next generation of blood monitors. These no longer had to count down from 30, but 20. The BM kit came in a pouch with a little plastic screen (that looked a bit like a Tamagotchi), testing strips you would add in one end and a separate spring-loaded finger pricker. Otherwise pretty much the same idea as before: Spring, prick, blood, sensor, count down, result.
There were no internal recording functions and so you had to write down every result, how you acted because of that result, what food you ate, whether you had a headache, and any other symptoms. Only when you start to see patterns in data is it possible to tweak your regimes and prescriptions and so the key to success was record everything you can think of and then take the time to find patterns in the results. At 7, I was not finding the patterns myself, but I was amazing at using my BM kit and understanding what the result meant for the short term.
If it beeped and revealed 3.4mmol/l. That’s very bad. I’m in danger of collapsing. Drink one carton of apple juice (15g of fast acting sugar) and eat a digestive biscuit (6g of slow acting carbohydrate), sit still and relax. Test again in 15 minutes and hope it’s over 4mmol/l – if not, repeat the food eating process. That is called going hypo or as I like to call it to this day: feeling wobbly. The closest I can describe the feeling is your tummy going to jelly, your legs heavy and giving out from under you. You feel wobbly.
15,14,13,12,11…
By the time I was 11, I was becoming resentful that my friends could go and play sport without thinking about it, could eat lunch without injecting themselves and didn’t have their workbooks covered in random smears of blood from all of the blood glucose tests that I was having to do. Blood does not always clot on your fingers as quickly as you think it does!
Luckily my family and friends were very supportive. The fact that my new BM kit was even smaller and fit inside a little black handbag with my glucose tablets (for hypo emergencies) and my insulin injections (for glucose regulation) made the whole thing much better! Even more excitingly, my BM kit only counted down from 10 not 20 now.
10,9,8,7,6…
5 seconds of countdown was quite amazing by the time I was 15 but that was not the most exciting part about my next generation BM Kit. It had not only an in-built memory so I no longer had to carry around pen and logbook everywhere, but also had an onboard calculator. No more guestimating using bad mental arithmetic for how many units of insulin I needed to take after every blood glucose result or gram of carbohydrate I ate.
This was the first major turning point in my lifetime for blood glucose measuring technology. The Accu-check Aviva Expert.
Many people think that type 1 diabetes is pretty straight forward to manage, and on the face of it I might agree. If you eat sugar, you take insulin. If you have too much insulin, you take sugar – finding the balance is the key. Sort of.
Insulin is a hormone and diabetes a continually changing hormone imbalance. Anyone who has gone through puberty, pregnancy, menopause or just a bad day knows that hormones are unpredictable and make you feel and act erratically. So does diabetes. There is predictability, but everything has to be taken into account, not just the obvious food, insulin, blood glucose level and exercise.
This is where the Aviva Expert made my life so much easier and gave me more freedom to be a teenager. Working with my hospital team we worked out my personal ratios for insulin dosage. Annoyingly humans are rather individual and so each diabetic’s ratios are unique. We experimented and found out I needed 1unit of insulin for every 7grams of carbohydrate eaten at breakfast, 1unit to 8g at lunch and 1unit to 9g at dinner. If my blood glucose was higher than the desired 6mmol/l then to bring it down I needed 1unit per 3mmol/l reduction and for me my insulin stayed working in my system for 4 hours before waring off.
Now my BM Kit could do it all. Just add a drop of blood, count down from 5 and bam 10.6mmol/l flashes up on the screen. Input that I am about to eat a cheese sandwich (30g of carbohydrate) click enter and it does all that calculation for you and says you need to take 5units.
5,4,3,2,1…
My last year of school was full of 18-year-old stresses about friends, university applications and A levels. It was made immeasurably better though by the Freestyle Libre.
Continuous glucose monitors had been around for a while. They were clunky things - large plastic devices with a needle in it that you could only wear continuously for 3 days in a row and had to be secured in place with a large wound dressing plaster. Needless to say I always got it caught on my trousers when getting changed yanking it off painfully. I was not a fan.
The Freestyle is different though. The needle isn’t a needle, it’s more like a thin hair like tube. The sensor is a small disk as big as a 2p coin that sits in your arm for 2 weeks. In 2015 you still had a BM Kit with inbuilt calculator, but no blood was needed. You would hover it over the sensor and it would beep, revealing your result. How? The Freestyle used new technology. Instead of testing your blood, the thin hair needle sat embedded just under the skin in the subdermal liquid. Pair that with an NFC tag and the data could be sent straight to the BM kit.
At first the results weren’t nearly as accurate as traditional BM kits, but by 2018 not only was this accurate, but it was also available as an app on your phone! Even better it was finally funded on the NHS saving me over £1000 per year.
No more blood. No more bulky equipment. No more countdown.
Today I just wave my mobile near me and beep - there you go. The app shows you the results on a graph and even tracks the patterns for the last 90 days’ worth of scans, predicting future trends. Sometimes I feel like I have been given a gift of foresight.
And for those busy days, the Freestyle Libre 2 has got me. It will send me a phone notification saying ‘high glucose’ or ‘low glucose’ prompting me to act fast. It can do this because it now continually beams the results via Bluetooth.
That is amazing.
0.
I get my glucose results straight to my phone produced there wirelessly without me asking for them in 0 seconds.
BM Kits have improved by 30 seconds in 20 years. I wonder what the next 20 hold.
Written by Charlotte Ward
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