Dr Kenneth Robertson
Consultant Paediatrician, NHS Greater Glasgow and Clyde
The OneTouch Verio Flex® Blood Glucose Meter in a Changing Landscape
I have been a paediatric diabetes consultant for 25 years and during that time three technical revolutions have occurred:
- home blood glucose monitoring
- insulin pump therapy
- continuous glucose monitoring
While each could be considered separately, the common thread is information technology and this continues to provide new insights and approaches to supporting the care of people with diabetes.
Obviously, the sharp end of care in the developed world is concentrating upon ‘closing the loop’ but there is still a place for straightforward home blood glucose monitoring whether as a stand-alone technology or as an adjunct to continuous monitoring. This is as true for pump patients as it is for those using MDI. Despite the unarguable potential benefits, not all patients will be suitable for flash-glucose solutions and some may be actively averse to this approach. Furthermore, many will not understand how to use this beyond a ‘replacement’ for capillary testing.
While manufacturers place great weight upon ISO compliance and purchasers upon cost-per-strip, the reality is that what actually matters, beyond reliable functionality, is the value, as opposed to the cost, of the test.
This is where vendors must concentrate and LifeScan have produced a meter in the OneTouch Verio Flex® which offers more than just a result. It is true that most vendors have begun to address the problem of how to offer insights into the blood glucose result in the context of the individual patient and I have seen and used several but I especially like the way that LifeScan have implemented their solution.
I will consider the benefits from two perspectives.
The Patient Perspective
For the average paediatric patient, the meter alone provides a blood glucose reading, just like many other options available.
The benefit comes through the pattern insights offered by the OneTouch Reveal® app when data is transferred from the OneTouch Verio Flex® meter via Bluetooth®.
As always, the utility increases as more information is captured but even blood glucose results alone are analysed and presented in an instructive and attractive way.
Now, while I like the App, the real benefits come with regular review of the data on a tablet or computer. This requires the effort of logging in to the OneTouch Reveal® web app but the reward is more real-estate and much clearer pattern viewing. Admittedly, this requires a motivated individual but I always recommend this extra step.
I am especially impressed with the insight features which can identify, for example, lows after highs caused by over-correction. This is a common error and it is displayed beautifully with a yellow ‘rubber band’ around the pairs of numbers. If there is then an over-treatment of the hypo the bands extend to a ‘V’ shape.
Another excellent, and incredibly useful feature is the ability to look at individual days such as the last three months of Mondays, together. Many people have a regular activity such as football or swimming that results in a pattern only evident when all the appropriate days are analysed together.
The Professional Perspective
Diabetes care is focused heavily upon supporting patients while they go about their lives far from hospital. This support is predicated upon instilling an understanding of the factors influencing blood glucose and the appropriate manipulation of insulin whether acutely or in the longer term. Traditionally, joint scrutiny of results face-to-face or via telephone has been the norm but increasingly, this model is facilitated by data uploads to bespoke software or commonly to an aggregate engine such as Diasend®.
This reduces confusion and saves time but the next iteration of improvement is real-time connectivity which can be invaluable in specific circumstances.
The OneTouch Verio Flex® meter combined with OneTouch Reveal® supports this provided the patient syncs after each reading and I have found this exceedingly useful in several situations. Being able to access an identified cohort of patients from a single login is essential.
A very young child diagnosed the day before Christmas Eve was able to go home and I could monitor her progress on a tablet. This had the distinct advantage that the twice daily phone calls with her parents were very short and focused.
A teenager was having problems with low blood glucose results and I was able to follow her results in near real-time and to intervene before she had a severe hypo. This would be supported by the feature of the web app for HCPs.
This one-to-one approach is, of course, generally inappropriate but I can envisage other circumstances where it would be extremely useful - e.g. support for a patient who has just begun a new insulin regimen or a woman with gestational diabetes unused to insulin.
The irony of many recent developments in diabetes is that clinical staff (and patients) are bombarded with a tsunami of data which can engender, rather than relieve, anxiety. We are beginning to see tools emerge that can help with this. The ease of use of OneTouch Verio Flex® meter and pattern recognition feature of OneTouch Reveal® platform is excellent.
Lead consultants of services are increasingly being expected to function like the heads of small businesses and currently have depressingly few tools that provide an aggregate functionality to give an overview of their ‘customer base’. I think it is refreshing that companies like LifeScan recognise this and are working to develop these.
Dr Kenneth Robertson, Consultant Paediatrician, NHS Greater Glasgow and Clyde. 18 June 2018
Kenneth Robertson is the Clinical Lead for Children's Diabetes Service in Glasgow, and is driving a collaboration with LifeScan to interface the OneTouch Reveal App with the NHS system in Scotland.
You must be at least 17 years of age to download the OneTouch Reveal® mobile app from the app store and at least 16 years old to download the OneTouch reveal® mobile app from Google Play.
Apple, the Apple logo, iphone, iPad and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries. App store is a service mark of Apple, Inc.
Android, Google Play and google Play logo are trademarks of Google Inc.
Diasend® - The trademarks and brand name displayed are the property of application owner or 3rd party owners.