BD vs Freestyle and CGMS

[someone]

I just got 3 Freestyle meters, and am feeling that they are not living up to their claimed accuracy. I have been closely comparing the Freestyle Flash with my old BD Logic, and every once and a while the Freestyle will be way different than the BD, yet sometimes they will be exactly the same. For example, tonight, I tested at 11:20 with both meters. The result with the Freestyle was 111 and the BD said 113. No problem here. 20 minutes later, I come to test. Freestyle says 144, BD says 123. I go to wash my hands, just in case, then once again test using the Freestyle... 144. Is it even possible that I went up that quickly considering I had not taken insulin or eaten for 3 hours?

Now, people are probably going to tell me that meters are not always going to be perfect. The issue arises when it comes to the CGMS. Do I calibrate at 123 or 144?

Ever since I have been using the Freestyle readings to calibrate the CGMS, it has been WAY off. As long as I calibrate with the BD, everything works great. I feel that the results from the BD are reasonable, while the Flash seems off some of the time.

I am dumbfounded and frustrated by the situation. Anyone have any suggestions? The reason I switched in the first place was because the Logics aren't made anymore.

[owlyn]

What you have observed is 100% normal and okay. Meters are only accurate to within 20%, so a 20% variation in readings at a given instant are expected. Then add in that you are not a machine where everything is equal and perfect throughout your system. I mean, there is no mixmaster whipping up your blood (at least there better not be!) so that it is all homogenized and every drop of blood contains the exact same amount of glucose and everything else that's in there. So, basically, relax, everything is fine. In terms of calibrating, it probably doesn't matter considering the above. Just test once and use that number. Best bet is to check with the manufacturer of you CBGM device. Bet they say the same thing.

[Dewey]

'Someone', I actually asked my endo to go ahead and write the prescription to include BD strips. BD has been bought by Sanvita, so their strips & meters are still being sold.

I stated in the letter to my endo, that if BD is the preferred meter for the CGMS system, then I'd like to use it to do my calibrations and all.

[someone]

I knew someone would come up with a post like that. For the most part, the blood in all of your fingers should be close to the same. The samples I have been using are are from the same fingerstick, which eliminates that variable.

I have reached the conclusion that the Freestyle just isn't accurate. Switched back to my BD today, and my CGMS is now within 5 mg/dL every time I test. At least I got a good deal on the meters I bought. One was free and the other 2 were $17 each.

I think next I will be trying out the precision, and if that doesn't work I will try aviva.

'Someone', I actually asked my endo to go ahead and write the prescription to include BD strips. BD has been bought by Sanvita, so their strips & meters are still being sold.

I stated in the letter to my endo, that if BD is the preferred meter for the CGMS system, then I'd like to use it to do my calibrations and all.

I know the strips are going to be sold, but what about the meters? I have not seen it in a single store. Knowing that the meter itself cannot be replaced makes me feel uncomfortable using it.

[owlyn]

I am happy that all of your fingers have the same amount of BG. That is NOT true for everyone. Read the patient care literature that comes wth the strips. The 20% variation will be mentioned in there.

[JediSkipdogg]

My question is how in the world do you know the Freestyle is off and not the BD?

BD has a history of bad meters which is one reason I'd say 75% of MM pumpers don't use the BD meter with the pump. They are either dead on, or dead off.

Personally, if you got two results on the same meter within the same reading that's what I would use to calibrate.

You mention the Freestyle being off of the CGMS. Keep in mind, you need to use the same meter to calibrate all the time. The CGMS will adjust to that meter. For example, if your body is truely running 200 and your meter says 100, then all of the results are going to be 100 off. Therefore, technically, if you run 100, your CGMS would say 0 and be alarming a storm at you even though you are perfectly fine.

[NoelD]

The BD meter I got with my 722 was so badly off an erratic, I threw the strips out and only use the meter for carelink.........

[someone]

My question is how in the world do you know the Freestyle is off and not the BD?

First of all, I get crazy readings that are not even reasonable with the Flash. Second, I tried using the Flash to calibrate my CGMS for a day (right after I inserted the sensor), and for that day, everytime I test with the Flash, it was not even close to what the Guardian said. Whereas when I use the BD to calibrate it, whenever I test, I am usually within 5 of what the Guardian says. I can see where this might be hard to see if you are not using a CGMS, but with the CGMS it is obvious that the Freestyle has issues.

Anyways, I just thought I would share my experience with the Freestyle. Anyone interested in getting a Freestyle might want to think twice before switching.

[Dewey]

I know the strips are going to be sold, but what about the meters? I have not seen it in a single store. Knowing that the meter itself cannot be replaced makes me feel uncomfortable using it.
Actually, found a BD meter in Wal-Mart more recently. I also noticed that MiniMed still sells their Logic Link meters. When I used my Link in the past, I did get some E-3 errors & had other issues, but it was at a time when the strips were problematic (& were actually recalled - that was in 2003). In more recent times, when I had received a couple of free BD meters via mail, I decided to do some comparisons, and found readings to be pretty darn close to others (i.e. UltraSmart, even to Freestyle Flash, etc.).

One thing I know for sure, and that's that NO meter is 100% accurate. I've had my Flash read 100 points off from what my bg actually was (& felt). If you're unsure and don't trust your meter, or if it reads far different than how you feel, the best way to determine your bg is to check again (either using the same or another meter), or perhaps go by the cgms.

[someone]

None of the stores have the BD Logic on their websites. The ones you saw must have just been ones that were never sold. I don't think they are manufactured anymore.

I cannot believe abbott has the guts to put this on their site. Clinical Study from the Albany College of Pharmacy and The Endocrine Group, LLP, Albany, NY (http://www.abbottdiabetescare.com/content/en_US/20.10.10:10/general_content/General_Content_0000231.htm)

[Funnygrl]

Why can't you believe abbott would put that on their site?

[JediSkipdogg]

None of the stores have the BD Logic on their websites. The ones you saw must have just been ones that were never sold. I don't think they are manufactured anymore.

I cannot believe abbott has the guts to put this on their site. Clinical Study from the Albany College of Pharmacy and The Endocrine Group, LLP, Albany, NY (http://www.abbottdiabetescare.com/content/en_US/20.10.10:10/general_content/General_Content_0000231.htm)

There are at least 100 studies that I know conducted showing accuracy of BG meters and it has ALWAYS come down to the Flash and the One Touch Ultra line being the most accurate.

Maybe you have a bad Flash meter. Try testing it with some Flash control solution.

[someone]

Actually I got 3 of them. I haven't really paid attention to which meter or strip vial I am using when I get inaccurate readings though.

[JediSkipdogg]

Are you also making sure that the meter is coded for the right strips. Miscoding can produce huge errors and reproduce those exact errors over and over.

[someone]

No, I coded it correctly.

[Keezheekoni]

My Flash has always been within 20 points of my One Touch UltraSmart. Usually it's 20 points over when I'm high, and 20 under when I'm low. It's dead on accurate for 90-140. I use the "Flash" that's attached to my pump almost exclusively now.

I don't know anything about CGMS though, I don't feel like I need one, so I haven't even tested one yet.

[someone]

Hmm.. I noticed that pattern as well in comparison with the BD. I completely freaked out when the flash read 49. This becomes a huge problem though when you have to calibrate the CGMS. I noticed that if I calibrate the CGMS with the freestyle at 180 for example, as soon as the CGMS reads a 10 mg/dl drop, the flash reads a 40 mg/dl drop.

[nneighbour]

To test the differential: (x-y)/y * 100
x = higher number
y = lower number
That will give you the percentage difference between two results.

The problem is when the meter is accurate with itself but not against other meters. OneTouch meters tend to be .5-1 mmol/L lower than Freestyle and iTest. I have all three and use the OneTouch because the results are lower, but I don't know which is the real accurate results. Does anyone know how to test this without a lab test?

[JediSkipdogg]

But I don't know which is the real accurate results. Does anyone know how to test this without a lab test?

Not possible since you don't have a zero factor. You would be using the lab test as the baseline and then the meter readings would all compare back to that. I'm sure though there are ways to get ahold of home lab tests or just simply get a Hemocue (HemoCue USA - Products - Glucose (http://www.hemocue.com/index.php?page=2005).) The Hemocue is the worlds most accurate and precise BG meter. Of course the device is $800, requires 5 uL of blood (5 times the Ultra line and 16 times the Flash) and strips are $248 for a box of 200 not covered by most insurance carriers.

Some here use the idea of how they feel compared to what the meter says. That works to an extent but is still not foolproof itself. The reason being is that the body doesn't know what norm is either unless you happen to have a 5% A1C with no standard deviation. Then when you do go low or high you will definitely feel it.

[JasonJayhawk]

This article was from this month's Diabetes Technology & Therapeutics journal.

Here's a paper on the difference between BD and Freestyle meters:

Mary Ann Liebert, Inc. - Cookie absent (http://www.liebertonline.com/doi/pdfplus/10.1089/dia.2006.0005?cookieSet=1)

I meant to find the thread where the accuracy of the BD meter was discussed, but couldn't find it.

The abstract says that the BD is not as accurate as the Freestyle.

[Dewey]

Some here use the idea of how they feel compared to what the meter says. That works to an extent but is still not foolproof itself. The reason being is that the body doesn't know what norm is either unless you happen to have a 5% A1C with no standard deviation. Then when you do go low or high you will definitely feel it.
I agree here Jedi. Sometimes I don't feel right about being low, but more than one meter will indicate that I am. That said, for the most part, I can usually feel it when I'm "off" (either high or low).

The abstract says that the BD is not as accurate as the Freestyle.
Perhaps not, but the truth remains that NO meter is 100% accurate all of the time....I've had my Flash read 100 points off from my UltraSmart. I don't believe for one second that any one specific meter can claim to be most accurate, when they ALL deviate and have a 20% margain of error. As with everything else, it's All about personal preference.

Hmm.. I noticed that pattern as well in comparison with the BD. I completely freaked out when the flash read 49. This becomes a huge problem though when you have to calibrate the CGMS. I noticed that if I calibrate the CGMS with the freestyle at 180 for example, as soon as the CGMS reads a 10 mg/dl drop, the flash reads a 40 mg/dl drop.
'Someone,' my thoughts on this are that you need to go with what you feel most comfortable using. Just as with pumps, people will likely have their favorite meters that they swear by....it doesn't mean that the meter(s) they choose will be the one to best suit your needs. I like the Flash, UltraSmart, Reli-On and many other meters....do I think any one of them are 100% accurate? NO. So, as I said, go with what suits your needs best.