Is the Livongo Blood Sugar Meter Accurate?

It occurred to me the other day that even though I wrote a couple of blog posts and even made a video about it, I still haven’t addressed one major component of my new Livongo blood sugar meter: its accuracy.

How does it stack up to my Verio meter? More importantly, do I think it’s accurate?

Well…the answer isn’t cut-and-dry because I think it can be accurate…as long as my blood sugar isn’t above 200.

How did I arrive at this conclusion?

I conducted a little experiment.

Bear in mind here, I’m no expert in experimental design, so I established a simple setup for this. During the period of approximately two weeks, whenever I checked my blood sugar, I used the same drop of blood on test strips for two different meters: my Livongo and my Verio.

And the results were interesting, to say the least.

Whenever I was about 80-180, my results from the Livongo meter and the Verio meter were within about 10 points from one another. One instance, I was 86 on the Livongo and 92 on the Verio. Another time, I was 105 on the Verio and 113 on the Livongo. The meters never reported the exact same number at any point during my experiment, but I was happy whenever they showed similar results.

Things got dicey, though, any time I entered the hyperglycemic range.

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That 163 and 165 show how at times, the two meters were in agreement with one another…but then there’s that 231 and 262. Those are just a little too different for my liking.

It was weird and I can’t explain it, but the Livongo would report that I was anywhere from 20-50 points higher than what was on my Verio at a given point in time when my levels were 200+. This really surprised me, because I’d suspected that my Verio skewed a little higher compared to most other meters, so I never thought that the Livongo would prove me wrong about that. At times, it was truly maddening: On one occasion, the Livongo said I was 251 and my Verio said I was 204. That’s the difference of at least 1-2 units of insulin for me in order to correct that high! Even more frustratingly, because I didn’t trust the result from either machine, I checked my blood sugar again immediately and the Verio said 242, while the Livongo said 228.

WTF?!

That particular example was extremely confusing because I didn’t know which piece of technology to trust. And that’s the big thing for me: I need to know that I can depend on whichever blood sugar meter I’m using to deliver accurate results.

So again, remember that I’m no good with numbers, and that this is simply an estimation…but if I had to guess how many times the Livongo agreed with the Verio, I’d say it was no more than 7 out of 10 times. And I’m super bummed about that, because I’d genuinely hoped that I could trust my Livongo meter and use it full-time whenever I was taking a break from my CGM. Given the fact that it seems to be accurate when my blood sugar is in range, though, I suppose I could use that as motivation to work harder to prevent hyperglycemic readings…but I’m not perfect and I know that they will still happen from time to time. And I deserve a piece of technology that will accurately report them to me so I can make the best possible treatment decisions.

In theory, I still like the Livongo: It has a great design and some of its features (e.g., test strip reordering) are totally unique. But in practice? It leaves a bit to be desired.

A Full Vlog Review of my Livongo Meter

As promised, here’s my vlog showcasing my thoughts on the Livongo meter! (Yes, I know it’s 10 minutes long, but I couldn’t help going into detail and really tried to showcase all of its features. Hopefully, my rainbow nails and peppy personality keep you engaged.) Like I say in the video, be sure to ask me any questions you may have about the meter – as I use it more, I discover additional details that I will cover in a follow-up post in the future. But for now, ENJOY the video and know that all opinions are my own: I am not being compensated in any way, shape, or form for creating this video and sharing my views.

First Impressions: My New Livongo Blood Sugar Meter

I shared that my company is offering a sweet new benefit for its associates with diabetes: a free blood sugar meter with free refills on test strips and lancets as the need arises.

Great perk, right?!

Naturally, I took advantage of this offer as soon as I could, seeing as I was eager to start playing around with a new meter (I talk about the reasons why in this blog post).

While I waited for my new meter to come in the mail, I did some research on it. I was excited to learn that it would be a back-lit, full-color touchscreen. It looked sleek and modern, and I was impressed that it seemed to have a lot more features compared to my blood sugar meters of yore (I still remember having to use a giant droplet of blood and waiting an entire minute for my blood sugar results to appear on a very clunky screen…oh, the 90s). I couldn’t remember the last time I was so pumped about a new piece of diabetes equipment – my anticipation for this Livongo meter was hiiiiiiiigh.

First Impressions_ My New Livongo Blood Sugar Meter
Here she is – my new Livongo meter which I’ve dubbed Livi. Because what else would you call it?!

So when it arrived, I eagerly checked out all of its features. It is, indeed, a well-designed meter – though a bit heftier than I was expecting. Maybe I’m too used to the lightweight nature of my Verio IQ, but this Livongo meter almost feels like a chunky smartphone. It’s not as big as my OmniPod PDM, but it’s in that neighborhood.

I was more so surprised by the test strips – they looked and felt huge compared to my Verio strips! They reminded me of the test strips I used in the first few years of my diabetes diagnosis.

I admit that I didn’t have the patience to read through the instruction manual, I just jumped right into my first blood sugar check. After all, once you’ve used any one type of meter, it’s pretty easy to figure out how the rest of ’em work: insert a test strip, prick a finger, swipe blood onto the strip, and wait for results.

That’s exactly how this meter works, with one caveat. Once I inserted the test strip into the machine, I got a message that notified me the machine was “checking” the test strip. Uhh…checking for what, exactly? I’m not really sure, but the “check” took about 3 seconds before a soft-pitched beep let me know that I could put my blood onto the test strip.

So I did, but I was mildly bemused by the actual amount of blood the strip needed – it felt like it needed more than my Verio strips. I have no idea if this is truly the case, but there is distinct design difference between the strips beyond the hardiness of the Livongo strips, which are not only at least double the size of Verio strips but also feature a vertical line for the blood sample rather than a horizontal. It’s slightly trickier to get just the right amount of blood onto the strip, and I admit that I’ve wasted 2-3 test strips at a time with the Livongo machine so far because I was unsuccessful in getting enough blood on the strips.

Anyways, once I applied blood to the strip, I noticed that the machine didn’t countdown to my results – it merely informed me it was processing them. My very first check with the Livongo was high, in the 250s, and I was yet again surprised when I received an actual message along with my results.

“Your blood sugar is high. Did you know that exercising after meals can help lower blood sugar?”

(I should note that the meter knew I’d just eaten dinner because once it makes the blood sugar result available, you notify the machine whether or not this result was before/after a meal/snack, and then you let it know how you feel – you can select from a handful of pre-loaded options.)

I was taken aback by the message because, well, of course I knew that my number wasn’t great, and I’ve always known that exercising after meals can help bring blood sugar down. This meter is kind of funny, because as I continue to use it, it populates a bunch of different messages depending on my blood sugar in a given moment. Sometimes I get a “kudos”, other times I get random facts about nutrition like, “did you know that spinach is a great source of potassium?” Maybe if I was a newly diagnosed person with diabetes who didn’t know much about nutrition or ways to improve blood sugar levels, I’d find these tidbits of advice more helpful, but for someone as experienced as me they come across as both funny and judge-y.

Since receiving the meter, I’ve used it to check my blood sugar dozens of times and I’m still formulating my opinion on it in terms of its accuracy, usability, design, and overall appeal. I’ll say this for now: I’m intrigued enough by the meter and its ability to immediately send blood sugar data to a cell phone/computer via Bluetooth. It’s definitely one of the most high-tech blood sugar meters I’ve ever used and the touchscreen does make it kind of fun to play around with.

I plan on making a video to better showcase the actual experience of doing a blood sugar check with the Livongo, and I’ll have a full review available in the coming weeks. Stay tuned!

Not 1, But 2 New Blood Sugar Meters: How I Got ‘Em and Why I Need ‘Em

Unexpectedly, I just obtained two brand-new blood sugar meters.

I’ve been a fairly loyal user of my OneTouch Verio IQ meter for about a decade now – that’s a longer relationship than the one I’ve had with Dexcom or OmniPod. It’s been mostly a loving relationship: From the beginning, I was a big fan of its sleek design, back-lit screen, and overall portability/usability. It grew a little more tumultuous over the years, though, as I noticed occasional, unprompted system shutdowns and questioned the overall accuracy of the device.

So I decided it was time to explore other options.

I brought this up to my endocrinologist during my very brief appointment with her a few weeks ago, and she let me know that a new Verio meter would be available soon. She said that she would set one aside for me when she received the shipments and that I could come and pick it up whenever I was back at the clinic.

Coincidentally, my gynecologist’s office is just down the hall from my endo, so I was able to pull double duty the other day and pick up the new meter right after my annual appointment with the lady doctor!

I was super excited to have a new meter, and even happier that it would take the same strips as my old meter. But there was one problem that I discovered when I got home…

…the meter I received isn’t the fancy-schmancy one just released by OneTouch.

Not 1, But 2 New Blood Sugar Meters_ How I Got 'Em and Why I Need 'Em
My old Verio IQ (left) with my new Verio Flex (right)

Instead, it was a generation after my Verio IQ – so it’s still a new one – though it’s decidedly less impressive, technology-wise, compared to its counterpart. It’s the OneTouch Verio Flex, and it’s very compact, but lacking a charging port (it runs on a battery) and the back-light that I loved so much about my Verio IQ.

Before I could fret too much about this minor disappointment – I can’t get too upset over a meter that I didn’t have to pay for – I noticed a letter on the counter addressed to me from my company.

I opened it up and was pleased to discover that my company is partnering with Livongo to offer a free blood glucose testing kit, free lancets/strips, and free coaching to all qualified associates with diabetes.

Talk about a sick benefit, right?!

I followed the instructions enclosed with the letter and within five minutes, my information was submitted to the Livongo website and my kit was on its way to me.

I’m totally pumped about this meter and this new program that my company set up. I’ve never heard of them doing anything like this before, and it will be a huge relief to know that I won’t have to worry about ordering blood sugar testing strips (or the associated cost) any time soon. But the meter itself sounds so dang cool, too – it has a full-color touchscreen! The meter actually knows when you’re running out of test strips and will remind you to reorder them!!! I’ve never heard of anything like that before, so I’m eagerly awaiting its arrival and can’t wait to check out all the features.

The one thing you might be wondering about these two new meters is…why the heck would I need them since I already have a Dexcom G6 that monitors my blood sugars 24/7???

There are two reasons: It never hurts to have back-ups and my Dexcom isn’t always accurate.

Let’s say that tomorrow, my Dexcom transmitter fails. Suddenly, I’d be without any blood sugar readings and I’d have to rely solely on my meters for blood sugar checks. That’s why it’s incredibly important to have functioning meters at all times, because you just never know when you may have no choice but to use them.

To compound that, my Dexcom doesn’t always work the way it should. Sometimes, I receive sensor errors and it doesn’t work properly for hours. Other times, I feel symptomatic of low or high blood sugars and my Dexcom doesn’t report them, so I resort to doing a finger stick check to verify the accuracy of my Dexcom’s readings.

It’s easy to understand, then, why I think it’s crucial to have at least one spare blood sugar meter. I may have come across these two new ones suddenly and fortuitously, but I welcome their addition to my diabetes toolkit and can’t wait to “test” ’em out (and of course, blog about ’em).

 

The Expired Test Strip Experiment

Nearly every diabetes supply I own comes with an expiration date. Insulin vials, pods, ketones testing strips, and Dexcom sensor/transmitters are among the items that I’m always closely monitoring to ensure they’re still fresh and usable, but test strips? They’re basically the last thing that I worry about.

So I was curious when I recently noticed that my current test strip vial has an expiration date of 12/31/19. Would these strips still measure my blood sugar accurately, or was the New Year’s Eve expiration hard and fast?

I wanted to find out.

The Expired Test Strip Experiment
An introductory blog post to a potentially ongoing experiment.

My experiment design was rudimentary: I’d simply continue to use the 12/31/19 test strips until the vial was empty. I’d check any blood sugar results that I was unsure about against my Dexcom readings, and in cases that I deemed necessary, I’d use test strips with a far-off expiration (July 2020) to see how they matched up with the expired strips.

To my slight surprise, though it’s only been about a week since the old strips expired, it doesn’t seem to affect things much at all. They’re just as accurate as newer strips and my Dexcom.

In fact, in many cases, the old strips were only off (according to my measurements) by no more than 9 points. Not bad. I’ve had a wider spread in results between strips from the exact same vial, so the fact that the old strips were so close to new ones was interesting to me. And four days after the strips expired, I checked my blood sugar (I was 263) and used a new strip to double check that (it read 262). A single point difference is pretty impressive.

So now I know that I’m safe if I use test strips a week after they’ve expired…which is great! But now I’m sort of curious to see just how far out from the expiration date I can use them. I might hang onto this vial of test strips for a few more weeks and continue to test them against newer test strips. I might not (because really, when it comes to diabetes, there are just more important things to be worried about…and I might not want to push my luck and end up wasting strips). We’ll see what I end up doing.

I think that the more compelling questions to stem from this experiment are 1) how many other diabetes supplies are safe (up to a certain limit) to use after expiring and 2) why are supplies labeled with expiration dates if, in the grand scheme of things, they seem to function just fine after expiring? Could it just be a nasty trick played on people with diabetes by prescription drug companies…?

Those are the kinds of questions that really make me wonder.