For Accuracy's Sake

The night hour was late. I suspect it must have been bedtime.

Earlier that night, I had eaten an easy carb-counted meal and dosed appropriately for it. That followed a Blood Glucose of 120 mg/dL. Certainly, a bedtime BG in the mid-100s wasn't an unreasonable expectation.

A 457 mg/dL flashed across the screen of my One Touch UltraLink.

"What the...?!?!?!"

I backtracked, not believing it.

All food calculations had been right, enough time had passed, no extra stress, no tea or coffee, etc...

My mind flashed to the recent debate about Blood Glucose Meter Accuracy and the existing error margin rate of 20%+/-, and how "patient error" is so often blamed for the inaccurate results rather than some device inadequacy. This must be a more inaccurate reading, I concluded.

Convinced, I became determined to get an accurate reading. Enough blood. Correct coding from test strips. Hands washed and dry.

Then, another thought came to my mind: What if "higher" blood remnants are clinging to the used-lancet in my finger poker? Hmm. When is the last time I really changed that little finger poker? Don't know. Maybe.... Hmm.

Changing the lancet, all the stars were aligned for a more accurate reading not tainted by any spot of "patient error." Finger pricked. Blood puddles on fingertip. Soakes into strip. Five... Four....Three...Two.... AND: 452.

Well. Crap. Fine.

Got over the frustration and corrected, then went to bed to get some sleep for the next workday.

But over the coming days, my mind couldn't get past the whole Lancet Changing issue. So many of us in the Diabetes Community reflect on the point that we rarely change these little lancets. Not nearly as much as we should, with every finger stick as the FDA recommends. Some of has habits of doing it once a week, or every time we change a vial of strips, or once a month, or... You get the point.

Ellen (@CureT1Diabetes) started a forum discussion over at Children With Diabetes directly on point, and someone rhetorically asked about members ever going through a full box of lancets. I started wondering that myself. Know that I have, but couldn't begin to say how long it took or when the last time that happened. Another realization: in my 26 years of living with Type 1, I doubt I've gone through 26 boxes of lancets. Now that makes you think.

Of course, Bennet made the great comment: "Remember, when you change your lancet, don't forget to change the battery in the smoke detector." Awesome.

More seriously, though: Patients may call it slacking, or not that important. But others, like those working at BG Meter Companies, this may be what they describe as "patient error." Basically, results can be off because of any number of things we do. This is one of them.

In March, I wrote about the Importance of Accuracy from a patient's perspective. Here's a step into what those at the recent FDA meeting described as the "patient error," to try and appreciate that aspect. Especially as the April 20, 2010 public comment deadline draws near. Go to the Regulations.gov page on Blood Glucose Meter Accuracy, which can be found by the Docket ID "FDA-2009-N-0604.” Questions about posted comments can be directed to the Dockets Management Public Room at (301) 827-6860.

Maybe we should pay attention. It's tough, but there's a reason.

We all want accuracy when basing our lives on these numbers. And, while we have much way to go as it relates to improving the meters themselves and pushing for better standards, we PWD have our own improvements to make. We, too, can do better.