A couple of weeks ago, Dario got in touch and asked me if I'd be interested in reviewing their new Smart Meter. It's a device that effectively turns your smart phone into a blood glucose tester.
Now if you're anything like me, you rarely go anywhere without your phone and BG testing kit so the idea of being able to combine the two (to a large extent) sounds appealing. Plus I think we're all allowed to get a little excited about new diabetes tech right? It's one of the few perks of putting up with Type 1 in my opinion.
So just over a week ago, I got my hands on the kit and here's how I think it performs...
The first thing to say is that it comes very well presented, as you can see below.
|Dario Smart Meter box|
I may have been a bit heavy handed opening the box, but I have a tendency to be like a kid at Christmas sometimes.
|I think the meter is supposed to be in the orange section below - my bad|
|Test strips. The box contains 2 x 25 strip cartridges|
The meter itself feels chunky, though I mean that in a good way. It feels like it can stand up to being carried around in your pocket or bag without falling apart. Mine has been carted pretty much everywhere with me over the last 10 days, and apart from being covered in fingerprints, it still looks brand new.
|Out of the box|
The device is split into 3 main components. The orange section to the left houses the lancet. You pull back on the black slider to prime it, then hit the orange button on top to inflict the pain that we're all familiar with. The orange cap is secure without being too difficult to remove and there's a slider inside to allow you to vary the needle depth as is common to every lancet device I've ever seen. I left mine on the default lowest setting and it's performed well even on my hardened fingertips.
The white section to the right houses a test strip cartridge. Slotting the cartridges in is pretty straight forward and each one contains 25 strips. It can be a little fiddly to get an individual strip out at first but once you've used a few it does get easier.
|Meter with the cartridge cap removed|
The final section is underneath and this is where the actual meter is hidden. It's accessed by moving the orange slider. The meter appears with a satisfying click and is easily removed.
|As if by magic, the meter appears!|
This surprisingly small component attaches to your phones via the headphone port - pretty nifty so far!
|The Smart Meter device|
At this point I should apologise for the rest of the photos as it becomes somewhat difficult to take a picture of your smartphone with your smartphone...
|All put together|
Now the only other thing you need to get going is the Dario app. You can download it from the App Store for iPhones and it's available on Google Play for Android devices. There's a QR code included in the box that you can scan to get a link to the app directly.
The app is free (as you might expect) but it's worth calling out at this point that one of the terms and conditions grants Dario the right to use your (anonymised) BG data for commercial purposes as well as for the usual things about improving the product. That's personally not a huge deal for me, but I know a lot of other people differ from me so it's worth adding this in here.
The app walks you through what you need to do to get a result. Once you've clicked the meter in, it prompts you to add a test strip, and then for a drop of blood (though I suspect many of us are way too familiar with the process already!) You can see the app calculating the result which is pleasing - I find it reassuring to be able to see it working.
When you get a result, you get the option to add any additional info to the reading (carbs, insulin, activity) before you save it. It also date/time stamps the info and there's location tagging if you have this switched on on your phone. The results are colour-coded for at-a-glance reassurance (though those with red/green colour blindness may not benefit from this). It's worth noting at this point that I didn't use those features so I can't comment on them, though I think if you keep track of that information in general, this is a useful addition.
|Add carbs, insulin doses, activity or even tags|
So how accurate is it? Well Dario say it's compliant with the upcoming rules that all meters will have to adhere to from May 2016. You can read a copy of that report in this link (opens in new tab/window). I compare it to my own Bayer Contour Next a few times to get some sense of what it was doing. I think the key thing with any meter is to feel like you trust it and that when you're acting on the info (treating a hypo or correcting a higher reading), you're doing so in confidence. (again, apologies for the dodgy quality - real world examples and all that)...
|Dario 4.1, Bayer 4.4|
|Dario 3.5, Bayer 3.7|
|Dario 3.5, Bayer 4.0|
Overall I was pretty happy with how it performed and it was close enough to let me feel comfortable without having to constantly check on my regular meter. I was happy to go out for the day and leave my Bayer behind and felt that I knew whatever I saw would be a fair reflection.
Two other features of the app are that it easily gives you an at a glance view of your recent history and the standard deviation of those results.
It also shows hypos and hypers so you can get an indication if the average is skewed by a lot of high or low readings. I know other meters/software offer this too (my Bayer shows number in range, above and below after a few clicks), but I do like that it's all available immediately.
The last feature I wanted to mention is the estimated HbA1c reading:
You can see here from 30 measurements over the time I'd had the device, it estimated my HbA1c as 6% (which I'd be pleased with if it was true!) I'm not sure how accurate that is but I like the dashboard feature so I can see how I've been doing overall. I'm not sure if you can edit the "ranges" as I think it's reasonable that these may need to be personalised for individual targets. There may be more infor on how to do that, but it wasn't immediately apparent to me after playing about in the menus for a little bit. I'm sure someone will be able to tell me how that's done.
So... how does it fair in the real world?
Overall, I think it has a lot going for it. It's definitely portable, and fits easily in my pocket alongside my phone and my pump. I'm happy that it's accurate and I think the information presented in the dashboards in the app is really helpful. You can use the Dario app without the meter and if you're interested in having that information at your fingertips, you might want to get the app anyway. I think the design is pretty ingenious, and fitting a meter, lancet and test strips into something relatively small (about the size of the Bayer meter itself) is a feat of engineering.
On the other hand, only having 25 strips at a time may put people off. I'm used to carrying 50 and I know roughly how long they last me. It'd be an adjustment to carry half as many and I'd possibly worry about running out when I wasn't expecting it. I'd be interested to see how the lancet part of the device stands up to prolonged use. At the moment it does very well but I'd be concerned that the mechanism could end up being compromised by lint and general bits and pieces that are in people's pockets.
Whilst I also definitely do love the portability factor of it all, I do also wonder about how well people may be able to 'construct' it in the midst of a hypo. It's not overly fiddly by any means, but compare having to get the constituent pieces, unlock you phone and get a reading to using a conventional meter then it's fair to say it does take longer and is a bit more involved.
Finally, from a purely personal point of view, in the testing case with my Bayer meter, I carry around a spare pump battery, some paracetamol and I use the spare pouch to bin the used test strips. Adjusting that kind of behaviour for me has been interesting, and I've ended up with used strips in my pocket on more than one occasion. I also don't believe it links to Diasend in the same way my existing meter does.
So - would I have one full time? I think I could be persuaded but I'd want to run it alongside my existing Bayer device. The Dario doesn't talk to my insulin pump and on more than one occasion I tried to use the Bolus Wizard and found I had to enter the info manually. You can't test if you have headphones in (I spend a lot of time on conference calls using headphones) so there's that practicality to consider too.
But I do really like the fact that it's portable and a little more discrete than my existing meter. I think having the choice when I go out to slip something in my pocket, or bring the bigger kit in a bag (or my wife's bag...) would be good. I've really enjoyed having it around and when you consider the whole package is pretty small, and the info from the app is really useful in my opinion. I don't think it could replace what I use today, but I think it does an excellent job of complimenting it, and makes living with diabetes a bit easier which is certainly no bad thing in my opinion.
If you're interested in finding out more about the Dario Smart Meter, you can head over to the Dario website where you can also see if your device is supported. This link is for the Dario shop if you're interested in buying one for yourself. Check with your diabetes team/GP/local CCG to see if any of it is available on prescription in your area first though. The meter is £19.95 (inc 25 strips) and then it's £14.95 for 50 strips after that. If you're self funding, it could start to add up so do take that into account.