EFFECTIVENESS OF GLUCOSE MONITORING SYSTEMS MODIFIED FOR THE VISUALLY-IMPAIRED

OBJECTIVE - To compare three glucose meters modified for use by indivi duals with diabetes and visual impairment regarding accuracy, precisio n, and clinical reliability. RESEARCH DESIGN AND METHODS - Ten subject s with diabetes and visual impairment performed self-monitoring of blo od glucose using each of the three commercially available blood glucos e meters modified for visually impaired users (the AccuChek Freedom [B oehringer Mannheim, Indianapolis, IN), the Diascan SVM [Home Diagnosti cs, Eatontown, NJ], and the One Touch [Lifescan, Milpitas, CA]). The m eters were independently evaluated by a laboratory technologist for pr ecision and accuracy determinations. RESULTS- Only two meters were acc eptable with regard to laboratory precision (coefficient of variation < 10%)-the Accuchek and the One Touch. The Accuchek and the One Touch did not differ significantly with regard to laboratory estimates of ac curacy. A great discrepancy of the clinical reliability results was ob served between these two meters. The Accuchek maintained a high degree of reliability (y = 0.99X + 0.44, r = 0.97, P = 0.001). The visually impaired subjects were unable to perform reliable testing using the On e Touch system because of a lack of appropriate tactile landmarks and auditory signals. CONCLUSIONS - In addition to laboratory assessments of glucose meters, monitoring systems designed for the visually impair ed must include adequate tactile and audible feedback features to allo w for the acquisition and placement of appropriate blood samples.