Medisense Optium Blood Glucose Monitoring System: A Review

A few years ago, glucometers began a competition for requiring smaller and smaller samples of blood to measure glucose levels. The advantages of this are obvious. Not only does a small sample require less of a wound to produce, it is also easier to obtain this sample from places other than the standard fingertip usually required by most measuring systems. The disadvantage of this trend may be somewhat less obvious. As any scientist knows, the smaller the sample obtained, the less accurate the conclusion that can be drawn. Unfortunately, blood glucose measuring systems appear to be no exception to that principle.

I have an intense personal, as well as some professional, interest in glucometers. In addition to being diabetic myself, I have a son-in-law and his daughter (my granddaughter) who are diabetic. My granddaughter is seven years old and a very fragile diabetic. Her insulin is carefully titrated (via a pump) against the measured glucose and this measurement had better be accurate. I have tested and calibrated many meters. I have found a frightening level of variability and inaccuracy in these devices. The manufacturers usually publish accuracy data. I have never found these data to be particularly accurate or in accord with my own measurements. Sometimes they are dismayingly inaccurate. The testing procedures that the manufacturers use to obtain the data that they publish are rigidly controlled in the manner that the sample is taken. This reduces the variability of the measurement, considerably, but it does not reflect the manner in which most people take their own measurements. It is far more important then most diabetics realize to use proper technique for obtaining the measurement. Unfortunately, this is not always enough.

I obtained a MediSense Optium "Blood Glucose Monitoring System" made by a subsidiary of Abbott Laboratories. I used a known solution and various blood samples (calibrated by laboratory measure when possible) to test the accuracy of this meter. Primarily, I tested it against the readings of a meter that I know to be highly accurate. The "OneTouch UltraSmart by Lifescan (definitely not to be confused with the OneTouch Ultra, see previous reviews). The Optium flunked.

My Optium came with a small, handy, nylon case (about 15 X 11 X 2cm) that held the meter, the lancet device, a supply of lancets, and a supply of measuring strips. The case maintains it's slim measurements because the packaging of the test strips allows for this. They come in perforated, connected strips, which can be accommodated, five to the strip, in the outside pocket of the case. I put six such strips (30 test strips) in the velcroed pocket and there was room to spare to more than double that with ease. It also has a zippered pocket on the other side and two additional compartments within for whatever you wish to put in them, The meter and the lancet are fastened by straps within the case. I like the case. It is small, handy and accommodates everything you might need for two week vacation trips.

The meter itself, however, is somewhat bulky next to today's smallest meters, being roughly 11 ½ X 7 ½ X 3 cm., not much larger than the UltraSmart, but noticeably so. It has a backlit screen, roughly 4 ½ X 3 cm., that is easy to read. It has one button that controls all functions below the screen. This is touted as a handy feature but, frankly, I prefer at least two buttons that do different things. Once the blood is in the strip, it has a fast countdown to the reading. The manual claims five seconds but that's because it doesn't count the first two seconds before the number five is on the screen. Still, it's fast enough. It is powered by two AAA batteries, which are easy to replace. It has a useful manual in English and Spanish.

The measuring strip is inserted into a slot on top of the meter and automatically calibrates the meter for that particular strip, a handy feature if the meter were reliable enough for it to matter. Now, the claim to fame of this device. Theoretically, it only requires a sample of about six tenths of a microliter in order to measure the glucose. Why theoretically? Well, it only takes this really small sample (there is a meter on the market that requires even less) in the strip but you can't, of course, provide exactly this amount for the strip to slurp up (capillary action) without risking very poor technique that will affect the reading. You need a small drop. OK, that's still not much and, indeed, you can get it from sites other than the fingertip, the advantage of which is a little less pain, but this actually reduces the accuracy even more.

I tested this meter extensively. I tested it with impeccable technique, reasonably careful technique, and terrible technique. Although it should display an error message if your sampling is bad, it doesn't always do this and I actually got readings from 140 mg./dL to over 330 mg./dL ON THE SAME SAMPLE by simply pushing the strip against the skin, as you would have to do if the drop was very small. This is ridiculously unacceptable. It's, also, not likely to happen in normal use for two reasons. Anyone who gets an unusual reading should ALWAYS test again and it took really bad technique to evoke a reading that far out. OK, now what happens with reasonably proper use? Fortunately, it performed much better, but still not well. It regularly varied by as much as 20 mg./dL on the same sample, and, when consecutive samples were used, it varied more, probably due to real fluctuations in the glucose levels of samples that small, which will vary some from different sites and different amounts of total sample. Moreover, there was a continuous bias toward overestimating the glucose level by nearly 15%.

Meters are, in general, more inaccurate than people realize and this one was only slightly worse than most and actually better than at least one that I have tested (see review of the Ultra). Is this performance good enough for most purposes? Maybe; for some type II, non-insulin dependent diabetics; it could be used to check extreme conditions, particularly if the user correlated the readings with how he or she feels. This will work if the readings are very low, because the individual is usually sensitive to internal changes when hypoglycemic. Most type II diabetics, unless they are on insulin, don't usually have trouble with low levels, though. Still, in a pinch, it's better than no meter. If I didn't have more meters than fingers, I would probably carry this on short trips for fear of losing my UltraSmart. BUT I WOULD NEVER RELY ON IT FOR INSULIN DECISIONS ON MY GRANDDAUGHTER.