# Microdot



## HappyHelen (Nov 26, 2011)

Hello

I recently posted on here about the difficulty I was having getting my GP to swap my prescription for blood testing sticks from optium to freestyle optium which was finally resolved a few weeks ago now. Sorry to ask but I now have another query which I hope you can help with.

Today I received a letter to say that my GP surgery has been instructed by the PCT to change all glucose meters to microdot.  Having never heard of it, I have looked at their website and as far as I can see this would mean that I cannot test ketones on the same meter as i can currently (I am 34 weeks pregnant so it isn't something I am keen to lose at this stage) and less importantly takes 10 seconds to complete a test rather than my current 5 seconds.

Is anyone else being forced to switch? I am going to call the surgery on Monday and ask that at the very least, this change is delayed until after I have the baby but I was wondering whether legally I can say that I don't wish to switch? I am hoping that they will delay until after the birth and then forget. However, (I wonder if I am being biased towards my optium xceed when in fact microdot might be better) does anyone use microdot and if so, what do you think of it? Does the meter calculate averages without connecting to a PC?

Thank you!


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## Northerner (Nov 26, 2011)

I would certainly think you have a case to keep the Optium Xceed, but it may be that you will only get the blood ketone strips for it and get the blood glucose strips for the new meter  - presumably they are switching because the new meter's strips are much cheaper. I doubt there is much you can do unless you can prove that the new meter (which I have never heard of) gives inferior and potentially dangerous readings. As it is particularly important that you should trust the readings at this stage of your pregnancy I would have thought an exception could be made to allow you sufficient strips until the birth.

Other members have mentioned similar blanket replacement of meters/strips and it can have an impact, especially as you are on insulin and subject to potential hypos. Also, the new meter won't work with any software you might be using to spot patterns and keep records etc. 

Hope you get to keep the Optium strips at least for the time being - let us know what the doctor says


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## Northerner (Nov 26, 2011)

p.s. I see they are Indian and that their website isn't even complete yet (Product Demo is 'Under Construction'  ). I'm pretty sure this is the meter other members have mentioned.


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## HappyHelen (Nov 26, 2011)

I have to say my gut feeling is that it is inferior but I can't really substantiate that. However, I will push to see if an exception can be made and I will do my best to ensure I don't have to carry 2 meters around so I can test ketones and blood sugars. If I can continue to use just one meter, I will try my best to maintain this.  

Having been more exposed than ever to the GP lately (due to the pregnancy) I am constantly amazed how short sighted they seem to be. Eg they don't want you testing too much because sticks are expensive but anyone can see how much better (and cheaper) it is to keep good control by testing and hence not need to be treated for diabetic complications and also for me at the moment, to ensure that I limit the likelihood of my diabetes affecting the baby. I could write a book about how annoyed I get about this...


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## Ellie Jones (Nov 26, 2011)

There is no legal way that they can enforce you do change meters..  As any meter listed on the BNF is available for prescription..

Different meter will be suitable for different people for various reasons, and as it's an inessential part of our diabetic tool kit so it needs to suit us not our PCT..

I couldn't get a price for the test strips off the BFN it's not listed so must assume that it's not on the list yet, unless your PCT had done it's own deal!

As to the meter it's self, errr personally I don't like it, yes you can mark your meal and input insulin used..  But only a 14 days average available that's pretty naff indeed..

So sounds like your PCT is going for the easy way, use one meter for all and they only have to buy one lot of software and train staff in using one meter and one lot of software..

Sometimes our nurses are the brightest of souls when it comes to diabetic glucose meters and/or insulin pens, I can tell you a story or two concerning district nurses and the hash they've made of using a meter or changing a cartridge in an insulin pen

Sounds as though you'll going to have to dig your heels in to get your own way though, but dropping hints such as MP, and Newspapers is likely to help if going gets tough


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## HappyHelen (Nov 26, 2011)

Thanks for your reply Ellie - it's good to know that legally I can refuse. Sorry for my ignorance but was is the BNF / BFN? I will call the surgery on Monday to talk to the practice manager and I will let you know how I get on.


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## Northerner (Nov 26, 2011)

The BNF lists all medicines etc. available on prescription on the NHS, including costs to the NHS http://bnf.org/bnf/index.htm

You can register for free  Microdot aren't on there


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## HappyHelen (Nov 26, 2011)

Thank you!


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## Robster65 (Nov 26, 2011)

I would have thought the BNF list is just for what's available on prescription, rather than what you can demand. They must be free to prescribe cheaper alternatives such as unbranded ibuprofen, etc. 

But you could argue for the xceed on grounds of familiarity and availability of strips to buy if you can't get your script in time, etc.

I can see it becoming more common until the other manufacturers are forced to lower their prices to compete. Then we'll be back to status quo.

Rob


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## Vicsetter (Nov 26, 2011)

You can find an independent test of the microdot here: www.accessdata.fda.gov
Various sites on the internet get results for microdot.  They purport to be designed by Cambridge Sensors, a UK company http://www.cs-limited.co.uk and were introduced in 2009-10.  However I found a link saying they were made in Korea.  Interesting that one of the founders of Cambridge Sensors was a found of Medisense which then became Abbott (of Freestyle fame).  The Cambridge Sensor test strips are available to anyone to supply with their own company branding.

You may find this interesting: http://www.midessex.nhs.uk/Document...Mid Essex Blood Glucose Meter Policy 2010.pdf
P.S. it says the test strips are ?1 per pot of 50 cheaper than other brands (not significant I would have thought given the limited test storage, larger sample size 600nl and long test time 10sec).

as it may be used throughout England and explains some of the rulings being handed out by PCTs.


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## Vicsetter (Nov 26, 2011)

It just gets better, found http://www.alibaba.com/product-free/110764925/MicroDot_Plus.html
NFS trade international - create your own market with microdot - wholesale suppliers in germany who claim the microdot is 100% made in Germany!

I tried a Nexus Glucorx meter (test strips are ?12 for 50) some time ago and report on it on this board.  Doing a search tonight I found that large parts of their site were up for sale.  At least with the major manufacturers you can guarantee continuity of supply.

One of the problems with these cheaper meters is that they seem to overread at higher levels so the a 'real' reading of say 7.4 could be reported at 8.4 or 9.  They seem to be fairly accurate at lower readings but for anyone on rapid insulin accuracy further up the scale needs to be as accurate as possible.


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## Robster65 (Nov 26, 2011)

Vicsetter said:


> It just gets better, found http://www.alibaba.com/product-free/110764925/MicroDot_Plus.html
> NFS trade international - create your own market with microdot - wholesale suppliers in germany who claim the microdot is 100% made in Germany!
> 
> I tried a Nexus Glucorx meter (test strips are ?12 for 50) some time ago and report on it on this board. Doing a search tonight I found that large parts of their site were up for sale. At least with the major manufacturers you can guarantee continuity of supply.
> ...


 
That's worrying innacuracy. Thanks for the info Vic, if it's ever needed in battle.

Over corrections could be a major issue.

Rob


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## HappyHelen (Nov 26, 2011)

Wow! I am so glad I asked on here - as per the other times I have asked questions on here, I always get such great information. I feel much more equipped to fight this with the GP now I have read all of your replies. Thank you all so much for taking the time to reply.


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## trophywench (Nov 26, 2011)

Well you know, your diabetes preg team should certainly help you out with this if you get rubbish from your GP.  And whatever they say at the surgery  - they always CAN over-ride PCT "bans on prescribing stuff" anyway!


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## grahams mum (Nov 27, 2011)

Very Good Informations Just In Case Something Happen On This Pct


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## HappyHelen (Dec 2, 2011)

Hello

I just wanted to let you all know what happened re the microdot.

As you suggested I spoke to the hospital team where I am going to give birth and they were horrified about the possibility of me being forced to swap to the microdot and they said I should say to the GP that it just isn't suitable for type 1's due to the fact that you cannot test for ketones on it.  

Anyway, armed with that and all of the information I got from here, I tried to speak to the doctor yesterday.  He called me back today and i was ready to make my case and before I could speak he asked if I was calling about not switching.  So I said yes that it isn't a good time because of the pregnancy but long term I didn't think it would work either and he said fine, no problems, we wont make you swap.  He explained that the PCT were trying to cut costs and were asking anyone who tests frequently to change but they accept that there will be individual exceptions and he agreed i was one.

So good news for me, in that I have been allowed to continue using the xceed meter.  I hope anyone else who is asked to change, gets the same response from their surgery.

Thanks again for all of the advice.

Helen


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## Northerner (Dec 2, 2011)

Thanks for the update Helen - good to hear you can continue with the Xceed without any arguments


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## Steff (Dec 2, 2011)

HappyHelen said:


> Hello
> 
> I just wanted to let you all know what happened re the microdot.
> 
> ...



Thank you for the update Helen and im pleased it was good news x


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## lizabetic (Dec 2, 2011)

Arg, annoys me. 
Just thinking about it... if it happens to me then i'll tell them I won't ever check and that it'll cost them more in the long run if complications etc arise!!!!! ?___?


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## HappyHelen (Dec 2, 2011)

I did think of saying that Lizabetic (I was all prepared for an argument but didn't need it in the end).  The nurse at the hospital said to me that if the GP didn't want to let me continue with the xceed, I should say that I want a pump instead! Didn't want to go down that route but as you suggest, the PCT's seem to be all about short term gains at the risk of long term complications and hence costs. Crazy!!


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## James McCann (Dec 23, 2011)

*Microdot Glucose meters*

Dear All, my name is James McCann and I am a 54 year old Cambridge trained engineer and I design the Microdot blood glucose strips at Cambridge Sensors Ltd.  I just wanted to correct some misconceptions. In fact,we are the only UK owned manufacturer of this type of equipment and our factory is in Huntingdon. You are all welcome to come and visit us by calling us and stating you are a user of the equpment. All the research, development, manufacturing is carried out in Huntingdon, Cambs by our team of 50 people. Our meters are assembled for us by a German sub-contractor. Great care is taken by all of our staff to ensure that the prodcuts are of the highest quality, Please see www.cs-limited.co.uk. for further information.

Prior to founding Cambridge Sensors I co -founded another glucose sensing company called MediSense (now part of Abbott) and led a development team that developed the first electrochemical glucose strips -which formed the basis of the Optimum products.
At the moment Microdot will only measure glucose but we are in the process of extedning the range of tests to Ketones.


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## Northerner (Dec 23, 2011)

Thanks for clarifying things James.


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## James McCann (Jan 3, 2012)

*Further comments on Microdot+*

Dear Northerner (and anyone else). You are more than welcome to visit us if you pass by Cambridge to see the strips being made (call 01480-482920). We are always appreciative of new comments/suggestions. For example, our meters automatically calculate a 14 day glucose average at the moment. Do people want 30, 60 and 90 day averaging as well? Our meters allow the user to manually input their insulin readings (number of units and type; date and time are automatically added); is this useful data to have available? Is insulin data entry useful? Many thanks for your comments. Best wishes for 2012.


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## everydayupsanddowns (Jan 3, 2012)

Late to this thread, but just to respond to James...

Yes I would say longer averages are of value. 30-60-90 day ones can give you a ready reckoner of likely HbA1c using one of several conversion formulae, and even it you don't like any of those a few dodgy days can quickly throw out a 14 day average, while longer term ones are more robust. Comparing shorter and longer averages can help to calm anxiety after a dodgy week.

One request in on-meter data management would be the availability of SD. I've only had this recently but Standard Deviation allows me to assess whether a decent average is 'faked' by a lot of highs and lows or is genuiunely a reflection of decent control.

As for whether the ability to log carbs/insulin etc are worthwhile, that can often be a question of whether the data is easy to a) input and b) extract. A good system can reduce/remove the need for separate logging/diary. But if your meter is at the 'smarter' end it can be very frustrating to have all your lovingly logged results stuck in there without an easy (and preferably freely available) way of transferring to PC/Mac to be printed out/further examined - Roche's Expert falls foul of this. The ability to export results as .csv or similar flexible format via a USB cable included in the meter box would satisfy the nerdiest of d-analysts! If nothing else it means you can at least get a print-out to take to your clinic appointments


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## ypauly (Jan 3, 2012)

James McCann said:


> Dear Northerner (and anyone else). You are more than welcome to visit us if you pass by Cambridge to see the strips being made (call 01480-482920). We are always appreciative of new comments/suggestions. For example, our meters automatically calculate a 14 day glucose average at the moment. Do people want 30, 60 and 90 day averaging as well? Our meters allow the user to manually input their insulin readings (number of units and type; date and time are automatically added); is this useful data to have available? Is insulin data entry useful? Many thanks for your comments. Best wishes for 2012.



I am so glad I popped in. My meter history is optium exeed, freedom freestyle lite and now the freedom insulinx.

I prefer the freedom products due to the small amounts of blood required but that isn't my problem
My problem is I am a driver and at some point I would like a class C on my lisence (will be hiring a nice motor home which at the moment only the wife can drive) means  I should be using a meter with a memory function of at least 90 days
http://www.dft.gov.uk/dvla/medical/Annex 3 changes to diabetes.aspx

None of the meters I use or know of will go beyond 30 days.


ETA A bus and lorry drivers should currently be using meters with 90 days memory but what meter do this? do yours?


I feel a mass cambridge meet coming on lol


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## everydayupsanddowns (Jan 3, 2012)

The Accu-Chek Expert offers 90 day averages.

Alternatively many others allow downloads/export (Contour USB being one of the easier ones) so that you could store up a few 'sets' of results, I suppose...


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## Vicsetter (Jan 3, 2012)

ypauly said:


> I am so glad I popped in. My meter history is optium exeed, freedom freestyle lite and now the freedom insulinx.
> 
> I prefer the freedom products due to the small amounts of blood required but that isn't my problem
> My problem is I am a driver and at some point I would like a class C on my lisence (will be hiring a nice motor home which at the moment only the wife can drive) means  I should be using a meter with a memory function of at least 90 days
> ...



I am sure you are misunderstanding the requirement by the DVLA.  You need to be able to recall 3 months (90 days) of readings not a 90 day average.  Your freestyle lite records 400 readings.  The Optium stores 450.  So probably neither meter will do if you take much over 4 tests per day.  The Contour USB records 2000 tests.  I use a One-Touch Ultra Easy which does over 3000 tests and does all the averages up to and including 90 days.  A 90 day average may be useful for comparison with your HBA1C but of no use for DVLA purposes.


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## Robster65 (Jan 3, 2012)

Would the DVLA not accept say a monthly download of daily BGs along with the 90 day average as a checksum to ensure no cheating ?

As per usual, beuarocrats have set a criterion without first ensuring it's possible to achieve. 

If they are made aware that they can't have the impossible, then they must accept the next best thing. Or they'll have nothing to do.

I agree on all other comments regarding meter features. The richer the data, the better.

Rob


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## ypauly (Jan 3, 2012)

Vicsetter said:


> I am sure you are misunderstanding the requirement by the DVLA.  You need to be able to recall 3 months (90 days) of readings not a 90 day average.  Your freestyle lite records 400 readings.  The Optium stores 450.  So probably neither meter will do if you take much over 4 tests per day.  The Contour USB records 2000 tests.  I use a One-Touch Ultra Easy which does over 3000 tests and does all the averages up to and including 90 days.  A 90 day average may be useful for comparison with your HBA1C but of no use for DVLA purposes.



I am not misunderstanding as I didn't say 90 day average I said 90 days of memeory. The link I posted explains what is required and the elctronically stored bit is the bit that's hard to achieve.

I think this is to prevent people just making up numbers and writing them down.

But I will be looking into the others you have posted. thanks


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## Vicsetter (Jan 3, 2012)

ypauly said:


> I am not misunderstanding as I didn't say 90 day average I said 90 days of memeory. The link I posted explains what is required and the elctronically stored bit is the bit that's hard to achieve.
> 
> I think this is to prevent people just making up numbers and writing them down.
> 
> But I will be looking into the others you have posted. thanks



Sorry,you are quite right.  Has anyone thought that as the requirement is all about driving, maybe you should keep a meter just for testing while driving, are would that not reduce your usage sufficiently?  We won't really know until someone here is interrogated by a consultant (or whoever is going to check your meter).


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## Vicsetter (Jan 3, 2012)

James McCann said:


> Dear Northerner (and anyone else). You are more than welcome to visit us if you pass by Cambridge to see the strips being made (call 01480-482920). We are always appreciative of new comments/suggestions. For example, our meters automatically calculate a 14 day glucose average at the moment. Do people want 30, 60 and 90 day averaging as well? Our meters allow the user to manually input their insulin readings (number of units and type; date and time are automatically added); is this useful data to have available? Is insulin data entry useful? Many thanks for your comments. Best wishes for 2012.



If you hadn't gathered from the comments on the message board there are two main requirements for a meter, one is the time taken for the test and the other is the sample size.  I'm afraid I would rule the microdot out for those reasons.  The meter also has a capacity of 500 tests so that could rule it out for some users as pointed out in this thread, it won't last 90 days.


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## Robster65 (Jan 3, 2012)

Vicsetter said:


> Sorry,you are quite right. Has anyone thought that as the requirement is all about driving, maybe you should keep a meter just for testing while driving, are would that not reduce your usage sufficiently? We won't really know until someone here is interrogated by a consultant (or whoever is going to check your meter).


 
I think, with the rules as they are at present, they include night times as well potential driving times, so I would imagine you'd need to show all results on the one meter. Or at least sourced from the one meter.

There's also the question of calibration. If they have specific upper or lower limits, our meters can be 10% or so out which might give a false reading outside of those parameters. Not a problem in everyday life but serious if your licence depends on it.

Rob


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## Vicsetter (Jan 3, 2012)

Robster65 said:


> I think, with the rules as they are at present, they include night times as well potential driving times, so I would imagine you'd need to show all results on the one meter. Or at least sourced from the one meter.
> 
> There's also the question of calibration. If they have specific upper or lower limits, our meters can be 10% or so out which might give a false reading outside of those parameters. Not a problem in everyday life but serious if your licence depends on it.
> 
> Rob



Car speedometers are no more accurate than 10% and we are expected to obey the speed limit!
The consultant or whoever will be aware of the limitations of our meters.  The rules since 2010 have required:The driver must show adequate control of the condition by regular blood glucose monitoring, at least twice daily and at times relevant to driving.  Can you really do this without a meter with memory function?
The new requirement however requires that you have a meter that records 3 months of tests for the consultant to view.  I can't imagine a consultant being interested in pressing a button on a meter 500 times or more to get back 3 months.


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## Robster65 (Jan 3, 2012)

Vicsetter said:


> Car speedometers are no more accurate than 10% and we are expected to obey the speed limit!
> The consultant or whoever will be aware of the limitations of our meters. The rules since 2010 have required:The driver must show adequate control of the condition by regular blood glucose monitoring, at least twice daily and at times relevant to driving. Can you really do this without a meter with memory function?
> The new requirement however requires that you have a meter that records 3 months of tests for the consultant to view. I can't imagine a consultant being interested in pressing a button on a meter 500 times or more to get back 3 months.


 

It does make you wonder who they consulted to come up with it. No working knowledge of diabetes or how diabetes care operates. Perhaps one civil servant passes his work to the next desk for checkign and then it's rubber stamped. And the world has to modify its behaviour to match their view of it. 

Rob


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## Mark T (Jan 4, 2012)

Vicsetter said:


> ...Car speedometers are no more accurate than 10% and we are expected to obey the speed limit!...


Actually it's a bit more accurate then that, since the regulation is that the displayed speed shall be between -0% and (+10% + 4km/h) of the actual speed.

However there is a comparable argument here.  Most automotive OEM's bias the speedometer so it reads 5% high (sometimes more) such that you are never unknowingly speeding.

But, I would suspect that it would not be a good idea of the meter manufacturer's all biased say 5% low to make sure even a borderline hypo was treated.


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## James McCann (Jan 4, 2012)

*Reply to comments on meter features*

Dear All, Many thanks for the comments about the averaging on Microdot meters. Our next generation meters will have much greater capacity for averaging over 14-30-60 and 90 days. 
On the issue of the memory size, Microdot currently stores the last 500 readings in the memory in the meter. The readings may be downloaded via a cable to a PC and all readings transferred can be stored on the PC for the last 12 months, so even if the reading is no longer on the Microdot meter it is still on the PC. Thus the last 500 readings are in the meter and an unlimited number, taken over the last 12 months, can be stored on the PC.

Microdot meters also allow the user to manually enter their insulin doses (unit size and type). The meter aso adds on the date and time. Is this a useful function or one that should be dropped? This data can also be viewed on hte PC after downloading.

If any of you wish to try out the Microdot meter and the PC software you can do so for free by calling 01480-482920


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## Vicsetter (Jan 4, 2012)

Mark T said:


> Actually it's a bit more accurate then that, since the regulation is that the displayed speed shall be between -0% and (+10% + 4km/h) of the actual speed.
> 
> However there is a comparable argument here.  Most automotive OEM's bias the speedometer so it reads 5% high (sometimes more) such that you are never unknowingly speeding.
> 
> But, I would suspect that it would not be a good idea of the meter manufacturer's all biased say 5% low to make sure even a borderline hypo was treated.


1. You are assuming that the car has correctly inflated tyres. It used to be said that the police allowed 10% + 3 mph before prosecuting because of speedo inaccuracy.
2. bg meters usually have spread of inaccuracy depending on the reading, of the ones I've looked at they are more accurate at low readings, which is what you need.


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## FM001 (Jan 4, 2012)

James McCann said:


> Microdot meters also allow the user to manually enter their insulin doses (unit size and type). The meter aso adds on the date and time. Is this a useful function or one that should be dropped? This data can also be viewed on hte PC after downloading.




The imputing of insulin doses would mean nothing unless you could also include the carbohydrate content for that meal, without this it would be left to memory or we would have to record it separately in a diary.


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## Mark T (Jan 4, 2012)

Vicsetter said:


> 1. You are assuming that the car has correctly inflated tyres. It used to be said that the police allowed 10% + 3 mph before prosecuting because of speedo inaccuracy....


And the correct size wheels fitted and...  yes I simplified things a bit.  You also have to have to factor in error for the speed detection device too.

I'm surprised that a meter can only store 500 readings (the electronics part of me would probably like to open up a meter and have a look at what is actually in it).  If you are testing 6x per day then that won't make the 90 days.  Although I could not imagine a police officer going through 500 readings to make sure you hadn't been too low.

Possibly some bright meter company ought to probably integrate a SD/microSD port to extend memory.


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## everydayupsanddowns (Jan 4, 2012)

James McCann said:


> Dear All, Many thanks for the comments about the averaging on Microdot meters. Our next generation meters will have much greater capacity for averaging over 14-30-60 and 90 days.
> On the issue of the memory size, Microdot currently stores the last 500 readings in the memory in the meter. The readings may be downloaded via a cable to a PC and all readings transferred can be stored on the PC for the last 12 months, so even if the reading is no longer on the Microdot meter it is still on the PC. Thus the last 500 readings are in the meter and an unlimited number, taken over the last 12 months, can be stored on the PC.
> 
> Microdot meters also allow the user to manually enter their insulin doses (unit size and type). The meter aso adds on the date and time. Is this a useful function or one that should be dropped? This data can also be viewed on hte PC after downloading.
> ...



James - This may be of interest... I had a comment on our blog today from someone with profound visual impairment who has tried (and failed) to find a decent BG meter suitable for use by blind people. Sounds like a bit of a gap in the market for a well designed solution...

Comment is at the bottom of this page: D-Tracker Review


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## Vicsetter (Jan 4, 2012)

Mark T said:


> And the correct size wheels fitted and...  yes I simplified things a bit.  You also have to have to factor in error for the speed detection device too.
> 
> I'm surprised that a meter can only store 500 readings (the electronics part of me would probably like to open up a meter and have a look at what is actually in it).  If you are testing 6x per day then that won't make the 90 days.  Although I could not imagine a police officer going through 500 readings to make sure you hadn't been too low.
> 
> Possibly some bright meter company ought to probably integrate a SD/microSD port to extend memory.


It must all come down to cost, Mark.  There are 2 meters that go to more than 2000 readings, the USB contour (one of them) is basically a USB stick with in-built software and metering device, you can even store your own data on it. As the profits are made from the test strips it must make it hard to build more memory in, although I am sure if you had to pay for it then ?5 should cover enough memory for an additional 2000 readings.

Do the police have the right to go through your meter? I think not, and the relevance of any readings before the current day would be irrelevant.


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