Updated April 16, 2008

Talking Meters
What’s New?

by Ann S. Williams, Ph.D., R.N., C.D.E.

Self-monitoring of blood glucose is one of the areas of diabetes self-management that is deeply affected by severe visual impairment. When people with diabetes learn they have permanent visual impairment, one of the first questions they often ask a diabetes educator is, “How will I check my blood glucose?”

Many standard meters now have large-print screens, which makes them more accessible for people with enough vision to see large print. However, most of the large-print screens have low contrast between the numbers and the background, limiting their usefulness for many people with moderate to severe visual impairment. And all standard meters currently available require the ability to read large print for at least some essential steps in their use, making them inaccessible for people whose visual impairment is severe enough that they cannot read large print. Fortunately, some manufacturers of blood glucose meters have recognized the need for meters for people who cannot read visual displays. For more than 10 years now, such meters have been available in the United States. And Medicare and most private insurance companies provide coverage for such meters for the people who need them. (See “Insurance Coverage for Talking Meters.”)

In the past couple of years, there have been major changes in the availability of accessible blood glucose meters for people with severe visual impairment. A number of accessible meters are no longer available. One meter that had been available since 1998, the Accu-Chek Voicemate, ceased being produced as of January 1, 2007. Two other meters that could be used with a separate voice attachment, the OneTouch Profile and OneTouch SureStep, are also no longer sold.

However, a variety of both new and familiar meters are on the scene. The OneTouch Basic, its voice attachment, and the Sure Guide (a device that helps place the drop of blood on the strip) are all still sold. And several new lines of talking meters are now available. These new meters are smaller, faster, and less expensive than older choices, and they need only a tiny drop of blood, making them much easier to use accurately.

If you have visual impairment, you may be wondering which of these meters is the best one. The answer is not simple; each person with visual impairment has a slightly different set of needs, and each of the talking meters has somewhat different characteristics. Put simply, the most suitable meter for you is the one that best matches your needs. This article explains some of the different features of the talking meters, so you, your diabetes educator, and your doctor can decide together which one is best for you.

What meter features are important?
People who use talking blood glucose meters need many of the same features in a meter that sighted users need. In addition, they need a few special features that relate to their inability to see. The following list includes questions that should be asked about both types of meter features.

While each question is important to some people, not every question is important to every person who needs a talking meter. As you read the questions, think about which ones are important to you.

• How big is the meter with its integrated voice or its voice attachment? Can it be carried easily in a pocket or purse?
• What is the cost of the meter?
• Where can the meter and strips be purchased?
• Is the meter's voice clear and easy to understand?
• Does the voice speak any language other than English?
• Can the volume be adjusted? Is there an earphone to allow private use in public places?
• If there is a separate voice attachment, does the same company manufacture both the meter and the voice?
• If the voice needed repairs, would it be serviced by the meter company or by a separate company?
• How big are the strips?
• Are the strips easy to handle?
• Is it easy to identify the insertion end of the strip nonvisually?
• Are the strips easy to insert in the meter nonvisually?
• Does the manufacturer provide accessible instructions (recorded instructions, for example) for the use of the meter?
• Does the voice guide the user through all of the steps for a blood glucose check?
• Does the meter require coding? If it does, can it be coded without seeing the code number?
• How large a drop of blood is needed for an accurate test?
• Is it easy to place blood on the right place on the strip nonvisually?
• How long does the procedure for checking blood glucose take?
• Does the meter read the result clearly? Can the user hear the result repeated if necessary?
• Does the meter store the result, date, and time in the memory? If so, how many results can be stored?
• Can the voice repeat information from the meter's memory?
• Can data in the meter's memory be uploaded to a computer?
• Does the meter do anything besides measuring blood glucose levels?

Also in this article:
Insurance Coverage for Talking Meters
Resources
Strips: Which End is Which?

Dr. Williams has been a diabetes educator for 20 years and for most of those years has worked in programs designed specifically to serve people with visual disabilities.

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