Magnifiers worn on the head, magnifiers used for hobbies and crafts, or gooseneck magnifiers may also be useful for some people to see the markings on syringes.
Some people who have visual impairment use insulin pumps successfully. None of the insulin pumps currently available have speech output. However, most insulin pumps have an audio bolus feature. Some insulin pumps have buttons that are easier to identify than others, and some insulin pumps have batteries that are easier to replace than others. If you wish to use an insulin pump, seek out a diabetes educator who is familiar with several models and can help you choose one you can use independently.
Blood glucose monitoring. Checking your blood glucose can be a challenge when you have low vision. Only one blood glucose meter, the Accu-Chek Voicemate System, has an integrated digital voice, available in English or Spanish, that talks the user through the monitoring procedure step by step as well as through calibrating the meter. The Voicemate can also “read” Lilly brand insulin vials to help with insulin identification.
Three other meters are compatible with voice attachments. LifeScan’s OneTouch Basic and OneTouch SureStep meters can be used with the Digi-Voice voice attachment module made by Science Products. The OneTouch Basic and OneTouch Profile can be used with the LHS-7B voice attachment by LS&S Group. Both devices attach to the meter with a cable. However, even when using one of these devices, assistance from a sighted person is necessary to calibrate the meter when a batch of strips is started.
People with some vision remaining may prefer to use a “nontalking” meter, possibly with a large display screen. Placing the meter on a nonslip mat in a contrasting color can make it more visible and help keep it from sliding around. A colored lancing device may be easier to see than a white one. Some people mark the strip insertion slot on their meter with a permanent marker to make it more visible.
To get enough blood for an accurate reading, wash your hands under warm water to stimulate more blood flow to your fingers. Shake and hold your hand below your waist for about 15 seconds. Massage or milk the finger from base to tip to get more blood to the tip. Place a rubber band between the first and second joints of the finger to be lanced to help get a big enough drop of blood (see illustration at “Rubber Band Tourniquet Trick”). Do not use your thumbs or the index finger of the hand you write with to check blood glucose. Use a different finger for each day of the week. If you have problems finding the drop of blood, try lancing the finger in a pattern, using the fingernail as a reference point. For example, lance near the top of the right side of the fingernail at breakfast, the base of the right side of the fingernail at lunch, the top of the left side of the fingernail at supper, and the base of the left side of the fingernail at bedtime. This makes it easier to remember where the finger was lanced and locate the drop of blood.
Foot care. Everyone with diabetes is advised to do a daily foot check. If you have some remaining vision, using a long-handled, magnified mirror can make examining your feet easier. When using a mirror, be sure to inspect the backs of your feet. Propping feet on furniture for long periods of time can cause sores.
Nonvisual techniques can be used to inspect the feet as well. An unpleasant odor when removing socks may be the first noticeable sign of a fungal or other infection. Use your fingers to feel all areas of each foot after washing and drying the feet. Apply lotion during the foot exam. First, feel around and between the toes. (Do not put lotion between your toes.) Move the fingers to the outer edge of the foot, the heel, the bottom of the foot, and finally the top. Note any pain or changes in temperature or texture of the skin. Changes can mean corns, calluses, cuts, or infection. The back of the hand may be more sensitive to temperature change than the fingertips. If you notice any changes in your feet, have a sighted person check them.