I was first introduced to the One Touch Verio IQ when I began using an Animas insulin pump in May 2016. The sales rep gave me a rave review of this blood glucose meter, telling me that it was one of the most accurate on the market. This meter had also been recommended for calibrating readings on a Dexcom system, which is often considered the golden child of continuous glucose monitoring in the diabetes community.
At the time, I was quite happy with my FreeStyle Insulinx and had no intention of switching. However, the Verio was quite a good looking meter and certainly more modern than any of the other devices I was using. So, I ended up placing it in my travel case and decided that I would use it as my spare.
As wonderful as the encasing, color screen, and rechargeable batteries were, my biggest deal breaker in using this meter was its accuracy. I have consistently found that the One Touch Verio reads at least 0.5 mmol/L (9 mg/dL), if not 1 mmol/L (18 mg/dL) higher than each of my other blood glucose meters.
There have been times where I’ve felt lows coming on, only to check my blood sugar using the Verio and still see a reading within range. From my personal experience, this is not a meter that I can trust.
To be fair, all blood glucose meters will only be accurate to the nearest 1 mmol/L (18 mg/dL) of a laboratory result. Which explains why two simultaneous blood glucose checks will likely produce two different results.
Most blood glucose meters must have a mean absolute relative difference (MARD) within 15 to 20 percent of laboratory results. This standard deems these devices a reliable indicator of blood glucose levels and safe to dose insulin from.
Which blood glucose meter can I trust? I conducted an experiment of sorts at home comparing all of the blood glucose monitoring devices that I currently use. Pictured from left to right, these include FreeStyle Libre, OneTouch Verio IQ, Accu-Chek Guide, and FreeStyle Insulinx. (Note: The FreeStyle Libre is a flash glucose monitoring system that measures interstitial fluid, and produces a reading each time the reader is waved over the sensor worn on the upper arm.)
Given that any moisture or dirt on my hands can impact glucose readings, I washed and dried my hands thoroughly before lancing my finger and repeated this experiment three times.
| Lowest Reading | Highest Reading | Variance | |
| Experiment 1 | FreeStyle Insulinx (7.0 mmol/L) | OneTouch Verio IQ (8.2 mmol/L) | 1.2 mmol/L |
| Experiment 2 | FreeStyle Insulinx (7.1 mmol/L) | OneTouch Verio IQ (8.4 mmol/L) | 1.3 mmol/L |
| Experiment 3 | FreeStyle Insulinx (6.2 mmol/L) | OneTouch Verio IQ (7.8 mmol/L) | 1.6 mmol/L |
The FreeStyle Insulinx produced the lowest blood glucose reading in each of my three checks, while the OneTouch Verio IQ produced the highest. Variances between the lowest and highest reading were fairly consistent, ranging from 1.2-1.6 mmol/L.
| Lowest Reading | Highest Reading | Variance | |
| FreeStyle Libre | 7.3 mmol/L | 7.4 mmol/L | 0.1 mmol/L |
| OneTouch Verio IQ | 7.8 mmol/L | 8.4 mmol/L | 0.6 mmol/L |
| Accu-Chek Guide | 7.2 mmol/L | 7.6 mmol/L | 0.4 mmol/L |
| FreeStyle Insulinx | 6.2 mmol/L | 7.1 mmol/L | 0.9 mmol/L |
When comparing the performance of each meter across my three checks, the Accu-Chek Guide reported the lowest variance among the standard blood glucose meters with 0.4 mmol/L. The FreeStyle Insulinx reported the greatest variance, with a 0.9 mmol/L difference between the lowest and highest reading.
I also decided to repeat my experiment a second time with an elevated post-meal blood sugar, as I had my suspicions that the variances might be greater.
| Lowest Reading | Highest Reading | Variance | |
| Experiment 1 | FreeStyle Insulinx (10.3 mmol/L) | OneTouch Verio IQ (11.5 mmol/L) | 1.2 mmol/L |
| Experiment 2 | FreeStyle Insulinx (10.6 mmol/L) | OneTouch Verio IQ (12.7 mmol/L) | 2.1 mmol/L |
| Experiment 3 | FreeStyle Insulinx (8.7 mmol/L) | OneTouch Verio IQ (12.1 mmol/L) | 3.4 mmol/L |
Once again the FreeStyle Insulinx produced the lowest blood glucose readings across my three checks, while the One Touch Verio produced the highest. Interestingly variances between the lowest and the highest readings ranged significantly higher than my first experiment, from 1.2 mmol/L to 3.4 mmol/L.
| Lowest Reading | Highest Reading | Variance | |
| FreeStyle Libre | 11.1 mmol/L | 11.3 mmol/L | 0.2 mmol/L |
| Accu-Chek Guide | 10.8 mmol/L | 11.1 mmol/L | 0.3 mmol/L |
| OneTouch Verio IQ | 11.5 mmol/L | 12.7 mmol/L | 1.2 mmol/L |
| FreeStyle Insulinx | 8.7 mmol/L | 10.6 mmol/L | 1.9 mmol/L |
The Accu-Chek Guide again reported the lowest variance in each of my three tests, while the FreeStyle Insulinx reported the greatest variance. Interestingly, the OneTouch Verio and FreeStyle Insulinx showed significantly larger variances in this second experiment.
I thought it would also be interesting to compare the accuracy of each brand of test strip with laboratory results. This information can also be found on the information packets inside test strip boxes.
Glucose concentrations of less than 5.5 mmol/L (100 mg/dL):
| Within 0.3 mmol/L (5 mg/dL) | Within 0.6 mmol/L (10 mg/dL) | Within 0.8 mmol/L (15 mg/dL) | |
| Accu-Chek Guide | 94.1% | 100% | 100% |
| FreeStyle Lite | 70.1% | 95.5% | 99.5% |
Glucose concentrations of less than 4.4 mmol/L (75 mg/dL):
| Within 0.3 mmol/L (5 mg/dL) | Within 0.6 mmol/L (10 mg/dL) | Within 0.8 mmol/L (15 mg/dL) | |
| OneTouch Verio | 88.2% | 100% | 100% |
Glucose concentrations greater than or equal to 5.5 mmol/L (100 mg/dL):
| Within 5% | Within 10% | Within 15% | |
| Accu-Chek Guide | 71.5% | 97.6% | 99.8% |
| FreeStyle Lite | 66.9% | 91.1% | 98.8% |
Glucose concentrations greater than or equal to 4.4 mmol/L (75 mg/dL):
| Within 5% | Within 10% | Within 15% | Within 20% | |
| OneTouch Verio | 71.1% | 94.8% | 90.0% | 100% |
All glucose meters were accurate within 15 or 20 percent of a laboratory result, likely meeting medical device regulations.
All meters showed greater accuracy among the lower glucose level classifications than higher ones. The Accu-Chek Guide also scored significantly better than the other brands at being within 5 and 10 percent laboratory result.
Interestingly, laboratory testing for the OneTouch Verio strips was classified differently from the FreeStyle Lite and FreeStyle Insulinx. The higher glucose level classification started at 4.4 mmol/L (75 mg/dL), compared to 5.5 mmol/L (100 mg/dL) for the other brands. In the higher glucose level classification, the Verio only reached near perfect accuracy at 20% of a laboratory result, compared to 15% for the other brands.
Feeling overwhelmed with all of this data? I think it is best not to get too caught up in the differences. Most meters are only accurate to the nearest 1 mmol/L (18 mg/dL), and two finger pricks will not guarantee you two identical results.
Stick with one meter that you feel comfortable with and that you feel you can trust. Ensure that your hands are clean and dry before lancing your finger and that you obtain a sufficient sample of blood. Finally, you will obtain more insight into your blood glucose data the more frequently you check your blood sugar. As the old saying goes, test early and test often!
ARYAN'S BLOG 