Diabetes is hard: A humbling experience with “Er5”

I don’t have diabetes.  But I do think about diabetes a lot, read about diabetes a lot, and certainly talk about diabetes a lot.  So, this past week, I decided it was time to walk the walk.  I opened up a shiny package for a new glucometer with the plan of monitoring my glucose 3 or 4 times a day for several days.  I actually read the instruction manual on how to properly set the time and date, and did so within a few minutes.  As long as I was going to do this, I at least wanted my data to be accurate, a true “quantified-self” experiment (of course, choosing a night where I went out for a hamburger and fries was a true test of my pancreas’ abilities!).

Then, like a know-it-all physician, I tried to check my sugar.  “Er5” said the screen.  Hmmm.  Did it again.  Punched hole #2 in my finger.  Ouch.  “Er5.”  Maybe I didn’t get a big enough drop of blood.  So, I cranked up the dial on the lancet device from “3” to “9” so I could get the deepest finger puncture and guarantee a burgundy nugget for the test strip.  This time, “ouch” out loud.  “Er5” on the screen again.  I did this several times, howling in pain down the hall of my apartment, and said to my fiancee, “this hurts!  I can’t believe I ask people to check their sugar multiple times a day!  And worse, I can’t even do it right!”  At this point, I figured the test strips must be defective so I googled “Er5 onetouch ultramini” to see what was going wrong.

I didn’t have another vial of test strips so I was hopeful that “test strip damage” was not my issue.  If it was, my experiment would be over rather quickly.  I had to read a little further to find out that an “incompletely filled confirmation window” actually means, “you are not putting the blood on the test strip properly.”  It turns out, rather than placing the drop of blood to the side of the test strip for it to be sucked in to a small channel, I had been just plopping the blood on top of the strip.  Whoops!  Embarrassing!

After discarding nearly a dozen wasted test strips into the garbage, I finally struck gold and got a real, live number on the screen.  “86” it read, and though my finger stung, I had finally erased the humiliating sting of “Er5.”  For the next 24 hours, I checked my fingerstick on schedule, but noticed that it REALLY hurt and that I had to talk myself into pressing that button on the lancet each time, knowing the pain that would follow.  I commented about this to one of our diabetes educators, Catherine, who laughed and spent ten minutes showing me the proper way to use a lancet to get a blood sample, ie using the side of my finger instead of the tip and shaking my hand toward the floor to get blood flowing into it.  Turns out, if you do it the right way, you can get a drop of blood with a lot more ease and a lot less pain.  Though I consider myself pretty good at helping analyze blood sugar patterns, I finally now, after four years of medical school, three years of Internal Medicine residency, a year as Internal Medicine faculty, and nearly a year of Endocrinology fellowship, actually know the right way to check a blood sugar.

Luckily for me, this experience was only that, and is not something I have to endure on a daily basis.  But as I spend my career trying to improve diabetes technology and caring for those of you with diabetes, you can at least know, that I do understand your pain.  And if a patient one day asks me why her meter says “Er5,” I hope she will forgive me if I take a moment to laugh at the dozen half-filled-with-blood test strips in my garbage can.

Published by

Aaron Neinstein, MD

I'm an Assistant Professor in Endocrinology and Director of Clinical Informatics at the University of California, San Francisco.

10 thoughts on “Diabetes is hard: A humbling experience with “Er5””

  1. Aaron,

    That was great – I am glad you got that figured out, i probably would have done the same. It’s amazing how we learn so much information about some aspects of disease and not others. Glad you experimented – I drank all the different types of contrast agents once, some of them are terrible! Hope you are well.



  2. I’m still laughing, no, crying with laughter over your mistakes.
    On a serious note, think of the cost. Many people with diabetes have to ration their test strips. The cost of those Er5’s would have covered your burger, fries, And a milkshake.

    I’m glad you were stupid enough to make the mistakes and smart enough to write about it.


  3. Hi!
    I’ve had Type 1 diabetes since September of 2011. I actually write a blog documenting a lot of my experiences. But one of the more minute, yet ever frustrating problems of diabetes is how often I have to use 4 or 5 fingers and waste 4 or 5 test strips before I get a successful reading.Usually this is because I cannot get enough blood out of my fingers. When i discussed this with an Endo, they suggested that I shake my fingers toward the floor–which I already did. And then they took my sugar and were surprised when I barely bled at all! Over time I have gotten a lot better at testing correctly, because if I cannot get blood I will just prick myself again instead of wasting a test strip, knowing I won’t entirely fill it, but not wanting to prick all of my fingers. Because I obviously didn’t plan on being diagnosed with diabetes, my insurance (which ends in August) capped on pharmaceuticals in November, and I have been paying out of pocket for test strips ever since.(Originally with One Touch, and now with TrueTrack) TrueTrack is a miserable waste of a test strip. When I am high, I can test three times in a row and it will first read 270, then 210, then 250 and I have no idea how much insulin to give myself in a corrective bolus. However, 100 test strips are between $40 and $50 depending on where you get them, where as One Touch strips are about $120 for 100. That’s when receiving error messages was particularly frustrating to me because I would thing “Awesome, I just wasted $6.”

    I recently went out with my boyfriend and all his coworkers, and we got onto the topic of diabetes, and I ended up testing everyone’s sugar. (I changed the lancets of course!) Everyone was amazed that I did it every day. I had to turn the dial all the way up for all of the men, their skin is a lot tougher.


  4. Good for you for taking the initiative the “walk the walk”, as you say. The Doc who diagnosed my Type 2 was a Type 1 lifelong insulin user, so I got little sympathy when I grumbled about the testing. As mentioned above, cost becomes a bigger issue than the discomfort. I’d test more frequently if I didn’t worry about the $$.


  5. Thank you and Amen!! For years you hear ‘be sure to cover entire window with drop!!’ 5 sticks later Er5’d to distraction and looking up One Touch online, as the print pn the package is . this big, I stumbled across your article. Greatly appreciated and worked like a charm on try 6. Can’t wait for the day when ‘…no resident shall say “I am sick”. Have a great evening.


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