Digital Lock-ins and Data Silos

Digital Lock-ins and Data Silos in [Diabetic Test Strips](/sell-diabetic-supplies/)

A blood glucose meter tends to tie you to one company in two ways. The strips have to match the meter, because the FDA treats a meter and its strips as one test system [1]. The readings, meanwhile, usually land in that same company's app, and getting them out again can take real effort [2]. We read FDA files, manufacturer pages and recent studies to see how each tie works and where it loosens.

Why strips only fit certain meters

The short answer is chemistry plus software. A strip carries an enzyme that converts glucose in a drop of blood, and that reaction creates an electrical current the meter interprets as a glucose result [3]. The FDA's guidance for home-use test systems puts it plainly: test strips and meters "work as integral systems" [1].

Roche's own lineup shows how this plays out. Its Guide meters (the Guide Me, Guide and Guide Link) take Accu-Chek Guide strips, while its Aviva meters take Aviva Plus strips [4]. The FDA records explain part of the split. The Guide strip uses an enzyme called FAD-dependent glucose dehydrogenase, or FAD-GDH [3]. Aviva Plus strips use a modified version of a different enzyme, GDH-PQQ [5]. One company, two strip chemistries, two meter families that can't trade strips.

That pairing is also a business model, since the meter is a one-time purchase and the strips are bought for years. We cover that side in our article on the razor-and-blade model in medtech.

Third-party strips and the fine print

Other companies can make strips for a brand-name meter, and the FDA's September 2020 guidance has a section on exactly that. It calls them "third party test strips" and asks their makers to explain, in their FDA submissions, how they will handle design changes to the meter, because such changes could affect whether the strip still works with it [1]. One option the FDA names is an agreement between the strip maker and the meter maker [1].

Here's what surprised us: a real clearance shows how narrow that fit can be. In November 2013 the FDA cleared Unistrip1 strips for meters in LifeScan's OneTouch Ultra family, but only for meters bought before October 2012 and set to calibration code 49 [6]. A calibration code is a number that tells a meter how to read a particular batch of strips. The decision summary doesn't say why October 2012 is the cutoff. It does show that the clearance depended on when the meter was bought, not only on its model.

Where your readings end up

The second tie is the app. Connected meters send readings to a phone or computer, and each major brand routes them to its own software. Roche's FDA file for the Accu-Chek Guide lists two ways data can leave the meter: USB to a computer and Bluetooth Low Energy for wireless transfer [3].

On the phone, Roche's mySugr app lists two compatible US meters, the Accu-Chek Guide and the Guide Me, and says pairing one unlocks the mySugr Pro features at no charge [7]. LifeScan's OneTouch Reveal page walks through connecting the OneTouch Verio Reflect and Verio Flex meters [8]. Ascensia's Contour Diabetes app pairs with its own connected meters, such as the Contour Next Gen and Contour Next One [9]. As of October 2026, none of those three pages names another company's meter.

The exits that exist are narrow. mySugr lists Apple Health and Google Fit as integrations and says you can download your reports at any time [7]. OneTouch Reveal can sync with Fitbit and Apple apps and share your progress with family or a care team [8]. Ascensia lets one account view data from several meters, though every meter on its list is a Contour [9].

What researchers found

A study led by researchers at UiT The Arctic University of Norway, published online in March 2025, looked at seven diabetes devices and nine regulated software products available in Norway. Its focus was whether outside apps could get real-time data. Only one product offered a publicly accessible API, short for application programming interface: a documented way for other software to request the data directly [2]. The authors argue that this gap holds back patient-driven tools, noting that do-it-yourself projects face both technical and legal barriers, and they propose an interoperability model that they say needs regulatory decisions to put in place [2].

A companion paper by two of the same researchers described highly experienced users struggling to obtain and share their own data. It traced the problem to fragmented data sources, proprietary interfaces and the lack of public APIs [10].

Clinics run into the same wall from the other side. When a pediatric diabetes center in Cincinnati brought CGM data from three vendors into its electronic health record, the team reported that the integration worked but required significant resources, with ongoing trouble mapping data and handling differences between vendors [11]. That study covered CGMs rather than meters; we include it because it describes the same vendor-by-vendor split from a clinic's point of view. Shared data formats for personal health devices are a separate topic, which we cover in our article on IEEE 11073 interoperability standards.

Before you pick a meter

A few checks take minutes. Look up which strips a meter takes; Roche, for one, publishes a meter-by-meter list [4]. Read the app's compatibility list too, since it decides where your readings will live [7]. If you use third-party strips, check the meter models and conditions in the strip's labeling, because the Unistrip1 clearance shows how specific those conditions can be [6]. Which meter fits your care is a decision to make with your care team.