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  • With Mayo Clinic diabetes educators

    Nancy Klobassa, R.N., and Peggy Moreland, R.N.

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  • Feb. 20, 2009

    Choosing the right blood glucose meter

    By Nancy Klobassa, R.N., and Peggy Moreland, R.N.

17 comments posted

If you have diabetes, blood glucose testing is a way of life. Blood glucose meters are small battery-operated devices that make it convenient for people to check their blood sugar levels anywhere. They are also smaller, faster, and require less blood than in the past.

Blood glucose meters require that you prick your finger or alternative site and put a drop of blood on a test strip that is inserted into the meter. Testing regularly allows you to look for patterns to see if your blood glucose is in a safe range. If not, a change in diet, increase exercise, or a visit to your healthcare provider for medication to lower blood sugar and your risk of complications may be needed.

Blood glucose monitoring can also tell you if your blood sugar is too low, a potentially dangerous situation that requires you to eat or drink something with 10-15 grams of carbohydrates.

You have probably seen many advertisements for blood glucose meters and are wondering which meter is the best one for you. Most meters are accurate in how they measure your glucose but they differ in type and number of features that they offer. The American Diabetes Association provides several tips for finding the blood glucose meter that best fits your needs and lifestyle:

  • Insurance — Many health insurance companies will only pay for specific meters or have limitations on cost. Check with your insurance company to see what it will pay for and if they cover the cost of test strips.
  • Budget — The cost of blood glucose testing is often a barrier to regular testing. Before buying a meter, check the cost of meter test strips, especially if your insurance does not pay for them. A meter may be the cheapest one on the market, but is not a good deal if the strips cost twice as much.
  • Ease of use — Larger meter or small? Small meters are more convenient for carrying, but also require more dexterity to use. Look at the packaging for the test strips; are they easy to open? If you have vision problems, look for a meter with a larger display or voice module. Size of strips may also be a consideration, Are the strips so small that you can't get a good grip on them? You might want to consider a meter that uses cartridges instead of individual strips.
  • Blood sample size — Check to see how big a blood sample is needed for blood glucose testing. Blood sample size ranges from 0.3 (amount that would fit on the head of a pin) to 4.0 microliters.
  • Check during the night? — Consider a meter that has a backlight.
  • Alternate site testing — Many new meters on the market today allow you to use alternate sites such as the palm or forearm for testing.
  • Support — Many meter manufacturers include a toll-free number on the back of the meter or packaging that you can call for help. Look for a meter that includes clear instructions that demonstrate the correct way to use the meter.
  • Smart meters — Some meters store a certain number of blood glucose results in memory. You can find meters with sophisticated data management systems that track diet and exercise as well as your blood glucose.
  • Download blood glucose readings to a computer — Most meters offer the ability to download your blood glucose readings to the computer and email the test results to your doctor. However, not all companies offer software that is compatible with Apple computers. Check out compatibility with the manufacturer before you buy.

What are your thoughts? Are there any features that you look for in a meter?

- Peggy

17 comments posted

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  • August 27, 2009 11:44 a.m.

    Any advice regarding the least painful method of obtaining a blood sample for testing? I find pricking my fingertips to be quite painful. I use the one touch ultra lancets. Unfortunately, I also find it difficult to use a less nerve filled site like my forearm -- can't get enough blood usually. Perhaps there is a better lancet on the market, and I would appreciate discovering the experiences of others.

    - Frank

  • August 20, 2009 12:31 p.m.

    My recent experience with Freestyle Freedom Lite strips has caused concern. The first vial's readings were comparable to lab results and my previous meter. The second vial of strips' readings showed an increase of about 30 points, compared to the first vial and to lab results. Being type II on glucophage, it was startling. These supplies were ordered from AARP pharmacy, covered by insurance. A representative I spoke with by phone said there had been other reports and that it was due to medication. She did agree to send a new and different meter and supplies which are purported to get different results. My concern is that if a person were on insulin, he/she would be misled into thinking the blood sugar was higher than it really was, a potentially dangerous situation. Incidentally, the Freestyle strips patient info. stated that it tested whole blood, which is what the lab tests. My A1C's have remained stable.

    - Beverly

  • July 28, 2009 5:46 p.m.

    I am surprised you didn't list Coding as an issue to consider when choosing a meter. My mother is elderly and has had several emergency room visits due to the fact her meter was miscoded, she inncorrectly dosed her insulin, and went hypo. After some investigation we determined what mom was (or should I say was not) doing and immediately purchased her a Bayer meter, which codes itself each time! What a saving grace this has been for our family!

    - Graham

  • July 27, 2009 10:11 p.m.

    Is there a meter on the horizon that uses "bloodless" technology, i.e., reads the blood sugar level through the skin as opposed to sticking? My sister said she has heard of such a marvelous thing.

    - Lori

  • July 23, 2009 3:36 p.m.

    Ed, we do perform meter evaluations on all meters we demo for patients at the Mayo Clinic and test for low and high bias. We only demo meters that pass our rigid lab standards. Unfortunately, I am not at liberty to release this list publicly but I can say that most of the brand names passed the testing. Nancy

    - Nancy and Peggy

  • July 22, 2009 11:09 a.m.

    We need a rating of meters based on degree of accuracy--degree of error. I haven't seen the Consumer Reports listing but I don't believe they evaluate on the margin of error. That is a service Mayo Clinic could provide.

    - Ed

  • July 3, 2009 12:52 p.m.

    The September 2008 issue of Consumer Reports magazine has a review of the various meters currently on the market.

    - Jackie

  • May 26, 2009 11:33 a.m.

    Your previous comments are correct. There is a need to list the top 5 or 10 meters and why are they the best.

    - Dave

  • May 11, 2009 11:50 a.m.

    It is not uncommon to get different blood glucose results when doing tests back to back with your meter. There are many variables involved.

    - Nancy and Peggy

  • May 6, 2009 6:51 a.m.

    my husband tests every morning. he pricks a finger, squeezes until enough blood comes out(this takes him a minute or longer) and then tests with the meter. sometimes his reading will be 160 and if he immediately tests again on a different finger, he'll get a reading of 135. is this normal? or is he doing something wrong? thanks

    - sandy

  • April 23, 2009 2:55 p.m.

    Alternative site testing: metering blood glucose is unfortunately not an exact science. Generally, alternative site testing is most accurate if it is done fasting when there is no rapid changes in your blood glucose occuring; like after eating or during a low blood glucose. There is a lag time in blood glucose reading results between a finger stick and alternatives sites. I often describe it this way; your fingers are a part of the freeway of your circulatory system and the small capillaries in your forearms are the back roads. The lag time can be at least 15 minutes. Never check an alternative site blood glucose during a low blood glucose reaction, it will not be accurate. If you do, the alternative site reading may read 90mg/dl or 5.0 mmol/dl when your actual blood glucose is 70 mg/dl or 3.9 mmol/dl.

    - Nancy and Peggy

  • April 22, 2009 6:38 a.m.

    can you address the problem with alternative site testing not being as accurate as finger testing? I tried it and the difference was way off.

    - bonnie davis

  • March 6, 2009 2:55 p.m.

    I loved your article, the info was great and I really enjoy reading it

    - Tank Anderson

  • March 3, 2009 10:56 a.m.

    Joyce, the POC or point of care blood glucose testing would need to meet specific guidelines and qualifications by governing agencies: JCAHO and College of American Pathologists. I don't think your dental office probably wants to go there.

    - Nancy

  • February 25, 2009 2:20 a.m.

    The smaller meters, shaped like a teardrop squeeze out of hand too easily and they go flyijng!

    - Sue

  • February 24, 2009 7:36 p.m.

    I am a registered dental hygienist and have been considering using a blood glucose test meter for my diabetic patients prior to doing periodontal therapy. Your article has been very helpful in choosing a meter. Do you have any suggestions. Would the insurance pay for testing in a dental setting? Thank you for you assistance. Joyce

    - Joyce Spieler, CDA, RDH

  • February 24, 2009 4:53 p.m.

    I AM DISAPPOINTED THAT YOU DID NOT LIST SAY, THE TOP 5 METERS WITH THE CAUSE OF THEIR RESULTS. OUR LOCAL T.V. CONSUMER AIRED CONSUMER REPORTS BEST METER AS THE ONE TOUCH ULTRA LIGHT METER-2007. THIS WAS JUST LAST WEEK. UNFORTUNATELY, THEY DID NOT LIST THE ENTIRE 20 BY THE BEST BUY LIST. SO YOUR ARTICLE IS BASICALLY THE SAME. WE ALL NEED SPECIFICITY. THANKS SO MUCH.

    - JUDITH CONNELL

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