Simpler is better -- not only for kids and the elderly, experts say, but for anyone with diabetes who uses a blood glucose meter. Fewer steps mean fewer mistakes, and reviews say the best meters are those that make the basic process of testing your blood sugar -- insert test strip, prick finger, apply blood, read result -- as foolproof as possible.
The Accu-Chek Aviva Plus (Est $25) is more user-friendly than most. Its test strips are a little larger than usual and if you happen to touch the testing surface while you're handling the test strip, it won't skew the results and thus waste the test strip. The meter itself is easy to hold and manipulate, so much so that it was the first glucose meter to earn an "Ease of Use" award from the Arthritis Foundation.
The Accu-Chek Aviva Plus isn't just user friendly; it also has a solid reputation for accuracy, with a slew of clinical trials and an "excellent" accuracy score from a leading consumer research group to back it up. We found a few complaints from Amazon.com and Walmart.com reviewers about quality-control issues with this glucometer, but they're a few years old and most customers feel that Accu-Chek's customer service responded well to their concerns. The Accu-Chek Aviva Plus requires a reasonable 0.6 microliter blood sample and returns results in about 5 seconds.
Other notable features include four programmable alerts to ensure you won't miss your test times, a 500-reading memory function and 7-, 14- and 30-day averages of your glucose levels. The Aviva Plus comes with an infrared data transfer port for transferring your data to a computer, but most people will have to purchase the appropriate infrared cable (which is strictly optional). If you do spring for the infrared port, you can manage, track, analyze and share your downloaded readings with Accu-Chek's optional diabetes management software (Est. $35, PC only).
The Accu-Chek Aviva accepts two types of test strips: regular Aviva strips and Aviva Plus test strips. The distinction between the two is important for some diabetics. The regular Aviva test strips were included in the FDA's 2009 warning to patients about GDH-PQQ (glucose dehydrogenase pyrroloquinoline quinone) test strips, which can interact with some non-glucose sugars to give falsely high blood sugar readings. The Accu-Chek website's also carries a safety warning.
Both types of Accu-Chek test strips sell for about $35 per box of 50. That really adds up -- a leading consumer research group estimates the yearly cost of using the Accu-Chek Aviva Plus at about $1,710 per year if you test your blood four times a day. However, the manufacturer, Roche Diagnostics, offers a discount program that brings the price of test strips down to about $15 per box of 50. You used to have to code the Aviva Plus once for each new vial of test strips (by inserting a white code key into the meter), but the system has been updated to use a black code key that you leave in the meter permanently -- effectively turning it to automatic coding.
We found several runner-up glucose meters that fall short of the Accu-Chek Aviva Plus in one way or another, but each has a particular strength that wins reviewers' admiration.
The FreeStyle Lite (Est. $25) is tiny -- no bigger than a pack of gum -- and requires an equally tiny blood sample, just 0.3 microliters. Like the Accu-Chek Aviva Plus, it receives top scores for accuracy and repeatability, both from professional testers and clinical trials. It doesn't require manual coding, allows several alternate testing sites (palm, forearm, thigh, upper arm and calf), stores up to 400 readings with calculated averages, and has a backlit screen and illuminated test strip port for easier testing in the dark. Like the Accu-Chek Aviva Plus, the FreeStyle Lite's test strips run about $35 per 50, with a co-pay program that limits your cost to about $15 per box of 50 strips if you qualify.
The OneTouch UltraMini is another tiny blood glucose meter. It draws very good accuracy scores and an excellent rating for its repeatability in one professional test, and users find it extremely easy to use. However, the UltraMini requires a relatively large drop of blood (1 microliter), doesn't allow many alternate test sites (just palm and forearm) and requires manual coding. The test strips are also expensive -- about $32 for 50 strips.
The Accu-Chek Compact Plus (Est. $30) also receives very high marks for accuracy and repeatability, and has an illuminated screen that's useful for testing at night. It comes with most of the same features you'd get in the Accu-Chek Aviva Plus, but not every user is a fan of the Compact Plus' motorized test-strip dispenser. It makes some noise and if you push the button by mistake, there's no way to put the strip back in -- it ends up wasted.
This meter also requires the largest sample size of the meters we evaluated: 1.5 microliters, which is larger than the head of a pin and five times as much as the 0.3 microliter sample required for several other meters in this report.
Finally, the Compact Plus is only compatible with GDH-PQQ test strips, which the FDA and the manufacturer warn should be avoided if you partake of therapies or medications involving non-glucose sugars.
The OneTouch Ultra 2 (Est. $60) is shown to provide results within acceptable ranges 99.5 percent of the time in one clinical test and draws an "excellent" accuracy score from a leading consumer research group. Some users complain about variable readings, though, and it requires a larger than usual (1 microliter) test sample. Its test strips are also pricey -- about $32 per box of 50 -- and some users complain that the test strip technology, which requires you to fill a narrow channel at the end of the strip with your blood, is dated.
The Precision Xtra (Est. $70) is one of the priciest blood glucose monitors we've evaluated, but it's also capable of testing your blood ketone levels. Its forgiving test protocol -- you can fill the test strips with blood from either end and add more blood (if needed) within 5 seconds of starting the test -- makes it very easy to use. It'll also warn you if you try to insert an expired test strip, and the icon-driven menu may be easier to navigate for some.
The Precision Xtra's 0.6 microliter sample size, 5-second test time and 450-reading memory capacity are all competitive, and its test strips are affordable at about $22 per 50 strips. (For ketone testing, it requires a 1.5 microliter sample and returns results in 10 seconds.) However, we found a few scattered complaints that it routinely reads about 20 points higher than other blood glucose meters.
Blood glucose monitors that interface with your mobile devices are clearly the wave of the future. The technology is already here, but manufacturers are still fine-tuning the meters and their user interfaces. For example, while one recent clinical trial found that the iOS-device-compatible iBGStar glucometer (Est. $75) provides readings within the clinically acceptable range 99.5 percent of the time, it only gets middle-of-the-road accuracy scores from a leading consumer research group.
In most other ways, however, the iBGStar is competitive. It requires a reasonable 0.5 microliter blood sample, returns results in about 5 seconds and can store up to 300 readings in its memory. A tiny, illuminated screen displays your results if you use it in stand-alone mode.
You can also use the iBGStar while it's docked with your iOS mobile device, in which case it also syncs its stored data to the accompanying app. Most users say the app is a huge bump in usability compared to non-mobile-compatible glucometers, allowing you to track your glucose, insulin and carbs, add notes to readings and chart your glucose levels over time. The iBGStar also has a mini-USB port for downloading its readings to a PC.
The iBGStar's test strips are extremely pricey -- about $60 per 50 strips. But that issue, and even the accuracy ratings (to a certain degree), fall by the wayside when users latch onto the techy vibe of this device that actually makes testing your blood sugar appealing. "[It's] the first cool thing in diabetes I can remember," writes one happy U.K. customer at Boots.com.