Before you buy a glucose monitor

Experts say a good blood glucose meter should be accurate, affordable and easy to use. After scouring expert tests and user feedback, we found several meters that qualify.

Beyond the basics -- prick finger, apply blood to test strip, wait a few seconds for the result -- each meter has subtle (or not-so-subtle) differences. Some require a tinier pinprick of blood than others. Some let you take blood from your arms, legs or other sites, giving your fingertips a break. Some can read test-strip codes automatically, so you don't have to type them in by hand. Some come with sophisticated software to help you track your blood sugar. Some glucose monitors can speak, talking you through the testing process and reading your blood sugar result aloud to you.

You can pay as little as $9 or as much as $110 for a glucose meter -- but do you really need the expensive extras? Reviewers say the following about shopping for a glucose meter.

  • Cost: Your insurance may pay for some glucose meters and not others. Even if you don't have insurance to cover any of your diabetic testing supplies, you can often get a free meter from your doctor or directly from the meter manufacturer -- but watch out for the cost of the test strips. The cheapest strips in this report, for the top-rated ReliOn Micro (*Est. $9) budget meter, cost about $20 for a box of 50, but we found other brands that cost more than three times as much. If you test several times a day, that cost can add up.
  • Accuracy: Currently, international standards allow blood glucose monitors a 20 percent margin of error. The U.S. Food and Drug Administration is pushing for tougher standards.  We found a few independent tests that examine meters' accuracy. We identify the most accurate meters in this report, but these tests don't cover all of the meters on the market. Experts say meters are generally accurate enough to help you make the right treatment decision -- for example, whether to take a glucose tablet or insulin shot.
  • Ease of use: If you find your glucose meter easy to use, you're more likely to test as often as you should -- and less likely to make a mistake.
  • No-code meters read the code on each test strip automatically (with other meters, you have to type the code in by hand or insert a chip or key into your meter each time you open a new pack of test strips). Experts say that with no-code meters there's less chance you'll make a mistake. However, some users say they're accustomed to coding and don't mind doing it, and they'll choose a meter based on its other features.
  • Amount of blood: Some of the meters in this report require 1 microliter of blood (about the size of the head of a pin); others require 0.6 microliters or just 0.3 microliters. The less blood the test takes, the less painful it may be, reviews say -- and the less likely you'll get an "insufficient blood" error and waste the test strip. Diabetes Forecast, a publication of the American Diabetes Association, publishes a chart showing how much blood is in each sample size.
  • Alternate-site testing: All of the meters in this report allow you to draw blood from your palm instead of your fingertip, and some allow other alternate sites (arms, legs or abdomen) as well. This can give your sensitive fingertips a break. However, some people have trouble getting enough blood from an alternate site. There are some situations in which you shouldn't use alternate-site testing (for example, during rapid blood glucose shifts), so you should ask your doctor before using this method.
  • Memory and advanced features: Most meters let you see your blood glucose averages for the past 30 days, and some record 90 days or even more. Most in the midpriced ($20 to $30) range let you transfer your readings to your computer, where you can use optional, downloadable software to look more closely at your blood-sugar patterns. Some cheaper budget models can store only about 50 glucose results in their memories and lack accompanying software.
  • Talking glucose meters are best for people with vision problems or blindness, experts say. The top-rated talking meter, the Prodigy Voice Meter (*Est. $65), talks users through every feature of the meter and reads glucose results aloud.
  • Smaller vs. larger glucose meters: Smaller meters can be easier to carry, but larger meters may be easier to read and handle. People with arthritis or other dexterity issues may want to choose a meter that uses bigger test strips that aren't individually wrapped. Some meters let you insert the entire vial of test strips, so you don't have to load each one individually.
  • Certain drugs can cause errors with some glucose meters. Meters that use a specific type of test-strip technology (known as GDH-PQQ) can be fooled by sugar-containing drugs and therapies. See our Introduction for details.

Faulty test strips recalled for some Precision, Optium and ReliOn glucose meters

Abbott Diabetes Care has recalled about 359 million test strips manufactured between January and September 2010 under the brands Precision Xtra, Precision Xceed Pro, Precision Point of Care, MediSense Optium, Optium, Optium EZ and ReliOn Ultima. The strips can give false low readings. "This can lead users to try to raise their blood glucose when it is unnecessary, or to fail to treat elevated blood glucose due to a falsely low reading," the FDA says, warning that treatment after a false reading can lead to serious health consequences or death.

The meters themselves have not been recalled. Find out which lot numbers have been recalled at Abbott's website, http://www.precisionoptiuminfo.com, or by calling 1-800-448-5234 (English) or 1-800-709-7010 (Spanish). Find more information and check for other blood glucose monitor-related recalls on the U.S. Food and Drug Administration website.

The FDA also sent Abbott a warning letter in July 2010 after inspecting the facility that makes Abbott's FreeStyle glucose meters. Inspectors found that Abbott didn't follow the right procedures when dealing with quality-control problems, including scratches on its FreeStyle Lite glucose test strips. In addition, inspectors found that some of Abbott's managers didn't have enough education and experience to make sure Abbott complies with government manufacturing standards; for example, Abbott's Director of Quality Systems was supposed to have a science, technical or engineering degree, but had a business degree instead. Abbott issued a statement that it "has taken and continues to take the actions necessary to address the items outlined in the letter and is communicating those actions directly to the agency," The Wall Street Journal reported. As of this update, the FDA had not posted a close-out letter on its website indicating that Abbott had fixed the problems.  

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