What the best blood glucose meter has

  • Accuracy. Several clinical studies show that just because a blood glucose monitor meets accuracy standards when it receives initial FDA clearance doesn't mean it'll still perform up to those standards in the real world. The best meters have a good track record for accuracy in clinical trials, independent tests and with consumers.
  • Ease of use. If your glucometer is easy to use, you're more likely to test as often as you should. For most users that means a bright, easy-to-read screen, buttons that are easy to handle, forgiving test strips and a reasonably small blood sample. If you're vision-impaired, a meter that talks can greatly improve your accessibility.
  • No coding necessary. Not having to code your meter every time you open a pack of test strips -- inputting a new code by hand or by using a key or chip -- means one less opportunity for error. However, some users say they're accustomed to coding and don't mind doing it.
  • Alternate-site testing. Being able to draw blood from your palms can give your sensitive fingertips a break. Some meters allow you to test with blood from your arms, legs or abdomen too. With that said, 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.
  • The ability to store readings. The best blood glucose meters can store hundreds or even thousands of readings with date and time stamps to help you track the timing and consistency of your results.
  • Averaging and flagging functions. Most blood glucose monitors will calculate your average readings over a 7-, 14- or 30-day period; some also let you flag before- or after-meal status for your readings and add custom notes, all of which helps track trends in your glucose levels.
  • Data transfer capability. Meters with data transfer capability -- often by USB cable -- can upload the information to a computer to better help you track your blood sugar and share it with your physician.
  • Affordable test strips. Test strips are far and away the most expensive aspect of using a blood glucose meter. The most affordable strips typically sell for $15 to $20 per box of 50, and some manufacturers with more expensive strips offer co-pay assistance programs to help drive the cost of test strips down into this range.

Know before you go

As of 2009, the most recent year for which data is available, the FDA received reports of 13 deaths because glucose meters and GDH-PQQ test strips misread blood sugar levels. Those people were taking certain sugar-containing therapies -- mostly a kidney dialysis solution -- that fooled the meter into thinking their blood glucose was high enough, when in reality it was fatally low.

This only happens to people on sugar-containing products and only with certain brands of test strips, including some strips under the popular Accu-Chek brand. These monitors use a type of test strip known as GDH-PQQ (glucose dehydrogenase pyrroloquinoline quinone) that can't tell the difference between glucose and other sugars.

The following glucose meters use GDH-PQQ strips, according to the most recent information available from the FDA and manufacturers:

  • Accu-Chek
  • FreeStyle
  • TRUE2Go
  • TRUEresult
  • TRUEtest
  • Abbott Diabetes Care FreeStyle test strips

If you take any of the following products, the FDA advises to never use the GDH-PQQ meters listed above:

  • Extraneal (icodextrin) peritoneal dialysis solution
  • Some immunoglobulins: Octagam 5 percent, Gamimune N 5 percent, WinRho SDF Liquid, Vaccinia Immune Globulin Intravenous (Human) and HepaGamB
  • Orencia (abatacept)
  • Adept adhesion reduction solution (4 percent icodextrin)
  • Bexxar radioimmunotherapy agent
  • Any product that contains, or the body breaks down into, maltose, galactose or xylose

FreeStyle Lite test strips -- used with the FreeStyle Lite (Est. $25) and FreeStyle Freedom Lite (Est. $20) blood glucose meters -- were included in the original FDA alert, but these strips are now made without GDH-PQQ. The FreeStyle Lite strips available today are safe to use with sugar-containing drugs.

Accu-Chek Aviva test strips remain unsafe to use with sugar-containing therapies, but the manufacturer states that Accu-Chek's Aviva Plus test strips, when paired with the Accu-Chek Aviva meter, will deliver accurate results in the presence of maltose. They say this makes the combination of the Accu-Chek Aviva meter and Accu-Chek Aviva Plus test strips suitable for use by people on peritoneal dialysis, those using solutions containing icodextrin, and people receiving therapy that contains maltose or metabolizes to maltose.

The manufacturer's website offers links to more information about icodextrin and blood glucose testing. If you're ever in doubt about whether a particular blood glucose monitoring system is safe for you, you should consult your medical provider.

See the FDA alert for more information.

What's to come

For now, pricking your finger and daubing a drop of blood onto a test strip remains a fact of life if you have diabetes. But several manufacturers are working hard to change that -- from Grove Instruments' spectroscopic technology to a non-invasive Israeli-developed device that measures changes in your skin color.

Researchers at Purdue are also working on a biosensor to measure glucose levels in other bodily fluids including saliva and tears, while "further out" research pursues everything from tattoos to contact lenses as a means of testing your blood sugar levels. The one thing all of these groundbreaking methods have in common, however, is that they're not yet available for purchase in the United States (and in some cases, the technology hasn't yet advanced past the experimental stage). Still, the day will come when drawing blood to test your blood sugar levels will be a thing of the past.

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