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
- Ease of use. If
your glucometer is simple 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
- 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.
- A small sample size. The less blood your meter requires for each test, the less
painful it tends to be, and the less likely you'll get an "insufficient
blood" error and waste the test strip.
- 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. However, 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. Prices on test strips can range anywhere from $8
to $50 or more per box of 50. 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.
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
Some of the
manufacturers whose glucometer test strips used GDH-PQQ have updated their
strips to return more accurate results. According to the most recent
information available from the FDA and manufacturers, those models that may
still use GDH-PQQ strips include:
Accu-Chek strips (the manufacturer reports that the Accu-Chek Aviva Plus test
strips will still return accurate results)
If you take any
of the following products, the FDA advises to never use the GDH-PQQ meters
(icodextrin) peritoneal dialysis solution
immunoglobulins: Octagam 5 percent, Gamimune N 5 percent, WinRho SDF Liquid,
Vaccinia Immune Globulin Intravenous (Human) and HepaGamB
adhesion reduction solution (4 percent icodextrin)
product that contains, or the body breaks down into, maltose, galactose or
test strips -- used with the FreeStyle Lite and FreeStyle Freedom Lite 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.
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 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.
Also see the FDA alert for more information.
in this report:
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