Blood Glucose Meter Review

Are some glucose meters more accurate than others?

A good blood glucose meter can help you control your diabetes -- but it must be both accurate and easy to use. ConsumerReports.org tests 15 blood glucose meters in its most recent rankings but only for ease of use. Editors explain that they don't publish any accuracy ratings because all of the tested meters meet federal accuracy guidelines.

However, the federal standards allow the devices to be wrong by as much as 20 percent, reports The New York Times. "Such a wide error rate can leave patients vulnerable to severe problems, including seizures, unconsciousness and coma" if they treat -- or fail to treat -- high or low blood sugar based on a faulty reading.

The Food and Drug Administration has started pushing for stronger international standards for glucose meters -- prompting the Times article -- and FDA officials say they may switch to higher federal standards on their own if necessary. Meanwhile, we found a few studies published in medical journals that test popular blood glucose meters for accuracy, and a Men's Health article gives results from a Consumer Reports test that judges accuracy (it's not published on the ConsumerReports.org website). Most of the 10 meters rated excellent or very good in that test, but the FreeStyle Freedom Lite (*Est. $20) rated just fair for accuracy according to the Men's Health article.

Accuracy questions aside, experts say you should still keep testing. "Multiple studies make clear that diabetics who routinely use monitors are healthier and suffer fewer serious complications than those who do not," The New York Times reports. And blood glucose meters are generally not so inaccurate that they would lead you to "say, eat glucose tabs instead of injecting insulin," says Diabetes Forecast, a publication of the American Diabetes Association. Dr. David G. Marrero, a professor of medicine at Indiana University and an expert in diabetes clinical trials, tells Diabetes Forecast: "Almost all current meters are accurate enough to help you make good decisions about your therapy."

You'll want to pick an easy-to-use glucose monitor, experts say -- and not just for your convenience. At its simplest, a blood glucose meter requires you to prick your finger, apply the drop of blood to a disposable test strip you have inserted into the meter, and wait a few seconds for the results. But some meters require extra steps, like typing in a code for a new bottle of test strips (other meters read the code automatically). Some require a bigger drop of blood than others. "If your blood-glucose meter is hard for you to use, you could also get inaccurate readings," ConsumerReports.org says. Besides ConsumerReports.org, other educational websites like ChildrenWithDiabetes.com and DiabetesWellBeing.com test blood glucose meters to find the ones that are easiest to master.

If you're sight-impaired -- a common complication of diabetes -- you may prefer a talking glucose meter. To choose the best one, we consulted a wealth of reputable studies and expert opinions from the Journal of Diabetes Science and Technology, National Federation of the Blind and American Foundation for the Blind.

Finally, folks who use blood glucose meters on a regular basis -- some for many years -- are an extremely helpful resource in themselves. Users who post their experiences on review sites such as Viewpoints.com and retail sites such as Amazon.com offer valuable feedback about glucose meters they have tried. In all, we consulted 19 sources of scientific tests, expert reviews and user ratings of blood glucose meters for this report.

There are two kinds of blood glucose monitors: the finger-stick type (discussed here) and continuous glucose monitors (CGM), which are inserted below the skin and worn for about a week at a time. CGMs are relatively new, and the FDA has approved only a few of them; we don't cover them in this report.

How drugs and glucose meters can be a deadly combination

If you take certain drugs or therapies -- and you use certain brands of glucose meters -- the resulting error could kill you, the FDA warns.

Thirteen people have died because their glucose meter misread their blood sugar. The 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 glucose meters, including the popular Accu-Chek brand. These meters 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 glucose meters
• TRUE2go
• TRUEresult
• TRUEtest

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%, Gamimune N 5%, WinRho SDF Liquid, Vaccinia Immune Globulin Intravenous (Human) and HepaGamB
• Orencia (abatacept)
• Adept adhesion reduction solution (4% 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. $24) 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.

See the FDA alert for more information.