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 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 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.
- 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
Although the FDA's previous warnings about GDH-PQQ test strips are no longer available online, as of 2009 they had received reports of 13 deaths due to glucose meters and GDH-PQQ test strips that 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. You can see a limited, archived version of their advisory here.
This only happens to people who take sugar-containing products and only with glucose meters that use a type of test strips known as GDH-PQQ (glucose dehydrogenase pyrroloquinoline quinone) that can't tell the difference between glucose and other sugars.
If you take any of the following products, the FDA advised to never use meters with GDH-PQQ test strips:
- 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.