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7 How to choose a blood glucose meter

Not everyone with diabetes needs to check his or her blood glucose multiple times throughout the day. In fact, depending on the advice of your health care team, you may not need to check all that often. Then again, if you’re on an insulin pump, you may need to check your glucose several times a day. No matter what your regimen, though, it still makes sense for almost everyone with diabetes to have a blood glucose meter. Even if you check only occasionally, knowing your blood glucose level gives you vital information to make appropriate decisions and take actions, if necessary.

There are many types of blood glucose meters available on the market. Just like everything else, there are a variety of options and features. Choosing the right one for you can take a little preparation and homework.

THINGS TO CONSIDER

With all of the choices available, there are a few things you should keep in mind once you begin shopping for a meter.

FIND OUT WHAT METER IS COVERED ON YOUR PLAN

Generally home meter costs are at least partially covered by health insurance plans, if not in full. Some insurance plans have contracts with only certain meter companies and consider devices from these companies “preferred” choices. If your insurance policy has a contract such as this and you don’t pick the “preferred” brand, you may be in for a higher co-payment—not just for the meter, but for the strips as well. If you expect you will pay some of the cost of the meter, ask your health care providers for rebate coupons or about discounts the company may be offering. Check out diabetes-related magazines for special offers in the advertising pages. Compare costs between hometown pharmacies as well; there can be a sizable difference.

DON’T FORGET ABOUT STRIPS

Remember you will also be purchasing strips on a regular basis, so if you are given a choice of products, compare costs of the strips, as well as what stores carries what strips. Most of the larger pharmacies stock a variety of test-strip brands, but some smaller pharmacies do not. Save yourself driving across town for strips; check into availability first.

WARRANTY

Pick a device that has a warranty, preferably for at least 3 years. This information should be printed on the box, or a pharmacist/health care provider should be able to find out for you. Meters have a life expectancy of about 3–5 years, but use and abuse over that period of time can shorten its lifespan. Frequent testers and travelers may want to consider a change every few years due to the wear and tear. A lifetime warranty is not usually a high priority, however, since meters continue to improve and chances are you will want to upgrade in the future.

CARRYING CASES

If you’re going to be testing frequently, you’re going to have your meter with you much of the time. Pick a size that will allow you to comfortably carry the meter and the necessary testing supplies (lancet, strips, etc.). Some of the cases will only hold the meter, and will require a second case or container for testing supplies.

FEATURES

All meters will give you a blood glucose result—but is that all you need or want? Some diabetes magazines and websites offer product guides each year and will compare products. Manufacturer websites will offer information about their product and, often, online demonstrations so you can check out a meter before buying. Keep in mind that, overall, most blood glucose meters generally have similar steps and provide quick results, but have some different features and looks. These features are discussed below.

A WORD ABOUT FREE GIVEAWAY METERS

When offered a free glucose meter, a person generally thinks three things: Free! Free! Free! While there is no denying that the price is right, there are other things to consider.

Check to make sure strips for this meter are covered by your insurance plan; if not, this “free” meter may actually cost you more in the long run.

Check to see if it is an older model—some of the newer meters have better features. Also consider that less expensive meters do not have the same durability or quality parts, and they may not last as long as more expensive devices.

While you may not have to pay money, free meters often still have a cost. Many times you’ll be asked to provide personal information or sign up for a service or an additional purchase to receive your free meter. Be very careful what you commit to—read the fine print, and ask questions.

BLOOD GLUCOSE METER FEATURE COMPARISONS—PROS AND CONS

There are many features offered by today’s advanced technology meters. Following is a summary of some things to consider.

FEATURE: AUTOMATIC CALIBRATION

How does it benefit me? Every batch of blood glucose test strips produced at the factory comes out a bit different. Before using a strip from a new package, most meters require you to perform step(s) so your meter can properly recognize the new batch of strips. This is called “calibration” or “coding,” and it is often done using code numbers or letters, or code chips. If your meter requires calibration, you need to perform these steps with every new package of strips, which is an obvious inconvenience. A meter with automatic calibration takes care of this for you.

Any drawbacks? You probably won’t be able to use generic strips, otherwise, there aren’t many drawbacks. Automatic calibration is a good thing.

FEATURE: ALTERNATIVE-SITE TESTING ABILITY

How does it benefit me? Alternative-site testing means you can test (stick) yourself at areas other than your fingertips. If you often use the computer, do needlecraft work, play a musical instrument, or work in a health care profession, you may welcome the opportunity to give your fingertips a rest. Areas for alternative-site testing usually include the palm, forearm, and thigh.

Any drawbacks? Because of differences in skin thickness, blood flow, and sensitivity, alternative-site testing does not work for everyone. For low blood glucose levels or extremely high blood glucose levels, some health care professionals recommended using finger-stick testing to confirm readings, as there can be differences in the results due to how blood flows throughout the body.

FEATURE: MEMORY

How does it benefit me? The memory feature in most blood glucose monitors saves previous readings to an internal drive. If you write down your blood glucose in your glucose diary every single time, you are a rare individual. Having a memory is great as a backup for those times when you don’t or can’t write down a reading.

Any drawbacks? Even with a “memory” meter, you still need to write down your numbers. When the memory gets full, it will usually discard the oldest reading. Also, the date and time must be set up correctly for the information to be useful—so don’t forget to adjust for daylight saving dates!

FEATURE: DATA MANAGEMENT FEATURES

How does it benefit me? Some meters will allow you to see your daily, seven-day, fourteen-day, or thirty-day blood glucose average with the touch of a button, which may help you visualize your overall control. In addition, some meters allow you to mark results with notations, such as pre-meal, post-meal, with medication, without medication, etc. Most meters with data management features can also upload data to computers.

Any drawbacks? Just as with the memory feature, you can begin to rely on your data management feature too much. You still need to write down your readings. When the memory gets full, it will usually discard the oldest reading. Uploading your data will also sometimes erase the memory, so make sure you print out the results after uploading, be it at home or at your doctor’s office. Data management features may also affect the battery life of your meter (though helping you identify trends, problems, and successes is well worth the cost of a AAA battery). Some of the advanced features look great, but are only useful if you are willing to take the extra time to input the information when testing.

FEATURE: SMALL SIZE, LIGHTWEIGHT

How does it benefit me? Portability.

Any drawbacks? Losing the little guy. Little meters may also have odd-sized batteries, as opposed to the more standard AA or AAA you will find in larger meters. And don’t forget you still need to be able to read the screen and work the buttons.

FEATURE: BROAD TESTING RANGE (FOR EXAMPLE, 20–600 MG/DL)

How does it benefit me? The range indicates how well the meter performs at different glucose levels. Most meters offer a broad enough range to capture your daily readings.

Any drawbacks? A meter with a narrow testing range may produce an error message when it is unable to read a glucose result out of its range (though this may be a technique error, so always try again). Generally, the broader the range, the better.

FEATURE: BATTERIES

How does it benefit me? It is easier to find standard AA and AAA batteries—especially on sale—than unique batteries. These standard batteries are also more likely to be available in a rechargeable format.

Any drawbacks? Meters that use standard batteries are usually larger and bulkier. Conversely, small batteries are sometimes difficult to insert if you have arthritis or neuropathy. And again, odd-sized batteries may be hard to find, especially when you really need one on a Saturday night.

FEATURE: INCLUDED LANCET DEVICE

How does it benefit me? Lancet devices, the object used to prick your finger for a drop of blood, generally come with a meter. Some lancet devices have adjustable depth guides, so you can pick a depth that is comfortable to you. Lancets may also have different end caps for alternative-site testing capabilities. Some devices have automatic triggers and needle removal features, which can help with loading and unloading.

Any drawbacks? Some lancet devices use only name-brand lancets, while others use a more generic size. There is not one perfect lancet device for all persons—skin thickness, sensitivity, and blood flow issues influence the outcome of the use of the device. If you don’t like the lancet that comes with your meter, you might have to purchase a lancet sold by another company to find one that gives you the results you need and the comfort you deserve.

MORE RESOURCES TO EXPLORE

MAGAZINES, JOURNALS, AND PERIODICALS

Diabetes Forecast—Resource Guide 2009

Every year, Diabetes Forecast, the magazine of the American Diabetes Association, produces a Resource Guide with the latest information on meters, lancets, insulins, medications, and much more.

WEBSITES

Abbott Laboratories…… WWW.ABBOTTDIABETESCARE.COM

Bayer Health Care…… WWW.BAYERDIABETES.COM

Home Diagnostics…… WWW.HOMEDIAGNOSTICS.COM

Johnson and Johnson…… WWW.LIFESCAN.COM

Roche Diagnostics…… WWW.ACCU-CHEK.COM

Sanvita Inc…… WWW.SANVITA.COM