Diabetes: Choosing and Using Your Glucose Meter

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• Choosing a glucose meter
• Using your glucose meter
• Important features of glucose meters
• Factors that affect glucose meter performance
• Making sure your meter works properly
• User experiences with glucose meters
• New technologies, alternative site testing
• Minimally invasive and non-invasive glucose meters
• How FDA regulates glucose meters
• Other diabetes management tests

The process of monitoring one's own blood glucose with a glucose meter is often referred to as self-monitoring of blood glucose or "SMBG." To test for glucose with a typical glucose meter, place a small sample of blood on a disposable "test strip" and place the strip in the meter. The test strips are coated with chemicals (glucose oxidase, dehydrogenase, or hexokinase) that combine with glucose in blood. The meter measures how much glucose is present. Meters do this in different ways. Some measure the amount of electricity that can pass through the sample. Others measure how much light reflects from it. The meter displays the glucose level as a number. Several new models can record and store a number of test results. Some models can connect to personal computers to store test results or print them out.

Choosing a Glucose Meter

At least 25 different meters are commercially available. They differ in several ways including:

• Amount of blood needed for each test
• Testing speed
• Overall size
• Ability to store test results in memory
• Cost of the meter
• Cost of the test strips used

Newer meters often have features that make them easier to use than older models. Some meters allow you to get blood from places other than your fingertip (alternative site testing). Some new models have automatic timing, error codes and signals, or barcode readers to help with calibration. Some meters have a large display screen or spoken instructions for people with visual impairments.

Using Your Glucose Meter

Diabetes care should be designed for each individual patient. Some patients may need to test (monitor) more often than others do. How often you use your glucose meter should be based on the recommendation of your health care provider. Self-monitoring of blood glucose (SMBG) is recommended for all people with diabetes, but especially for those who take insulin. The role of SMBG has not been defined for people with stable type 2 diabetes treated only with diet.

As a general rule, the American Diabetes Association (ADA) recommends that most patients with type 1 diabetes test glucose three or more times per day. Pregnant women taking insulin for gestational diabetes should test two times per day. ADA does not specify how often people with type 2 diabetes should test their glucose, but testing often helps control.

Often, self-monitoring plans direct you to test your blood sugar before meals, 2 hours after meals, at bedtime, at 3 a.m., and anytime you experience signs or symptoms. You should test more often when you change medications, when you have unusual stress or illness, or in other unusual circumstances.

Learning to Use Your Glucose Meter

Not all glucose meters work the same way. Since you need to know how to use your glucose meter and interpret its results, you should get training from a diabetes educator. The educator should watch you test your glucose to make sure you can use your meter correctly. This training is better if it is part of an overall diabetes education program.

Instructions for Using Glucose Meters

The following are the general instructions for using a glucose meter:

1. Wash hands with soap and warm water and dry completely or clean the area with alcohol and dry completely.
2. Prick the fingertip with a lancet.
3. Hold the hand down and hold the finger until a small drop of blood appears; catch the blood with the test strip.
4. Follow the instructions for inserting the test strip and using the SMBG meter.
5. Record the test result.

FDA requires that glucose meters and the strips used with them have instructions for use. You should read carefully the instructions for both the meter and its test strips. Meter instructions are found in the user manual. Keep this manual to help you solve any problems that may arise. Many meters use "error codes" when there is a problem with the meter, the test strip, or the blood sample on the strip. You will need the manual to interpret these error codes and fix the problem.