How To Choose a Blood Glucose Monitor

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Q: I’ve recently been diagnosed with diabetes and need to check my blood sugar at home. Are there any certificates or standards I should look for in choosing a home blood sugar monitor or self test?

A: Prior to their being made available to the public, all home blood glucose meters (and test strips) must be approved by the U.S. Food and Drug Administration. This ensures the meter compares in consistency and accuracy to similar products on the market. You also play a very important role in the reliability of the results, so it is vital to be properly trained to use whichever meter you choose. Your physician (family doctor, endocrinologist, internist) or diabetes educator will be able to help.

There are many factors to consider before your purchase, including but not limited to:

Ease of use. No matter what, if the monitor is too complex to figure out or difficult to use, compliance will take a back seat to frustration and, potentially, a failure to take charge of your blood glucose control.
Accuracy. While they all need to be accurate, some are more consistent than others regarding the reliability of their readings. In other words, the particular meter may be accurate some of the time or most of the time. Your physician or diabetes educator can help.
The amount of blood needed for each test (some require more than others).
Cleaning requirements. Some meters require regular cleaning, while others have electronic readouts that signal the appropriate time.
Alternate site testing. Instead of always needing to get blood from the fingertips, some may utilize samples from the forearm, base of thumb, thigh or other areas. However, please check with your physician, as readings from these areas may not be as reliable, especially with rapid changes in blood sugar.
Display size. If the numbers are too small or difficult to read, results will be harder to interpret. For those with visual impairments, meters are available with technology that allows them to speak your results.
Blood glucose measurement range to detect hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). Some meters read as low as zero and as high as 600. Please note that very low or high values should be rechecked while also ensuring proper technique (enough blood on test strip, correctly inserted, etc.). If the abnormal value is confirmed, recalibrate your meter. If the results are still out of range, speak with your physician.
Cost of the meter. Often there is no cost, or it is minimal; check with your insurance company.
Cost of the test strips (check with your insurance company) may be a huge factor as they vary according to manufacturer, as well as the frequency needed to check your blood glucose. And, even though “generic agent” test strips are available, they may not always work well with your particular meter. Before using a generic version, it is best to call the manufacturer to ensure product compatibility.
Are the test strips too small or difficult to handle (especially if you have visual impairment, arthritis or other conditions limiting hand movement and dexterity)? If so, perhaps a meter that uses a cartridge instead of individual test strips would be best.
Ability to store and recall blood glucose readings. This makes it easier to average or follow the trend of your blood sugar control.
Battery life and type of batteries required.
Size and weight of the glucose meter.
Customer support, including a toll-free number to reach the manufacturer for any problems or questions regarding the meter.
Can the results be downloaded to a home computer, or directly emailed to your physicians’ office?

Lastly, whichever unit you choose, over time it may be dropped, exposed to very humid and hot environments (this combination may damage the test strips), or even experienced wear and tear of some of its electrical components. This makes it especially important to periodically (according to manufacturers’ instructions) test your meter to ensure it is taking accurate readings. This can be accomplished with pre-tested solutions and/or special “control” cartridge or test strips where the correct sugar level is already known. Your unit should yield results close to these values.

Another option is to stop by your physicians’ office to have a simultaneously drawn blood sample (sent to a certified laboratory) and fingertip sample (checked by your meter). Results would be compared to give a better idea of the accuracy of your unit.

For further information, please go to the American Diabetes Association and the United States Food and Drug Administration as well as the Global Diabetes Community.

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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)