Glucose Monitors

As their name suggests, blood glucose monitors help you measure the level of glucose in your blood. An accurate blood glucose reading can tell you how well your medication is working and help you make adjustments to your treatment regimen, if necessary. You can choose from several different monitors, so it's important to know what will work best for you.

How to choose a glucose monitor

Before you run out and grab the first monitor you see, sit down with your doctor or someone on your healthcare team. Find out how often you're expected to test your blood glucose (it depends on your lifestyle and the type and severity of your diabetes), and what you need to do with the test results. Ask which monitors your team recommends, and why. Next, check with your health plan. Find out whether your insurance covers all monitors and test strips—or a select few. Also ask whether you need a prescription to get reimbursed for test strips.

This preliminary work should narrow the field, and save you some grief and expense. Evaluate your remaining choices on the basis of cost, time and ease of testing, and extras like memory storage and data transfer capabilities.

Size of glucose monitor

Monitors can be as small as a pen or credit card, but most are about as large as a medium-sized calculator. If you're on the go, a smaller size may work best, provided you have the manual dexterity to use it. Even larger monitors weigh only a few ounces.

Time and ease of testing

Depending on the monitor you choose, it can take from under 20 seconds to a minute or two to get a test result. Two minutes may be too long to wait if you're trying to get children ready for school or rushing to get to work on time. It could be fine if your schedule is less harried.

As for ease, there are two basic types of monitors. They're close in accuracy and precision, but the newer type is a bit handier to use.

• The older type uses a test strip that changes color when it comes in contact with blood glucose. The machine reads the change in color and calculates your blood glucose level. To use these, you have to apply a drop of blood, wait exactly 60 seconds, and then blot excess blood from the test strip with a cotton ball. And you may need to insert the strip into the monitor within a certain time frame, like 30 seconds, after blotting.
• The newer type uses a test strip that relies on an electrical current to measure the blood glucose level. Usually, they don't require timing or blotting—you can put the test strip in first, then add a drop of blood. One new model—Glucometer DEX—doesn't use strips at all; instead, it has sensors that you can load into the machine in cartridges of 10 at a time.

Readability of glucose monitor

Diabetes can affect your eyesight. To use a monitor, you have to be able to see it, so make sure the digital printout is large enough for you to read. Avoid those with red and green numbers if you have color blindness. If you have a severe visual impairment, you may need a monitor that provides audio instructions and test results, such as Voice Touch or the Accu-Chek Voicemate.

• Some monitors, like One Touch, provide instructions and results in several different languages.

Care and maintenance of glucose monitor

• Most monitors need calibration with each new batch of test strips, and some are harder to calibrate. A few, like ExacTech R-S-G, use precalibrated strips to save you the trouble.
• Ask what kind of batteries the monitor uses—costly, hard-to-find electronics batteries, or standard AAAs?
• Also ask how often you must clean the monitor to keep it working well.

Check out the level of technical support the manufacturer provides. Some offer toll-free support lines or training tapes.

Memory and data management

It's important to keep track of your blood glucose readings, so you and your health team can tell whether your treatment is working. Monitors help you do this in a couple of ways.

Most monitors have a memory feature: They'll store a given number of readings, from 10 or fewer all the way up to 1,000 for AccuChek Complete. Some monitors record only the number, while others also save the date and time of the reading—important information for tracking your blood glucose levels over time.

• In addition, many new monitors have data management capabilities. They can display trends in your blood glucose levels, and you can even download the information to your computer for sophisticated analysis—or send it to your doctor via modem. Make sure the monitor is compatible with your computer and/or your doctor's. The analysis software is sold separately.

Amount of blood

Monitors need different amounts of blood for the test. If you have poor circulation, or live in a cold climate that slows your circulation, choose a monitor that requires less blood, like the LifeScan FastTake.

How to use a glucose monitor

Always calibrate your monitor and test with control solution as often as the maker recommends—usually every time you start on a new batch of test strips. Control solution has a set amount of glucose that helps you test the monitor's accuracy. It's a great idea to take your monitor with you to the clinic when you have tests done there. You can use it to compare results with the clinic's testing equipment. Your results should fall within an acceptable range of the clinic's, usually 15 percent.

In addition to daily blood glucose testing, here are a couple of other blood tests that people with diabetes can now do at home:

• You need a glycosylated hemoglobin (HbA1c) test once or twice a year if you take insulin, or as often as your doctor recommends. This test provides a long-term picture of your average blood glucose levels. You used to have to go to a clinic for HbA1c testing, but now you can take a blood sample at home using a kit from a maker like Accu-Base or A1c-Express. You can send your sample to a lab and get results by mail, email, or fax.
• A new brand of monitor, the Duet Diabetes Control System, allows you to do both daily blood glucose testing and a periodic test of fructosamine—which reflects your average blood glucose levels over the past two to three weeks.