Diabetes Forecast

Making the Most of Your Blood Glucose Meter

By Molly McElwee-Malloy, RN, CDE , ,

Blood glucose meter manufacturers have added lots of models and extra features to win your loyalty. But what’s necessary, and what’s just nice? Read on for ways to get the most out of your meter purchase.

 Download a full chart of blood glucose meters and their features.

 Download a refresher course on blood glucose meters.


Help Wanted

If you have a condition that makes it challenging to check your blood glucose, extra features may be helpful for you. Here are a few things to take into consideration:

Eyesight Problems

People who have a hard time reading their meters may benefit from a high-contrast screen. Displays with vibrant colors or larger numbers also can make a difference. Meters with audio functions can be useful, too. But backlights are another story: Some people can view readings on a backlit screen without issue, while others have a tough time. See what works for you by viewing a demo at your pharmacy or with your health care provider.

If you have diabetes and are blind, there is no perfect meter on the market for solo checking. Placing the drop of blood on the right area of the strip can be a true challenge. A friend, family member, colleague, or caregiver may be able to help. If you’re unable to find a helper or choose to check on your own, work with a diabetes educator to find a meter that improves your chances of success. For instance, a talking meter can walk you through the process and announce the result. 

Dexterity Issues

Whether you have arthritis or another condition that makes handling objects difficult, you’ll want to seek out a meter that’ll make checking your blood glucose a smoother experience. When visiting your diabetes educator, doctor, or pharmacist, ask to see several meter models to evaluate these factors for your own comfort:

Meter Size: A too-small meter will be difficult to grasp effectively and hold steady as you check your level. Your meter need not be the size of a brick, but you may want to steer clear of the smaller models.

Strip Size: As with meters, test strip size matters for those who have a hard time gripping things. Some strips are very short and thin, while others are longer and thicker. Larger strips will be easier to grab for people with dexterity issues and are packaged in larger, easier-to-grip containers.

Difficulty Drawing Blood

If calluses on your fingers make it difficult to get enough blood from your fingers, consider a meter that does alternate site testing. It’ll allow you to test on select sites elsewhere on your body, such as the palm of your hand or your forearm. (You’ll still need to test on your fingers when you suspect your blood glucose is low or when it’s changing rapidly, such as after a meal.)

Special Features

Let’s get one thing straight: There’s nothing wrong with a barebones meter. In fact, if you do only a couple of checks per day, you may not need fancy features. But if you’re looking to make frequent checks a bit easier or otherwise streamline your diabetes management, additional features may be right for you.

Bolus Calculator

A bolus calculator is a boon for anyone on intensive insulin therapy. Work with your health care provider to determine your insulin-to-carb ratio, which specifies how many grams of carb are covered by a single unit of insulin. Your care team can also help you determine your correction factor (also known as an insulin sensitivity factor)—the amount that 1 unit of insulin brings down your blood glucose in mg/dl. These factors are unique to you.

Once you and your health care provider have worked out your values, bolusing for meals becomes much easier: Check your blood glucose, input the amount of carbohydrate grams you plan to eat, and—voila!— you have the units of insulin you will need to dose for that meal.

While the feature is especially useful for people on basal-bolus injections (pump users can rely on their pump for this feature), it can be a valuable tool for anyone with diabetes on multiple daily injections who’s willing to count carbs to more precisely dose mealtime insulin. Whether that’s worthwhile depends on your lifestyle and diabetes management plan.

On-Demand Education

Education is a critical element of diabetes management. If your health care system has limited or no access to a diabetes educator or education program, consider a meter with a “coaching” app. Several brands tackle education with “coaching” features or sessions with a diabetes educator. Many of these programs are covered by insurance, and some are even covered by large employers. Discuss this option with your health care provider if you’re interested. And look for the following symbol on our meter listing—it points to meters that connect you with educators.

Wireless Transfer

Diabetes takes up enough of your time. So why bother manually entering your glucose readings when your devices can do it for you? Many meters offer Bluetooth connectivity—the ability to send blood glucose readings to an app, pump, or continuous glucose monitor (CGM) automatically, no cables required.

There are lots of reasons why this can be useful. For starters, it eases the burden on you. But it also reduces the likelihood of errors: There’s always a chance you can mistype a reading during manual entry, but that risk is reduced when the meter sends the reading automatically.

If you don’t have a computer or compatible program for uploading your glucose data via meter and cable, a device that uploads using Bluetooth technology is a great workaround. It’s worth noting that some meters that integrate with apps can use cellular communication as a backup to Wi-Fi when transmitting data. It’s just another way to automatically transfer your readings.

As useful as this feature is, it can be disappointing when interconnected devices are denied by your insurance. Consider this situation, for example: Your favorite meter wirelessly transmits readings to your insulin pump. As a result, your pump provides all relevant glucose data when downloaded, giving you a more complete picture of what is happening than separate meter and pump data reports would. But your insurance company prefers that you use another meter—one that doesn’t connect to your pump.

So, what can you do? Appeal to your insurer with a letter of medical necessity from your health care provider, explaining why a different type of meter and test strip is needed for improved diabetes management. Your health care provider can help you with that. Head here  for more on that.

Download Capability

If you prefer keeping a handwritten log (and can do it regularly), go for it. But if you’d prefer to download an electronic log to avoid recording each check that you do, you’re in luck: You can download data straight from your meter. It will store the date, time, and test result, allowing you to tag it with further information, such as whether you checked before or after a meal.

Of course, that data is useless if you do nothing with it. It’s important to review the data—especially when you and your health care provider are making medication changes, determining the effect of exercise and certain foods on your blood glucose, and tracking patterns.

There are so many meters and download programs available that your doctor may not have the right software to quickly download your data during a visit. So do it yourself at home before the visit, if possible. Most meters are easy to download, and the software can either be sent to you from the company or obtained from its website. You can call the number on the back of your meter box to ask for assistance.

Most meters use a special USB cable to communicate with your computer for the download. You can obtain this by calling the meter manufacturer or by requesting it from your mail-order diabetes supplier. If your health care provider is able to download your meter data at your appointment, you may not need to download it from home, but it’s a smart idea to do so. You may see patterns, notice problems, and have insights that you can discuss with your care team.

How Accurate Is My Meter?

Last October, the Food and Drug Administration (FDA) released a new guidance for manufacturers regarding the approval of new meters and the accuracy standards they must meet. Under the new, stricter guideline, 95 percent of all self-monitoring blood glucose results must be within 15 percent of the actual result (based on lab testing) and 99 percent of all self-monitoring blood glucose results must be within 20 percent of the actual result.

Furthermore, all accuracy claims must be printed on the outside of the meter box for the consumer to evaluate before buying. (In the future, accuracy information will be required on test strip vials, too.) This standard is being implemented for all new meters, though some meters may already meet this requirement.

Meters and Medicare

When making the switch from private insurance to Medicare, do your homework to determine the best way to order devices and supplies. Some Medicare plans ask that you buy durable medical equipment (including your meter and test strips) at your pharmacy rather than through a mail-order supplier. Find out whether sticking with your mail-order supplier or switching to a pharmacy will be cheaper for you by calling both your current supplier and prospective mail order companies to ask about your out-of-pocket cost. To find Medicare suppliers in your ZIP code, go to medicare.gov/supplierdirectory.

Keep in mind: Mail-order suppliers and pharmacies are not allowed to substitute your prescribed meter with a different one. Medicare (or your insurance company, if you’re not on Medicare) may have a preferred brand that is lower in cost to you. If your health care provider prescribes a different brand because it better meets your needs, it may be denied coverage. In that case, your provider may need to file a letter of medical necessity with Medicare or your insurer.

Also note that you can always purchase a meter and test strips over the counter at the pharmacy, but you won’t be reimbursed through your insurance or Medicare without a prescription. And while over-the-counter meters might be relatively cheap, paying out of pocket for test strips is not. If you don’t have insurance or your coverage for test strips is minimal, you may want to look into meters that offer unlimited test strips, such as One Drop and Livongo. There’s typically a monthly or yearly charge, which buys you the meter, unlimited test strips, and extras such as help from on-call diabetes educators. Whether shelling out a monthly fee for unlimited strips is cost effective depends on a variety of factors, such as your insurance and how many test strips you typically use.

 Download a full chart of blood glucose meters and their features.



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