Diabetes
Glucose Meters & Diabetes Management

When people with diabetes can control their blood sugar (glucose), they are more likely to stay healthy. People with diabetes use two kinds of management devices: glucose meters and other diabetes management tests. Glucose meters help people with diabetes check their blood sugar at home, school, work, and play. Other blood and urine tests reveal trends in diabetes management and help identify diabetes complications.

Glucose Meters

Self-Monitoring of Blood Glucose

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."

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

Instructions for Using Glucose Meters

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

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

Cleaning. Some meters need regular cleaning to be accurate. Clean your meter with soap and water, using only a dampened soft cloth to avoid damage to sensitive parts. Do not use alcohol (unless recommended in the instructions), cleansers with ammonia, glass cleaners, or abrasive cleaners. Some meters do not require regular cleaning but contain electronic alerts indicating when you should clean them. Other meters can be cleaned only by the manufacturer.

Making Sure Your Meter Works properly

You should perform quality-control checks to make sure that your home glucose testing is accurate and reliable. There are two kinds of quality control checks:

Check Using "Test Quality Control Solutions" or "Electronic Controls".

Test quality control solutions and electronic controls are both used to check the operation of your meter. Test quality control solutions check the accuracy of the meter and test strip. They may also give an indication of how well you use your system. Electronic controls only check that the meter is working properly.

Manufacturers sometimes include quality control solution with their meter. However, most often you must order it separately from a manufacturer or pharmacy.

Take Your Meter with You to The Health Care Provider's Office

This way you can test your glucose while your health care provider watches your technique to make sure you are using the meter correctly. Your healthcare provider will also take a sample of blood and evaluate it using a routine laboratory method. If values obtained on the glucose meter match the laboratory method, you and your healthcare provider will see that your meter is working well and that you are using good technique. If results do not match the laboratory method results, then results you get from your meter may be inaccurate and you should discuss the issue with your healthcare provider and contact the manufacturer if necessary.

New Technologies: Alternative Site Testing

• Minimally Invasive and Non-Invasive Glucose Meters

Researchers are exploring new technologies for glucose testing that avoid finger sticks. One of these is based on near-infrared spectroscopy for measurement of glucose. Essentially, this amounts to measuring glucose by shining a beam of light on the skin. It is painless. There are increasing numbers of reports in the scientific literature on the challenges, strengths, and weaknesses of this and other new approaches to testing glucose without finger sticks.

FDA has approved one "minimally invasive" meter and one "non-invasive" glucose meter. Neither of these should replace standard glucose testing. They are used to obtain additional glucose values between finger stick tests. Both devices require daily calibration using standard finger stick glucose measurements and both remain the subject of continuing studies to find how they are best used as tools for diabetes management.

• MiniMed Continuous Glucose Monitoring System. The MiniMed system consists of a small plastic catheter (very small tube) inserted just under the skin. The catheter collects small amounts of liquid that is passed through a "biosensor" to measure the amount of glucose present.

Minimed is intended for occasional use and to discover trends in glucose levels during the day. It does not give you readings for individual tests and therefore you can't use it for typical day-to-day monitoring. The device collects measurements over a 72-hour period and then must be downloaded by the patient or healthcare provider. Understanding trends over time might help patients know the best time to do their standard finger stick tests. You need a prescription to buy MiniMed.

* Source "U.S. Food and Drug Administration"