The Best Blood Sugar Monitors?
What You Need to Know

Please don't think you need the newest or smallest or most fully "loaded" diabetic meter. The important part of any glucose monitor is that you use it and use the information it produces. You might even need more than one glucose meter - one at home, one at office, one at bedside - if it helps you remember to do blood sugar testing.

FYI: Blood Sugar Meter Recall. (Jan, 2006)

If you need help with lowering your blood sugars, please see your physician or health educator and check here for solutions on how to lower blood sugar.

An early P.S. If you're an insulin pump user , there are some cool blood sugar meters available to work with insulin pumps, check here (number six on the list of that page, I believe).

1. Ease of use/complexity: Ask the pharmacist or educator to show you how the meter is used. Then you try it with a sample solution. If you can't get right in 2 tries then maybe it's not the best blood sugar monitor for you. Are you button phobic? Then don't get a blood glucose tester with more than 1 button. You can get blood sugar monitors with no buttons! Be sure to check out all the points below though before you decide. Remember, the perfect meter for you must meet your needs! My perfect meter will be different than yours. Read this comment:

   One reader notes how useful she's found the Compact meter: " I have found one advantage that I did not see mentioned in your article on the advantages of specific meters that I have found immensely helpful. The Accucheck Compact has a lansing device that stores and can be used whild attached to the meter. This means that all activity related to testing can be done with one hand, even if that one hand is shaking due to low sugar. Push one buttton and it extends the strip, one click on the lansing devise preps it for lansing and another sticks you. Move the meter over an inch and you are collecting the sample. You even have extra time in case you are having difficulty due to shaking. This has been a godsend to me with some problems I have been having in the last few months. There are times I can hardly see straight, but I can still collect good data." -- Thanks for sharing Jane!

2. Speed: 5 seconds up to 45 seconds. Yes, for some this matters. Have you ever sat, stared and waited 45 seconds for something you don't particularly want to see?

3. Convenience: A few blood sugar monitors can handle pre-loaded strips. For example a disk (sort of like a birth control disk- sorry to alienate you guys) or a cartridge (like a small film roll) put into the meter and hold 10-17 strips. When empty, you reload another disk or cartridge. Check Ascencia Breeze or Accuchek Compact. Another convenience if you are taking Novolin insulin is the InDuo system. It is an Ultra meter attached to an insulin doser. So your meter and insulin are together in one device. (It does not accommodate penfills for Humulin insulins).

4. Size of blood sugar monitor: Answer this - where will you carry the diabetic meter? This helps you decide if . . .dare I say it? . . . size matters. Also consider the shape of the meter - handle it, hold it, pretend you will be using it. One of the tiniest blood sugar monitors on the market was too small for one of the my patients with big hands. But don't just consider the size of the meter. See the next point.

5. Size of meter in its case with accessories: The meter might be small but the carrying case with all the necessary accessories may not be. Ask to see the size of the meter when in the case with the strips and the lancet device if . . .ahem . . . if size matters to you.

6. Size of blood sample: Meters now-a-days require significantly less blood than the models from a few years ago. So if you have an old model it is worth updating for this (and for accuracy ). Most people have no problem getting a big enough sample for their meter. In fact, many people set their lancet devices too deep and get far more blood than they need. However, if you're stingy with your blood and don't give it up easily, then ask to see picture comparisons of blood samples. To date, as far as I know, the Freestyle glucose meter requires the smallest blood sample.

   Another note here is that the newer Freedom, Freestyle mini and Medisense blood sugar monitors will all allow you up to 1 minute to re-apply a sample of blood if you didn't get enough on the first time. This might save you money if you waste a lot of strips because of inadequate blood sample.

7. Alternate site testing: Some blood sugar monitors allow for testing on the forearm, earlobe, thigh as well as the fingertip. Wee warning: don't use the same lancet end cap for the finger as for the forearm. At least, not if you don't want to scream. Also, if you feel you are are experiencing a low blood sugar, you should test using fingertip - although some recent research shows that the palm of the hand might be just as accurate. When in doubt, use the finger (because, don't we all want to give the finger to our diabetes. Err. Sorry about that folks.)

8. Size and handling of diabetic test strip: Now, this is worth reading. I see a number of people who have test strips that do not suit their dexterity, arthritis or poor vision. Some of the small meters have - you guessed it - small strips. And yes, these small strips might even be inside small containers that perhaps you can't fit your finger into (men in particular can have this problem). I've seen whole vials of strips fall onto the floor when people need to "shake" the vial to get a strip because they can't fit a finger in. With arthritis you might have the problem holding a tiny strip. Perhaps a bigger strip (like the Accuchek) or a meter that spits out strips like those mentioned in number 3 above. Also, if you can't see the strip well enough to get the blood in it, you might try the Accucheck diabetic meter as it has a big strip with a curve on the slip your finger into. Some of the strips come individually packed in a foiled type package. Ask the pharmacist if you can try opening a few before you purchase the meter. I've had patients who cannot get these packages open easily. The same goes for some of the vials. You don't want to choose options that will get in the way of you doing blood sugar testing. Check with your local Institute for the Blind if you or a loved one needs a talking blood glucose meter.

9. Strip outdating/staling: Some strips will "stale" after 3 months once the vial has been opened. The Freedom and Freestyle Mini meters have strips that are usuable even after 1.5 years after opening the vial!! So the company rep tells us. This is great for people who don't test too often and don't want strips to spoil and be wasted. Also, you can purchase strips that come in individual foil packs - like the Medisense.

10. Size of numbers on screen: An issue for those with poor vision or cataracts. Compare the display size and the actual size of the number displayed on the screen. If vision is extremely limited then consider the next option.

11. Talking/voice features: The ACCU-CHEK® Voicemate System is one talking meter on the market. Recently I had a reader inform me of another (Thank you, Aman). The Prodigy Talking Glucose meter is either made or distributed by Diagnostic Devices Inc in Florida, US. You can visit their website at www.diagnosticdevicesinc.com to learn more about it. Also, in looking for more news on talking meters, I came across the SensoCard Plus which is currently available in the U.K. (2006). Please see this page for more information www.diabetes.org.uk/news/may05/talking.htm Please contact The National Federation of the Blind or The Canadian National Institute for the Blind for information regarding purchases, possible subsidies and of course useful management tips when visually impaired. Also, if you are aware of another talking meter, I'd appreciate hearing from you through my contact form. Thanks.

12. Backlight: Mothers who test their kids while sleeping like having a backlight. Likewise, if you go to a lot of movies you might like the backlight too. Very few blood sugar monitors have a backlight. Offhand, I can think only of the Freestyle but please don't hold me to that. I don't have a backlight on mine and am always bugged when I go the movies and test but luckily (or unluckily) I don't go to the movies often so this isn't a concern for me.

13. Strip availability: does your pharmacy regularly the diabetic test strips for your desired meter? Do they have to special order? What is your cost is the strips must be special ordered? Best to ask the pharmacist.

14. Cost: For many people, the cost is simply the biggest barrier. If finances are an issue, focus on the cheapest strips. You can often get blood sugar monitors for minimal or no cost through pharmacy or online promotions. The strips are the long-term repeating expense. Talk to your pharmacist about cost then ask 5 other competing pharmacies or check online for diabetic testing supply. Pharmaceutical companies hate me for suggesting this next cost saving tidbit. If you get meters free collect the different brands and use whatever one is on sale at the moment. Pharmacies often have rotating sales on glucose test strips. So, the heck with brand loyalty if finances are a concern. The meters are designed to benefit health and that can't happen if the strips cost too much. Just make sure all your meters are accurate. Also, some places sell generic test strips but make sure they are appropriate for your meter and you've done a lab/meter comparison to see if they are accurate. See below re: accuracy. Also, in some places visual blood sugar testing strips are still available. You can cut them lengthwise to stretch your supply. However, they are more cumbersome and less accurate but they are definitely better than no blood sugar testing.

15. Insurance coverage: Some insurance companies may only cover the cost of specific blood sugar monitors and their strips. Be sure to check, particularly if you live in the U.S.

16. Type of lancet device included: Lancet devices are not all equal. Most lancing devices have a dial or some mechanism to choose the depth of the poke. However, some "pokers" are more dramatic in their action than others. If yours really bounces when it pokes and you're not happy, seek out another one. Also, most meters offer lancet devices that will take the standard lancets (that's the needle part that actually pokes you). However, Accuchek products take a flattened lancet that fits only their lancet devices. This matters only if you are splitting a box of lancets with another family member (I know oodles of people doing this). Also, Accuchek now offers a "Multiclix lancing device". A poker with 6 lancets inside so you rotate through them, discard the end piece and click on a new one with 6 new lancets.

17. Temperature Range: If you go hiking or work outside in hot or cold weather check the working temperature range for blood sugar monitors. You want one that extends over the broadest range. Otherwise, the meter might not work when you need it. Also check the notes under accuracy .

18. If you're on peritoneal dialysis: Not all blood sugar monitors are approved for use in those on peritoneal dialysis. Please call the meter company and ask before you purchase the meter. Some of the chemicals in the dialysis solution interfere with the readings.

19. On screen logbook: This is the Ultrasmart meter. Sounds cool and is cool for many people BUT lots of buttons and you need to know how to "over-ride" it. For example, if you eat a late breakfast at 1000 it will code that reading as an "after breakfast". You would need to "over-ride" it with some quick programming to tell it to code it as a before breakfast test. Also, this meter is larger than most others. But fast!

20. Size of time, date, blood sugar memory: Most meters have this. Double check if you rely heavily on the memory instead of recording the readings in a logbook. By the way, all the blood sugar monitors come with a glucose logbook.

21. Averages: Many blood sugar monitors offer this but you are not losing out if the meter you like doesn't have it. Diabetes educators like to look at trends for specific times of the day - you should start thinking like that too. Don't worry if your meter doesn't give you averages.

22. Can record grams carb, insulin dose, exercise: Cool feature, particularly for those on multiple doses of insulin and trying to determine insulin to carb ratios. However, of all the people I see on insulin (too many to count) only a handful decide on this option and only 1-2 actually use it (perhaps less). Still, it might be an option you need and one that makes your life more organized. The Ultrasmart offers it.

23. Coding: Why in red? So many people have meters that should be coded to their strips but do not do it. This could result in meter readings up to 43% off!! And not consistently either. See here for accuracy issues. Apparently, if your meter is coded for a "2" and the strips are a "3" that does not necessarily make things "close enough". Many blood sugar monitors exist that do not require coding. The coding is done automatically by the machine. Ahhh - what a relief. Mind you, it is not a big feat to code a meter. But ask how and do it with each new batch of strips.

24. Memory capacity: they all pretty much have loads but if you must rely on memory be sure to check the number of readings the meter will hold.

25. Computer software: Many blood sugar monitors offer a form of computer software to download your results to your computer. They also arrange the results in various graphs. Some of the software is easy to use and understand, others well . . . I'd say please see an example of the printed screen or printed reports before you invest in buying the hookup cable. Although, of late, some companies are offering the cable free. Also, be sure you will use the data. What is the point in you spending time creating, downloading graphs etc if you don't know how to use that data? If you've got good data and need some specific ideas for how to lower blood sugar check here: lower fasting sugars , lower lunch sugars , lower supper sugars or lower bedtime sugars .

26. Opinions of friends & family: No matter how exciting the advertising is for blood glucose monitors, it's always nice to talk to someone about why they like or don't like their particular meter. Meters can have their quirks (and you won't read about them in the advertisements).

27. The Guardian® RT Continuous Glucose Monitoring System : As of Nov 2005 this device from Medtronic/Minimed is approved in Canada and select U.S. cities. I imagine it will quickly be available in all U.S. states. It is a flexible cannula (tube) placed into the fat of the stomach that senses glucose in interstitial fluid and sends the results to a cordless monitor (about 4 inches by 3 inches and 1.5 inches thick). You can read the results on the screen. I have had the opportunity to wear it. Comfort for me wasn't an issue but I must say that I wasn't pleased with how slow it reacted to my changing sugars. And although it didn't read badly at "nice" levels it sure was off when I had higher blood sugars. I would not (and did not) use it to make insulin dosage changes. It simply was not giving me as up to date data as my blood sugar monitor. It is a costly beast running into the thousands. Also, the sensors are about 50 dollars each and can be used for about 3 days. I believe the monitor will be included in Minimed's next insulin pump (as an option). Should you purchase it, work closely with your diabetes educator when setting it up. It requires much calibration (eg. finger sticks on your blood sugar monitor). The more the better I'm told. Which frankly seemed to defeat the purpose of the thing for me. But, alas, for others this may well serve to be a most useful tool for evaluating overnight blood sugars. Regardless, you cannot give up fingerstick testing if you have one of these monitors.

28. The emotional factor: Okay, this one defies reason. But some people just bond with a look. One of the nurses I work with just loves the look of one of the meters. A few patients just think its so cool their blood sugar monitor looks like a cell phone. Hey, whatever makes you happy and gets you blood sugar testing.

I suppose because I'm always multitasking I like blood sugar monitors that spit the strip out after I touch a button. My husband doesn't like this one at all. He'd rather open a vial and manhandle a tiny strip to put in his glucose tester. BUT, it is his meter, his choice and he sure likes the thing (truth be told I'm too clumsy to take individual strips out of a container. I've fed too many of them to the floor in the past). Now my daughter is at risk for diabetes (since both her folks have it) and she periodically tests but uses a meter different from what either of us use).

So when people tell you that that they know THE BEST blood sugar monitor, take it with a grain of salt or with a drop of blood.

THE BEST blood sugar monitor is one that suits your needs. That includes one with the BEST DIABETES TEST STRIPS to suit your needs. NEXT >>