Blood Glucose Monitors And Data Management Systems
Before you buy a blood glucose monitor (also known as a blood glucose meter), check with your doctor and diabetes educator. Make sure the one you choose is well suited to your particular needs. You might want to have one at home and one for use at school or the office.
Health care providers agree that blood glucose monitors offer substantial benefits to users that other methods do not begin to approach. Although urine testing is important for checking things like ketones, urine testing for glucose is no longer considered to be a reliable method for monitoring.
So monitors are your best choice for top-notch diabetes care. To help you in your hunt to find the best one for you, here are a few things to look for:
Expense. The cost of a blood glucose monitor and diabetes care supplies is often covered by health insurance. But don't just assume your insurance will reimburse you. Get approval from your insurance company before you buy. Some insurance companies and/or health care systems have special arrangements for certain monitors or systems. If you have an established health care team, you should discuss choices and cost before you buy.
You can usually find a deal on monitor trade-ins with rebates and special purchase offers. Check with your doctor and diabetes educator. Keep an eye on ads and compare prices before you buy.
In addition to the cost of a monitor, check the cost of testing supplies that you will need for that monitor. Over time, the price of test strips or sensors, control solutions, and other supplies will prove much more costly than the monitor itself. These added costs may influence your decision more than the cost of the monitor. You should always check with your insurance company before buying. Some insurers will only pay for certain strips. If the strips are not covered, you'll need to assess whether the costs associated with a given meter are prohibitive. You should also discuss with health care professionals how many times you should check your blood each day and what your budget can cover. Although you do not need a prescription to purchase strips, you may need one to get insurance reimbursement (co-pay).
Ease of use. Some monitors are easier to use than others. Some require a smaller drop of blood than others. Some require fewer steps to operate, and some take less time than others. If possible, talk with others who use monitors before you make your purchase to find out the pluses and minuses of various models. Remember that most monitor manufacturers have toll-free numbers for customer questions. Your health care team may be familiar with several different types, so check with them. Also, make sure your doctor will be able to work with the machine you choose. If you buy a monitor your doctor or diabetes educator is unfamiliar with or does not recommend, you may wind up not using it to its maximum potential.
Accuracy. All monitors currently on the market have a fairly high degree of accuracy if used properly. The monitor may become less accurate over time, so it is important to test your glucose monitor to ensure it is providing an accurate reading. Test monitor accuracy at least once a month (or according to manufacturer's instructions), or anytime you suspect a problem—for example, when strips are stored in unusual conditions during travel.
One way to test your monitor's accuracy is to check your blood glucose on your meter at the same time you are having blood drawn from your vein at your next doctor visit. The two samples should be taken within a minute or two of each other to get the most accurate comparison.
Blood glucose levels measured by a meter do use capillary blood directly from fingersticks. In contrast, blood glucose drawn from a vein by your doctor is sent to a laboratory, which spins blood cells out of the sample, leaving only plasma. Glucose is more concentrated in blood plasma than whole blood—roughly 15 percent higher. But virtually all new monitors and test strips are calibrated to yield a plasma glucose value, so these different methods shouldn't influence the results.
Check your box of strips to see if they give a plasma reading. Assuming they do, readings from these strips and monitors should correspond closely (within 15 percent) to lab readings taken at the same time. If you are not sure how to interpret the readings, check with your doctor or educator.
If the readings go beyond this margin, something is wrong. Poor readings can occur if your glucose monitor is dirty, old, or stored at extremes of temperature or humidity; if strips are outdated; or if there is a problem in your testing technique. Also, your monitor may not be calibrated to the lot of strips you are using. Be sure you know how and when to calibrate or code your particular model.
Cleaning and maintenance. No monitor is indestructible; each kind needs proper care. However, some need more cleaning and maintenance than others, another option to consider. Once you do buy a monitor, follow the manufacturer's instructions on the proper care for your monitor. Make sure training on the equipment is available nearby. Training that you can't take advantage of is of no practical use to you.
Portability. All of today's monitors are lightweight and run on batteries, so they are all extremely portable.
Test time. All the monitors provide fast results, usually in a minute or less. Some of the newer meters even give blood glucose results in five seconds. So this probably isn't going to be a major issue in your buying decision. If it is, however, compare the speeds of different monitors.
Audio monitors. If you have a severe visual impairment, you can still do your own blood glucose monitoring. There are several blood glucose monitors on the market that give verbal instructions to guide a person through the entire testing procedure and give verbal test results.
In the "Aids for People Who Are Visually or Physically Impaired" section of this guide, you will find a few "talking" products that announce, audibly, the results calculated by certain monitors (see chart). Units that "speak" Spanish and other languages are included.
Because technique is important in getting accurate results, you should work through the procedures for several different models, to find one that's easy and comfortable for you to use.
Test site. Alternative test site or forearm capillary blood glucose monitoring recently has been touted as a less painful means of testing blood glucose than traditional fingerstick methods. Studies have shown good correlation between fingerstick and forearm methods in the fasting person but higher blood glucose values from fingerstick sites after eating. This may be due to less vigorous blood flow in the forearm. Some studies have shown a difference in readings taken from a finger versus the forearm when blood glucose is low. Check with your doctor or educator. It may be safer to do a finger check if you feel the symptoms of low blood glucose coming on. Some studies, however, have shown good correlation between finger and forearm blood glucose levels when the forearm is rubbed or tapped before blood is taken.
The decision to buy a blood glucose monitor is a good one. The determination to use one regularly is even more important. So take the time to find the monitor that best meets your needs, one that you'll put to regular use.
A note on record keeping. Record keeping is almost as important as blood glucose monitoring itself. Keep a written log of blood glucose test results, even if your monitor has a memory, and take the log book to each appointment. (Your health care team can provide these books.) Be sure to also record other important factors such as eating, activity, and timing. Although paper records are still quite adequate for many people, some prefer to use data management systems.
Data Management Systems
The introduction of blood glucose monitors more than 20 years ago proved to be a boon in helping people take control of their diabetes. Data management systems can now make the job of tracking your diabetes care even easier.
Data management systems automatically record various aspects of your diabetes control each time you perform a blood glucose test. Data management systems can store hundreds of test results and other information (depending on the system) such as your glucose levels, the time and date of your tests, insulin types and doses, meals, and a log of your exercises.
If your provider has a personal computer that is compatible with your system, he or she can get a complete and accurate record of your test results over a period of time. (Some systems allow downloading to your doctor's computer by modem.) This information can then help you and your health care team design a plan for improving your treatment.
Another advantage of data management systems is that the information collected can be transferred to a computer and plotted on a graph. A graph allows you and your health care team to see patterns of blood glucose levels and determine at a glance what your blood glucose control has been over a given period of time.
If you're in the market for a data management system, you'll want to do a little homework first. Here are a few tips to help you decide which system to buy:
Compatibility. If you buy a system that is not compatible with your blood glucose monitor, your home computer, or your doctor's computer, you may be in for an unpleasant surprise when you go to use it. In computer language, compatibility refers to the fact that two systems are able to "speak" the same language. If two systems aren't compatible, they won't be able to "talk" to each other.
Size and convenience. Some data management systems are part of the blood glucose monitor itself. Others must be connected to the monitor. If you don't want to keep track of two units, get the kind that is combined into one unit.
Type of records. Ask your doctor what information about your treatment plan he or she needs you to record. For some, glucose values with the time and date may be enough. Other doctors may want you to record information on exercise, insulin dosage, diet, or other pertinent facts. It's important to decide what your needs are beforehand and purchase a system that will have the capability to meet those needs.
Ease of use. While you don't need to be a computer programmer to use these data management systems, some may be harder for you to operate than others. If you can, try several before buying. It may help to ask a diabetes educator on your health care team which products he or she would recommend.
Expense. A data management system is a luxury, not a requirement. So you must decide whether you want to spend your money on one. And you can spend a lot on these systems—especially if you choose to purchase a personal computer and printer, which can cost hundreds or even thousands of dollars. You have to decide what your wants are and what you can afford.
Data management systems are not for everyone. However, they can make the work of gathering and reviewing information concerning diabetes care more convenient. If you decide to buy a data management system, take the time to do some research and find a system with which you'll be satisfied.
Data Management Systems
The introduction of blood glucose monitors more than 20 years ago proved to be a boon in helping people take control of their diabetes. Data management systems can now make the job of tracking your diabetes care even easier.
Data management systems automatically record various aspects of your diabetes control each time you perform a blood glucose test. Data management systems can store hundreds of test results and other information (depending on the system) such as your glucose levels, the time and date of your tests, insulin types and doses, meals, and a log of your exercises.
If your provider has a personal computer that is compatible with your system, he or she can get a complete and accurate record of your test results over a period of time. (Some systems allow downloading to your doctor's computer by modem.) This information can then help you and your health care team design a plan for improving your treatment.
Another advantage of data management systems is that the information collected can be transferred to a computer and plotted on a graph. A graph allows you and your health care team to see patterns of blood glucose levels and determine at a glance what your blood glucose control has been over a given period of time.
If you're in the market for a data management system, you'll want to do a little homework first. Here are a few tips to help you decide which system to buy:
Compatibility. If you buy a system that is not compatible with your blood glucose monitor, your home computer, or your doctor's computer, you may be in for an unpleasant surprise when you go to use it. In computer language, compatibility refers to the fact that two systems are able to "speak" the same language. If two systems aren't compatible, they won't be able to "talk" to each other.
Size and convenience. Some data management systems are part of the blood glucose monitor itself. Others must be connected to the monitor. If you don't want to keep track of two units, get the kind that is combined into one unit.
Type of records. Ask your doctor what information about your treatment plan he or she needs you to record. For some, glucose values with the time and date may be enough. Other doctors may want you to record information on exercise, insulin dosage, diet, or other pertinent facts. It's important to decide what your needs are beforehand and purchase a system that will have the capability to meet those needs.
Ease of use. While you don't need to be a computer programmer to use these data management systems, some may be harder for you to operate than others. If you can, try several before buying. It may help to ask a diabetes educator on your health care team which products he or she would recommend.
Expense. A data management system is a luxury, not a requirement. So you must decide whether you want to spend your money on one. And you can spend a lot on these systems—especially if you choose to purchase a personal computer and printer, which can cost hundreds or even thousands of dollars. You have to decide what your wants are and what you can afford.
Data management systems are not for everyone. However, they can make the work of gathering and reviewing information concerning diabetes care more convenient. If you decide to buy a data management system, take the time to do some research and find a system with which you'll be satisfied.
Products For Testing Glycohemoglobin
The American Diabetes Association recommends that all people using insulin have glycohemoglobin (A1C) tests quarterly, if treatment changes or the patient is not meeting goals, or twice a year otherwise. Those not using insulin should have the tests every six months, or as often as necessary to maintain good blood glucose control. These tests provide an estimate of average blood glucose control over the previous two to three months.
Traditionally, people visit their doctors for these tests. However, kits are now available for performing A1C tests from home, and when used properly, these kits are reported to provide accurate results. Always check with your doctor about the use of A1C kits. And make sure that if you do use the home kit, you have a good understanding of what the results mean.
When using all but one of these kits, you'll place a drop of blood on a test strip and send the sample to a lab. You'll then be notified of the results by mail. If you decide to use these kits, we urge you to perform the first couple of tests under the supervision of your physician or diabetes specialist, to ensure that you are doing the test properly.
One new system, however, does allow you to test your A1C and provides results without having to mail in a sample.
Keep in mind that you should continue to discuss the results of these tests with your physician.
Blood-Sampling Supplies
Lancets and automatic lancing devices are frequently provided as part of blood glucose monitoring kits. Most lancet devices come with short and long lancet covers to provide different degrees of penetration, and many have adjustable covers or caps. Generally, people who are first-time users, children, or people with delicate skin prefer a longer cover for more shallow penetration of the lancet. People who have tougher skin or poor circulation choose a shorter cover for deeper penetration by the lancet. An individual may need to use different lancet covers for different fingers or when finger temperature affects blood flow.
Ease of resetting the lancet for the next use varies. Some products require the cover to be removed so that the lancet can be pushed back into position. Others have a simple push-pull mechanism that resets the spring. The latter may be preferable for children or people with coordination problems.
It's a good idea to keep an automatic lancing device at each place you may test—at home, at work, at school—so you won't have to carry one from place to place. Automatic lancing devices are inexpensive and last a long time, so owning more than one should be affordable. Remember that you should never share your automatic lancing device because of the small but real risk of transmitting disease by contaminated blood.
Discuss these considerations and others, such as lancet reuse and sterilization, with your health care provider.
