Blood Glucose Meters and Monitoring

July 28 , 2006

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All patients with diabetes should have their own blood glucose monitor and strips. The frequency of testing should be based primarily on the treatment regimen. Complexity of the meter as well as cost to the patient should also be taken into consideration.

Comparing Meters

Accuracy: All meters currently on the market have a fairly high degree of accuracy if used properly. You should have your patient compare their meter to a lab drawn blood sugar by having the lab draw the blood ample and then they do a stick and compare the results.

Expense : The cost of blood glucose meter and supplies are covered by all third party payers. This does not mean that all third party payers cover all meters and supplies. Most meters are covered by the durable medical benefit and the strips and lancets are covered by the pharmacy benefit. Managed care covers different strips on different tiers. The best way to know what coverage your patient has, is to have them call the 800 # on the back of their insurance card.

It does not help to give a patient with free care or no insurance coverage a “free” meter with expensive strips. These patients are best served with the use of an Accu-check active or a store brand (Wall-mart, CVS, Walgreens, etc.) meter as these strips are much more affordable to patients and lead to increase in use.

Test time: Today’s meters provide fast results, typically in less than a minute. Some of the newer meters display the results in less than 5 seconds.

Test sites: Many people with diabetes are asking for alternate site testing meters as these have been touted as being less painful. Fingerstick readings do tend to be higher than forearm glucose readings after meals. Patients should be asked to check a fingerstinck if they suspect hypoglycemia

Jo-Ann’s Picks

Best overall: Lifescan ,Ultra; Roche, Accucheck Avivia

• Covered by most insurers at lowest copay Easy to use
• Can be downloaded by patient and provider

Best for Medicare/Medicaid , low literacy, technically challenged: Bayer Contour

• No coding of strips needed
• Easy to use
• Covered by Medicare and Medicaid
• Not covered by all insurers at lowest tier

Best for dexterity challenged: Bayer Breeze; Roche, Compact

• No individual strips, both use prepackaged strips in a drum or packet

Using a Blood glucose meter

Once a meter has been selected, successful use of the meter is extremely important, since clinical decisions are based on these results. Most meter companies offer free software for the office to download patients’ results. Ask your local sales rep for more information.

When writing a prescription for a meter, include the name of the meter be careful not to write “glucometer, use as directed”. Glucometer is the brand name of an old Bayer product. Also include prescriptions for lancets. Irregular renewal of the prescription for strips may be an indicator that the patient is not testing as prescribed.

Home Glucose Meters Available

• Models in underlined print have software for personal computer links
• Models in italics print are approved for “alternate site testing”
• Please note that these sites are not appropriate during times of rapid change in glucose (postprandial, hypoglycemia)
• Models that have an * and are in bold are suggested most often by the Certified Diabetes Educators within Partners Healthcare

For any additional questions feel free to contact Jo-Ann Barrett, RN,CDE Diabetes Education Program Manager at :jbarrett2@partners.org

For more information Diabetes Forecast puts out an annual resource guide. You can access this link at: http://www.diabetes.org/diabetes-forecast/resource-guide.jsp

.©Partners Community HealthCare, Inc. This information is intended for general educational purposes for professional medical personnel only. It is not intended to be relied upon for the treatment of an individual patient without the exercise of independent judgment by a physician.

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