According to the Centers for Disease Control and Prevention, nearly 30 million people in the U.S. have some form of diabetes. Whether you’ve been recently diagnosed or you’ve had it for a long time, an accurate glucometer is an essential part of managing your diabetes. It’s not just another electronic gadget – it’s a necessary part of your treatment. As such, buying a glucometer is not a decision you should make lightly.
You don’t need a prescription from your doctor to buy a blood glucose meter. You can buy most brands of glucometers, including the test strips, from your local drug store near the pharmacy. There is a wide variety of devices that range from high-tech Bluetooth-enabled models to low-tech manual-coding devices.
We began our review of blood glucose meters by researching over 30 of the most popular options on the market. We looked at specifications, features, user reviews and medical studies. After over 80 hours of research, we separated the wheat from the chafe by eliminating glucometers that are too expensive, too cheap and severely low rated as well as those that require coding, which is an indication of old technology.
We settled on a list of 12 glucometers, which we purchased with the intent of testing the accuracy of each device. After all, a glucometer is a tool to help you manage your diabetes, so accuracy is critical. However, we soon discovered that we couldn’t adequately test for accuracy. Time, costs, sampling size and a host of variables proved to be too much of a hurdle to provide defendable results. As such, we decided to trust that each product maintains the FDA requirements – accurate within 15 percent of real blood glucose levels, 95 percent of the time.
Instead of finding the most accurate glucometer, we decided to review the devices based on specific priorities. In our research, we found three trends in user comments: complaints about cost and availability, eyesight problems, and a need for better data management. Using these concerns as guides, we rated the glucometers based on their ability to fulfill these needs.
Before diving into our review process and our recommendations for the best glucometers, it’s important to note that Top Ten Reviews is not a substitute for your primary care physician. Our recommendations are made based on common scenarios, hands-on experience, market cost evaluations and a comparison of important features, but they’re not a replacement for advice from your doctor. We are not medical experts.
Best Glucometer for Diabetics With Poor Eyesight
Between 40 and 45 percent of diabetics have vision problems as a direct result of their diabetes. With diabetic retinopathy, the blood vessels near the light-sensitive tissue are affected, causing poor vision that slowly deteriorates and can eventually lead to blindness. With diabetic macular edema, there’s a buildup of fluid near the retina in the macula, which hinders your sharp, straight-ahead vision. In addition, diabetics develop cataracts at an earlier age and are nearly twice as likely to develop glaucoma.
Surprisingly, most glucometers don’t address vision issues. Many glucometers don’t even have high-contrast screens with large text. It doesn’t do you much good to test your blood if you can’t read the numbers. As such, we looked at the few glucometers on the market that have voice guidance features. With voice guidance, you’re given auditory instructions, and your blood sugar levels are read to you. You can be completely blind and still use these glucometers effectively.
The FORA TN’G Voice reads your glucose levels to you and guides you through the features with a voice guidance system. If you have vision problems caused by your diabetes, this is your best option for a blood glucose meter. Not only is it easy to use without sight, but it’s also one of the few glucometers with Bluetooth and a free app to help manage your diabetes in real time. The test strips aren’t widely available, but they aren’t expensive, which is a major bonus in the long term.
Best Glucometer for Data Management
Many diabetics just use glucometers when they’re feeling like their blood sugar might be low or high. If you’re newly diagnosed or pre-diabetic, you might only test your blood once a week or a few times a month. However, keeping track of your blood sugar levels can help you slow the progression of the disease by allowing you to spot trends so you can get ahead of minor issues before they become big problems.
Every glucometer on the market can store hundreds of readings, and some can analyze the data and spot trends directly on the device. Most allow you to add small notes to each reading such as whether it was taken before or after a meal. The best glucometers help you manage the data with data management software. In some cases, you have to buy the software separately, though it’s often included. You integrate the data on your glucometer by transferring it to your computer. By using the software, you can create graphs and export reports to send to your doctor, if needed. That said, this is quickly becoming a thing of the past.
The best glucometers for data management use Bluetooth to integrate with an app on your smartphone. When you take a reading, the glucometer automatically transfers the information to the app. The data is there, in your pocket. You can make long-term decisions while you’re in the moment, rather than waiting until you can transfer the data to your computer. However, few glucometers on the market have taken advantage of this technology.
The FORA Test N’GO is one of the few glucometers on the market to take advantage of Bluetooth technology to incorporate your readings with an app on your smartphone. The app makes managing your diabetes easy and immediate, allowing you to spot trends in your glucose levels in real time. While the test strips are only available at a few online stores, they are reasonably priced.
Best Glucometer for Cost & Availability
Most glucometers cost between $20 and $30 – not a major expense. However, the long-term costs add up when you consider the test strips. The price of test strips varies depending on the distributer, but most cost between $0.12 and more than $2 per strip. If you test four or five times a day, test strips can very quickly become a major expense. In addition, a common complaint is the availability of the test strips. If you run out and need to run into a pharmacy, will you find compatible strips?
We evaluated the cost of the test strips by buying packs of 50 and packs of 100 from 15 online stores and five local pharmacies. To evaluate availability, we looked at how easy it was to find the necessary test strips, both in stores and online. We visited over a dozen local pharmacies, including national chains like Walmart, Walgreens and CVS and smaller, local family-owned pharmacies. We also considered online stores, including many diabetic supply stores – Express Diabetic, Diabetes Supplies 4 Less, Total Diabetes Supply, Diabetic Corner and more. We also considered whether the online stores offered overnight or express shipping.
The Bayer CONTOUR NEXT meter is one of the few glucometers that uses test strips that are available in every pharmacy and online store we checked. The strips are also among the most affordable available. It has a Second-Chance feature that allows you to add more blood to a test strip if you didn’t gather enough the first time, which saves you from wasting them. When you combine this availability and affordability with the device’s ease of use and high-contrast display, it’s easy to see that it’s one of the best glucometers available.
How Do They Work?
Blood glucose meters are relatively simple devices that use an electrical current to gauge how much glucose is in your blood. You start by using a lancet to prick your finger so you can squeeze a drop of blood onto a test strip. The test strip has glucose oxidase, an enzyme that reacts to the glucose in your blood. When you insert the strip into the glucometer, the meter uses an electrical current to determine the conductivity of the blood droplet. The more glucose in the blood, the more conductive it is.
By using calibrated algorithms, the glucometer is able to convert the conductivity to a blood glucose level. You use this number to determine how to treat your diabetes in real time and to record glucose level trends over time so you can better monitor the progress of the disease. However, glucometers aren’t necessarily accurate. In order to receive FDA approval, they only need to be within 15 percent of the actual blood glucose levels and only 95 percent of the time. So if you have a reading that doesn’t seem right, you should test your blood multiple times and maybe even test with a second glucometer.
Issues With Testing Accuracy
Your blood glucose readings affect how you treat your diabetes. If it’s too low, you take glucose tablets. If it’s too high, you might take a shot of insulin. But what if it’s not accurate? What if the numbers you’re reading are off? You might take a dose of insulin when you shouldn’t or miss a dose when you desperately need it. The ramifications of an inaccurate reading can be serious.
As mentioned above, for a glucometer to be approved by the FDA, it has to be within 15 percent of a laboratory result. However, it only needs to be within this range 95 percent of the time, which means that 5 percent of the time, you could have readings that are grossly inaccurate. After reading hundreds of user comments, we found that many diabetics don’t believe their glucometers fall within those guidelines. As such, it makes perfect sense to test the best glucometers for accuracy.
However, we found that such tests are very difficult to pull off, especially on a small scale. There are many factors that can make your readings inaccurate – calibration of the meter, ambient temperature, dirty hands, altitude, humidity, the age of test strips and more. There are so many variables that only a large-scale comparative test could be defensible. That said, we still tried.
Issues With Testing Blood
The first and most obvious approach was to test actual blood. The idea was to collect a sample of blood and have a portion of it tested in a lab while using the rest to test with the glucometers. However, to account for variables, we’d have to perform the test hundreds of times on many different individuals. The lab costs would have been exorbitant. And since we’d want to gauge the glucometer’s high, middle and low reading accuracies, we’d have to use samples from enough people to ensure we covered each range adequately.
Testing With Control Solutions
Since blood testing would be too time consuming and costly, we decided to run tests using control solution, which are small vials of liquid that have known glucose levels. These solutions are used to make sure your glucometer is still accurate. On the surface, it seems like a one-to-one substitute for blood.
We bought control solutions from multiple brands in the low glucose, normal glucose and high glucose ranges and then bought hundreds of test strips for each device. We pushed out a large droplet from the vial and ran 50 rounds of each glucose range. However, we learned that the control solutions aren’t an exact substitute for blood. Some glucometers didn’t have a single accurate reading, and some recognized the solution as not being blood and provided an error message. It became clear that the solutions include proprietary chemicals, so they are likely only going to be accurately read by the glucometers they’re made for.
Finally, we realized that any tests we performed wouldn’t be defensible, so we abandoned the goal of finding the most accurate glucometer.
Having a Backup Plan
In a perfect world, your glucometer would be 100 percent accurate every time you used it. You’d also be able to accurately guess whether your blood sugar was high or low based on how you felt. However, this is not the case. Sometimes you can’t trust how you feel, and often, glucometers aren’t as accurate as they should be. As such, having a backup plan for measuring your blood sugar is an important part of managing your diabetes.
First, if you have strange reading, you should run a second test. If that also proves strange, then the best backup plan is to have a second glucometer. This can be your old glucometer, so long as it still works and provides accurate readings. The backup doesn’t need to be expensive. You simply need a second device to see if the readings are way different from those on your primary device.
For example, if your reading seems way too high or too low or doesn’t match with how you’re feeling, you can test your blood with a second glucometer to see if the results match. If the readings are close, then you know that the first one was accurate, and you can treat the situation accordingly. But if the reading from the backup meter shows as normal, then your primary glucometer may need calibration, or there could be an issue with the test strips.
In addition, if the readings are the same or close but you feel different than you think you should based on your glucose level, then you should talk to your physician as soon as possible and have your blood tested in a lab.
The Pros & Cons of Alternate Site Testing
Alternate site testing refers to taking blood samples from anywhere but your fingertips. This usually means drawing blood from the forearm, upper arm, palm, thigh or calf. However, to use blood from these alternate sites, you need a glucometer approved for alternate site testing.
Pros: Alternate site testing is ideal for diabetics that need to monitor their blood four or more times a day. These alternate sites are less painful to lance than fingertips because there are fewer nerve endings, and you’re not left with sensitivity in your fingers after a reading. Also, alternate sites are generally less susceptible to contaminates like food, dirt and grease.
Cons: There is a lag time in the flow of blood to these alternate sites, particularly when your blood glucose is low, after a meal or after exercise. This means that the glucose level the glucometer reads from the alternate site is not an accurate representation of your current level but rather a reflection of your glucose level 20 to 30 minutes prior. You blood flows faster in your fingertips, which is why blood samples taken from there are a better reflection of your current blood sugar levels.
When to use an alternate site: Routinely before meals; two hours before or after a meal, a rapid-acting insulin injection or insulin pump bolus, and exercise.
When not to use an alternate site: You think your blood sugar is falling; within two hours of a meal, insulin injection or exercise; you are concerned about hypoglycemia or an insulin reaction; before driving or operating dangerous machinery.
Will Your Insurance Cover the Cost?
You don’t need a prescription to purchase glucometers, test strips or lancets. These are all over-the-counter products. However, since the long-term costs can be high, many insurance plans cover the meters and the test strips. While co-pays and coverage may vary, you should contact your insurance provider and talk to your doctor about what brands are covered under your insurance plan.
The one downside to using insurance to offset some of the costs is that your plan often dictates what brand you can use. This is one of the most common complaints among diabetics because too often the only glucometer brands approved by their insurance providers have very expensive test strips.
Medicare Part B covers some diabetic supplies, including test strips, with a 20 percent Medicare-approved co-pay. However, this only applies if your physician and pharmacy are enrolled with Medicare.