Self-testing your blood sugar (blood glucose) is an important part of diabetes care and can help you gain vital insight into how you’re affected by diet, exercise, lifestyle and other factors. Glucometers (glucose meters) can help you measure your blood glucose, and there are several considerations to make when choosing the best glucose meter for you, from additional costs to spotting trends in your blood sugar levels.
The majority of glucometers come with lancets to prick your finger to produce a drop of blood. You’ll then add that blood to a test strip to gain a blood sugar reading, which will be displayed on the glucose meter. Other glucometers use a sensor patch, usually placed on your arm, to monitor blood sugar levels.
To help you choose a glucometer, we spoke with diabetes educator and nurse clinician Susan Stauffer (BSN, RN, CDE), of Poudre Valley Health System, to gain her insight into blood sugar monitors and what you need to factor in before choosing one.
1. Get clear on the different types of glucometers
There are several types of glucose monitor to choose from, starting with self-monitoring meters. These are the most common glucose monitors and are used to test glucose levels in blood samples absorbed on a test strip after pricking your finger.
In comparison to other glucometers, noninvasive glucose meters are fairly new and aim to monitor blood glucose levels without implants or skin pricking. For instance, the Abbott FreeStyle Libre uses a sensor patch placed on your arm.
Continuous glucose monitors (CGMs) use a monitoring sensor implanted under your skin to take readings throughout the day and night. These devices provide constant data and don’t require test strips. However, they require implanting and some still need finger-pricking for calibration.
“CGM devices are wonderful alternatives to routine blood glucose testing," says Stauffer, "however, not all people need these devices and they are expensive to use. The accuracy of both the Dexcom G6 and the FreeStyle Libre has proven to be as good if not better than blood glucose meters, and the FDA has approved the BG number to be used for insulin dosing.”
2. Determine if you need one that tests ketones
Some people need to measure blood glucose levels and diabetic ketoacidosis, and there are all-in-one-testers, such as the Fora 6 Connect, that check for both. When asked whether these are preferable over separate, specialized equipment for each type of test, Stauffer said: “While people with type 1 diabetes need to check for ketones, you can buy a bottle of urine ketone strips for about $10 and blood ketone strips may cost $20 for 10 strips with insurance. It’s often easier and cheaper just to check urine ketones.”
3. Check the glucose meter’s accuracy rating
Current FDA standards require 95% of all glucometer results to be within +/- 15% of ‘comparator’ (lab tested) results, and 99% of results to fall within +/- 20% of lab results. However, just because a meter is FDA approved doesn’t mean it’s always going to be accurate, so check if the meter can self-calibrate. In our round-up of glucometers, the Accu-Chek Guide ranked top for accuracy.
4. Pay attention to the meter's blood sample size
When checking the specifications of your new glucose meter, look for the size of the blood sample needed to perform a test. The size of samples needed range from 3.0 microliters down to 0.3 microliters. It’s a spec worth paying attention to, especially for parents of children with diabetes. In our guide to glucometers, the model with the smallest required sample size was the Dario LC Blood Glucose Management System at 0.3 microliters.
5. Factor in how frequently you need to test
How often you need to test your glucose levels will give you a steer on which type of glucose meter to use. If you test your blood sugar throughout the day, look for a glucometer with a large memory, plus the ability to easily download results. If you test less frequently, a self-monitoring meter is suitable. Check the cost of the test strips if your insurance doesn’t cover them. On that note…
6. Check your health insurance coverage
In Stauffer’s opinion, health insurance is the most important factor when choosing a glucometer. “I’ve always believed a crucial factor for people who routinely check their blood sugar is insurance coverage.” says Stauffer. “Checking blood sugar is the most important thing, but whether you use the FreeStyle Lite or Contour Next One, it’s insurance coverage that rules.”
Stauffer advises you to check if your insurance covers both the cost of the glucose meter and the test strips. “Some strips cost $18 for 100 and some will cost $150 for 100.” If you’re testing four times a day the price quickly adds up, and insurance companies often set a limit on how many strips they’ll pay for per month or year.
7. Decide how you want to record your results
Keeping a track of your blood glucose numbers is vital, so check that your preferred glucometer has ample storage functions or offers the ability to create and download data logs. Some glucose meters link to popular monitoring apps (so that you can store and analyze readings), and we found the Contour Next One to be one of the most full-featured smart glucose meters available.