The biggest advancement in diabetes control has been the development of blood glucose monitors. A blood glucose monitor (GM) is a small, portable device that can be used by a person who has diabetes to measure the level of glucose in their own blood. These instruments allow people to measure changes which occur in their blood glucose levels on a regular basis.
Blood glucose levels can be measured using a drop of blood from a finger tip and applying it to a reagent strip. The blood on the test strip reacts with the materials on the test area causing a colour change or an electric current in proportion to the amount of glucose in the blood. The electrical components of the GM use the colour change or electric current to identify the amount of glucose present in the blood sample. This result is displayed on the GM screen.
There are many different GMs now available in Canada with more to come, including a “talking” GM for the visually impaired or blind. Modern technology is constantly making the GMs more reliable, smaller, faster and easier to use. Research is progressing on non-invasive GMs that will not require a blood sample, but these products are still five to 10 years away.
Diabetics should test their blood glucose levels regularly to determine if they need insulin or medication adjustments. This regular testing helps avoid emergency situations, such as hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar). Testing is especially important for anyone who does not feel the onset of a hypoglycemic episode, particularly those who live alone. Monitoring blood glucose levels motivates people with diabetes to manage their diabetes more effectively and, therefore, improve the quality of life and reduce serious long-term consequences of diabetes.
Glucose monitoring is strongly recommended for:
If you are diabetic and thinking of buying a glucose monitor, keep the following points in mind:
Accuracy and Precision
All the GMs on the market are fairly accurate (within 15 per cent of clinical laboratory measurements) when used according to manufacturer’s instructions. It is important to conduct regular quality control tests on your GM by using the control solution provided by the manufacturer and by checking the GM with the calibration strip.
Maintaining the precision of the GM is equally important. Precision refers to the similarity or 'closeness' of the test results using the same blood sample for a series (for instance, 20) of tests with the same GM. Most GM strips have been improved to produce more lab-like results.
The price of a GM has dropped in the last few years. Also, most manufacturers have trade-in or rebate offers to allow you to purchase a newer GM. However, the cost of the test strips remains relatively high and is still one of the biggest problems with the use of a GM. Some insurance companies cover a percentage of the cost of the GM and strips. Check with your insurance company and find out what is covered for a person with diabetes. Some provincial governments have programs that cover a percentage of the cost of supplies. Ask your pharmacy to keep you informed about sales, rebates and trade-in offers. Also, ask your pharmacist for information on financial assistance for your diabetes supplies.
Ease of Use
Most of the new models of GM are very user-friendly. They require fewer steps to use them and they have larger visual displays. Some even have instructions on how to operate the GM shown on the display. Older models of GM needed special cleaning but this is not necessary with most new models.
Size of the Drop of Blood
Most of the new models require a smaller drop of blood than the older models.
Be sure the GM you buy has a warranty and do not forget to fill in the warranty card and mail it to the manufacturer. Most GMs have four-year warranties and some even have lifetime warranties. All the manufacturers have excellent customer service departments. If there is something wrong with your GM, they will replace it.
Size and Portability of the GM
Most of the newer models are smaller and have more compact cases, making it easier to carry the GM with you at all time. However, it is important to note that the GM should be protected against extreme temperatures during transport.
Memory: Most GMs can store from one to 250 test results in their memories. The GM memory, however, should not be used to replace your diabetes log book.
Computer Program: Some GMs have computer programs that can show statistics to make the test results more meaningful.
Voice Synthesizer: Voice synthesizers that gives auditory instructions for the visually impaired or blind person.
GMs may come with various accessories such as strips, lancets, a finger lancing device and quality control solutions. Sometimes these accessories need to be purchased separately. Find out what is included with each type of kit and what needs to be purchased in addition for the proper use of the GM.
What To Do If Your Glucose Monitor Is Not Working Properly
As with any procedure where the skin is punctured, there is always the need to prevent infection.
See your doctor and diabetes educator. They will work out a treatment plan for managing your diabetes according to your age and type of diabetes. They will also set a target range for your blood glucose levels and work out a testing schedule.
Remember, keeping your blood glucose levels as close to normal as possible will help prevent or delay the serious complications of diabetes. It is recommended that blood glucose levels be tested more frequently during:
It is important to buy your GM at a pharmacy with a diabetes center that can provide the necessary support for both you and the instrument. Proper instructions for the operation of a GM should be provided by a qualified person. Look for a pharmacy that provides a teaching area away from distractions and noise. Ask about the different types of GMs and discuss their operation as it applies to your individual needs. Choose a GM that fits your lifestyle and addresses your concerns. For instance, if you have a problem with vision, look for a GM with a large display.
Develop a good relationship with your pharmacy in order to keep up-to-date on new products, sales, trade-in and rebate offers. The pharmacy may also provide you with pamphlets and videos from the resource centre. The pharmacy will also have the computer programs available to provide print outs of your GM test results.
It is very important to talk to your pharmacist about over-the-counter drugs and prescriptions that might affect your blood glucose levels. Many prescription medications may raise blood glucose levels or lower them and can do so in varying degrees in different people. Most can still be used by diabetics but the patients should be aware of the possible effect the drugs may have on their glucose levels and report any noticeable changes to their doctors.
It is important to try to fill your prescriptions at the same pharmacy each time so the pharmacist has an accurate record of all of the medications you are currently using and can warn you of any potential problems.
There are also a number of non-prescription medications that may alter blood glucose levels.
Non-prescription medications or ingredients that raise or lower glucose levels.
Always check with your pharmacist before buying over-the-counter medications if you are unsure about the effect on your glucose levels. For instance, a number of cold or flu remedies contain decongestants that may lead to hyperglycemia (high blood glucose levels). Read the labels carefully and take the product only as directed on the package.
Your pharmacist is always willing and able to give advice and help you find a product best suited to your needs.