Blood Glucose Monitors 

Updated: Apr 08, 2015
  • Author: Benjamin Daniel Liess, MD; Chief Editor: George T Griffing, MD  more...
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Practice Essentials

Blood glucose monitors are devices that measure blood glucose levels electronically. They are indicated for individuals with diabetes mellitus type 1 or 2.

Essential update: First continuous glucose monitoring system approved for young children

In February 2014, the FDA expanded its approval of the Dexcom G4 Platinum continuous glucose monitoring (CGM) system to include use in children aged 2 to 17 years of age, making it the first CGM system approved for use in young children. The FDA cautions that in studies in pediatric patients, the device was not as accurate as it is in adults, and its ability to issue an alert at glucose levels in the hypoglycemic range in children was poor. The product’s label will include warnings about these limitations. [1, 2]

Design

Blood glucose meters measure blood glucose levels electronically. Such measurement utilizes only a small drop of blood from the fingertip placed on a disposable test strip. The digital meter obtains information from the blood on the strip, and within seconds, the glucose level is displayed on the screen. Patient discomfort and inconvenience are minimal, and compliance with testing regimens is therefore high.

Continuous blood glucose monitors

A continuous blood glucose monitor (CGM) assesses blood glucose levels on a near-continuous basis. A typical system consists of a glucose sensor placed subcutaneously, a non-implanted transmitter, and a receiver worn like a pager, which records blood glucose levels at frequent intervals and monitors trends.

CGM systems monitor interstitial fluid glucose levels. They must be calibrated with traditional fingerstick tests.

Continuous monitoring provides documentation of blood glucose response to insulin dosing, eating, exercise, and additional influences. Overnight monitoring may identify problems with insulin dosing and allow adjustments of basal levels. Many units are equipped with alarms to warn patients of hyperglycemia or hypoglycemia and provide time for treatment.

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Products

Blood glucose monitors are devices that measure blood glucose levels electronically.

Category

Blood glucose monitors

Device details

Dozens of blood glucose monitors are commercially available. The following examples do not represent an all-inclusive list and are in no specific order.

  • Roche Diagnostics - ACCU-CHEK
  • Nova Biomedical - Nova Max Plus, Nova Max Link
  • Abbott Diabetes Care - Precision Xtra, FreeStyle Lite, FreeStyle Freedom Lite
  • LifeScan - OneTouch
  • Nipro Diagnostics - TRUE2go, TRUEresult, TRUEtrack
  • Diagnostic Devices - Prodigy
  • Diabetic Supply of Suncoast - Advocate
  • Arkray - GLUCOCARD
  • Bayer Diabetes Care - Contour, Breeze 2
  • Sanofi - iBGStar (the first blood gluse meter to connect directly to iPhone or iPod Touch)
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Design Features

Blood glucose meters measure blood glucose levels electronically. Such measurement utilizes only a small drop of blood from the fingertip placed on a disposable test strip. The digital meter obtains information from the blood on the strip, and within seconds, the glucose level is displayed on the screen. Patient discomfort and inconvenience are minimal, and compliance with testing regimens is therefore high. There is a recurring cost to using blood glucose meters and disposable strips, but it is outweighed by the costs related to complications of diabetes.

Alternate-site testing uses the same meter and strip but acquires blood from the palm or the forearm. Thus, it causes virtually no pain and allows patients to rest sore fingertips. The disadvantage of alternate-site testing is that decreased blood flow may be encountered and may affect testing accuracy.

Multitest systems are available that utilize a cartridge or a disk with multiple test strips. These systems may be more convenient for patients.

Many meters allow patients to download results to a computer so that they can be shared with their health care provider; this has the potential to improve diabetes management.

iBGStar (Sanofi) is the first blood glucose meter to connect directly to iPhone and iPod Touch. It uses the iBGStar Diabetes Manager application for recording, tracking, managing, and sharing blood glucose data. Recent research has shown good interassay and high intra-assay precision using the device. [3]

Continuous blood glucose monitors

A continuous blood glucose monitor (CGM) assesses blood glucose levels on a near-continuous basis. A typical system consists of a glucose sensor placed subcutaneously, a nonimplanted transmitter, and a receiver worn like a pager, which records blood glucose levels at frequent intervals and monitors trends.

CGM systems monitor interstitial fluid glucose levels. They must be calibrated with traditional fingerstick tests. Before treatment of reported hypoglycemia or hyperglycemia with insulin, confirmation with a fingerstick test is recommended because of the 5- to 15-minute lag in data reporting.

Continuous monitoring provides documentation of blood glucose response to insulin dosing, eating, exercise, and additional influences. Overnight monitoring may identify problems with insulin dosing and allow adjustments of basal levels. Many units are equipped with alarms to warn patients of hyperglycemia or hypoglycemia and provide time for treatment. Studies have demonstrated that patients using CGMs experience fewer hyperglycemic episodes and may decrease their glycated hemoglobin (HbA1C) levels. [4, 5, 6]

One recent concern, however, is proper calibration and availability of control solutions at pharmacies and appropriate use by patients during calibration. Lack of adherence to proscribed methodologies of use may lead to erroneous data and thus possible mistreatment of diabetes by patients. [7] Future development and technological advancements aim to allow for improved sensors and calibration software, creating better systems designed to automate delivery of insulin partially (eg, low glucose suspend) or entirely (eg, “fully closed-loop” artificial pancreas). [8]

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Indications

Blood glucose monitors are indicated in individuals with diabetes mellitus type 1 or 2.

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Clinical Trial Evidence

There is extensive evidence demonstrating the utility of blood glucose testing in persons with diabetes, especially those using insulin. Patients with diabetes who use insulin typically test their blood sugar more often (3-10 times per day) to assess the effectiveness of the previous dose and to determine the next dose.

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Clinical Implementation

Blood glucose monitoring allows patients to understand patterns of blood glucose changes and to adjust diet, exercise, and medication dosing. Neither the significance nor the optimal frequency of monitoring has yet been clearly elucidated in patients with diabetes mellitus type 2.

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Follow-up/Monitoring

Health care providers should follow standard protocols for monitoring blood glucose levels. Information gathered from blood glucose monitors and glycated hemoglobin (HbA1C) levels may help guide management of patients with diabetes. Monitoring of patients with newly diagnosed diabetes may also help patients achieve a better understanding of their disease.

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Complications

Complications of using blood glucose monitors include pain and soreness caused by the testing prick.

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