2012年9月19日 星期三

Glucose Monitor Accuracy, How Much Do You Trust It?


Glucose monitor accuracy is not something diabetics want to lie awake thinking about. If you take insulin you rely on the accuracy of your monitor, checking your level before you take insulin so you know how much to inject.

Even type 2 diabetics who are not on insulin will test first thing in the morning as a fasting baseline and after exercise if they feel weak or dizzy. It is not comforting to find out that the international standards for diabetic meters allow for an up to 20% error rate.

The New York Times has an article, published July 18, 2009, that states a 16-year-old girl bought seven meters and took them home to be tested by her diabetic dad as a science project. The results on the meters varied by up to 75 points. That's disturbing.

The student's mother, who works for a senator, told him about the experiment results, and he wrote a letter to the FDA asking for an investigation. So there are rumblings that something might be done to force meter makers to raise their standards.

The meter companies' response was that it will make meters more expensive, and people won't buy them. It sounds a lot like the complaints car makers were giving when they were forced to make cars safer. What they should worry about is the lowered confidence their customers will have in their diabetic meters when the news spreads.

The companies that improve accuracy on their own will be the smart ones. There is one, the WaveSense meter; AgaMatrix is saying they have concentrated on glucose monitor accuracy and addressed many of the problems other meters have.

The Problems That Make Meters Inaccurate

Every meter has issues with medications, according to a company spokesperson. Things like aspirin, Tylenol, vitamin C and dialysis medications can mess with glucose monitor accuracy. Then there are the methods used by each meter to measure blood sugar, and the fact that the makers know it's okay to be off by up to 20%. It's the old argument of what's cost effective, and it cheapens their product.

The fact that meters can be so inaccurate exposes another problem. Many hospitals choose to save money on testing by using home meters to check blood sugar in patients. And some FDA officials are worried that this has already led to deaths in some high risk cases. A hospital should not be using home monitors because they are not accurate enough, they said.

It's Not Always the Meter's Fault

Beyond those problems lies another glucose monitor accuracy issue. Human error can make monitor readings unreliable. If you haven't been taught how to use your monitor correctly, or if you get in a hurry and skip steps you could get numbers that are wrong.

If you have alcohol on your skin it affects your readings. It's better to prepare your fingers by washing your hands with soap and drying them well before you test. And be sure to let your skin dry after you use alcohol wipes.

Then there are the problems caused by outdated or damaged test strips, using the wrong strips for a meter, and using a meter that was exposed to high heat or humidity or allowed to get dirty.

What You Can Do For Glucose Monitor Accuracy

First you can do some homework and find out which monitor really is best for you. I love that monitors can be free, but some are truly better than others. And while you're deciding which is best, look at the price of the test strips because that's what you'll be buying every month. A free monitor with high-priced test strips is not a bargain.

Keep your meter stored at room temperature and don't expose it to high heat, humidity or dust. All meters have cases, so store yours inside one. Next, if your meter has to be coded, check to make sure the number on the test strip vial matches the one on your display.

Wash your hands before handling test strips. Make sure the strip is inserted all the way, and the right way up, in your meter. Glucose monitor accuracy is only as good as the test strip you are using.

Don't use outdated test strips or strips that have been exposed to high heat or humidity. Store the test strips in the sealed container they came in. And apply enough blood for the test. You can't add more after the countdown starts.

If you use an alternate site like your arm for the blood test, be aware that the number will be a little different from your fingerstick, because the arm test lags behind a little. Your test site choice affects glucose monitoring accuracy. So if you think your blood sugar is lowering fast but the arm test isn't showing that, test again on your fingertip to be sure.

Remember, you have to change the batteries. Monitors will warn you about that usually, but if yours is acting up, check that first. If you still aren't confident about your glucose monitor accuracy, take the meter with you to the doctor's office and check a reading at the same time they take one so you can compare.

The hemoglobin A1C numbers are the best way to know how your blood sugars have been doing over the past couple of months, and when you compare your daily numbers to the A1C that will give you proof that your monitor is doing a pretty good job.

As long as you're aware that glucose monitoring is not a precise numbers game, you will depend on your symptoms and reactions as well as to your monitor to know whether you are hypo- or hyperglycemic.

Knowing how your body reacts to low blood sugar is important when you are taking insulin, and a glucose monitor you can have confidence in is not a luxury; it's a necessity.




Martha Zimmer invites you to visit her website and learn more about type 2 diabetes, its complications and how you can deal with them, as well as great tips for eating healthy that will make living with diabetes less painful.

Go to http://www.a-diabetic-life.com and find out what you can do to avoid many of the pitfalls of this life-changing condition, like paying for cures that don't work and spending money for things you could have gotten free. Martha has made the mistakes and done the research so you don't have to.





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