Devices are great
when they work, but
when they fail, then the
service is where you
should turn... If you
think you might need
the brand and device
before making your
This area of meter performance is
contentious and difficult to quantify.
Officially, all blood glucose meters
need to meet a standard. However, in
a 2017 study1 it was found that just six
out of 18 meters cheked met accuracy
requirements. It might be thought that
these requirements are stringent, but at
most levels, the tolerance is at least 2
mmol/l. Finger prick testing with a home
meter may not be the gold standard that
many think it is.
3. Customer service
Devices are great when they work,
but when they fail, then the supplier's
customer service is where you should
turn. Some of the suppliers are easy to
contact with free phone support and
detailed websites. Others are almost
entirely uncontactable. If you think you
might need support, research the brand
and device before making your choice.
4. Data sharing/reporting
Until 10-15 years ago the only option for
recording levels, food, insulin etc., was to
jot it down in one of the infamous blood
glucose diaries. These were often works
of fiction or had the first page completed
and then nothing else. Modern meters
should enable you to download the
data to a computer so you can analyse
yourself. There may also be a companion
application that can be used to crunch
the data and produce informative reports.
These can then be printed out or emailed
to clinicians to enlighten discussions at
5. Light on strip port
Night-time hypos are a fact of life for many
people with diabetes. Some meters have
small LEDs that enable the test strip
port to be illuminated. As well as in dark
conditions, having an illuminated display
can help if eyesight is compromised in any
way, or if you are a fan of the movies and
might need to do a test in the dark once
in a while.
Again, related to eyesight, sometimes it
may be desirable to have a larger display.
7. Device size
For many, they will carry their device
around with them at all times. The device
may therefore need to be pocketable or
be smaller enough to fit in a handbag.
Some devices are sleek and miniaturised.
Others are far more bulky.
8. Bolus calculator
Most in-meter bolus calculations are
based on the target blood glucose
level, the current glucose level, the
carbohydrate-to-insulin ratio, total grams
of carbohydrate to be consumed in the
meal, insulin on board and an insulin
sensitivity factor. Not all meters give
this functionality, but it may be important
particularly for pump users.
9. Ketone testing
People with Type 1 should have the
ability to test for ketones. Unfortunately,
relatively few meters have the ability to
perform a ketone test.
10. Size of blood sample
Sample sizes range from around 0.3
microliters up to 1.0 microliters or more.
If people have difficulty getting a sample, a
drop requirement may be a useful feature.
1 Investigation of the Accuracy of 18 Marketed
Blood Glucose Monitors, Klonoff et al, Diabetes
Care Aug 2018, 41 (8) 1681-1688; DOI: 10.2337/
Nick Cahm has lived with T1D since
2007 and worked on the campaign for
Libre access across the NHS. Find him at
Views expressed in this article are Mr
Cahm's and not those of the publisher. "