Research shows that optimum blood glucose control is the key to managing diabetes and preventing its complications. For many people with diabetes, the blood glucose meter is a crucial tool for doing just that. In the short term, a meter can help you avoid blood glucose highs and lows, and feel your best. By testing over time, you can better understand how diet, exercise, stress, and illness can affect your blood glucose levels, so that you can be armed with the information you need to achieve the best control possible of your diabetes.

The meter isn’t the only tool involved in blood glucose testing; you’ll also need lancing devices, test strips, and accessories ranging from a carrying case to a disposal container for used lancets. And for some users, like children and people with limited vision or dexterity, the features of a meter or a lancing device can be significant.

There are about 75 meters currently available in the United States, and each is in some way different from the rest. So selecting the meter that is right for you requires a little homework. Here are some things to consider in making your choice.

	Listen Up Meters with an audio function
» Advocate
» Advocate Duo
» Advocate Redi-Code
» Advocate Redi-Code Duo
» EasyMaxV
» Fora D10 and D20
» Fora V10, V12, V20, V22, and V30a
» gDrive
» MyGlucoHealth Wireless
» Prodigy Autocode
» Prodigy Voice

What Will It Cost?
This guide doesn’t include prices. That’s intentional: The retail cost of a meter often is a poor indicator of what you will actually spend. Your insurance may cover it fully or in part, or you may get one free of charge from a doctor or diabetes educator. You may be able to find inexpensive meters at large retail chains like Walmart, Target, and Kroger. Cheaper doesn’t necessarily mean inferior, by the way. You can check the product packaging of any meter sold at a major chain to find out who the manufacturer is; it’s most likely a company listed in this guide.

The price tag that really counts is not the one on the meter but the one on the test strips. They are an ongoing expense that increases the more you test and the longer you have diabetes. Meters can only be used with compatible test strips, so once you choose a device, you’re locked into spending whatever your meter’s strips cost. Besides talking with your doctor or educator about which meter and strips to use, you’ll want to call your insurance provider. Find out what brands of strips your plan covers (it may be part of your prescription coverage or your durable medical equipment coverage, which might be separate policies). Ask how many test strips and how much of their cost are covered each month; the answer may depend on whether you use insulin. Strips can run anywhere from 50 cents to $1 apiece. If you test five times a day, that’s as much as $1,825 a year. And remember, just because your insurer says you need to test only three times a day, that doesn’t mean you and your doctor will agree. Your doctor may need to ask your insurer to cover more strips.

There are ways to save money on diabetes medications and supplies. Your pharmacy may have special discount programs. You can also call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or the Partnership for Prescription Assistance at 1-888-4PPA-NOW (1-888-477-2669) for information about discount programs run by pharmaceutical companies, state agencies, and health organizations.

Functions That Matter
The makers of blood glucose meters are improving technology to make testing faster, easier, and less painful. Many features that once were hard to find are now standard in nearly every meter sold. When you see phrases like “small sample size,” “test results in seconds,” or “alternate site testing” (drawing blood from places other than a fingertip), know that most other products offer the same benefits. Other meter specifications do differ and may matter a great deal, depending on your needs. These features include:

Coding. Also known as “calibrating,” this process involves manually programming the meter to recognize a particular batch of test strips. Most new “auto-code” or “no-code” meters don’t require this step. Either the device recognizes the test strip code automatically, or the manufacturer has chosen just one code of strips to sell with that meter. In the latter case, you might still see a code number on an auto-code meter’s display screen, and you should visually confirm that it’s accurate. But there is no need for you to enter a code.

If your meter does need calibrating, you’ll need to follow the manufacturer’s instructions to make sure your results will be accurate for all the tests you do using one vial of strips. You might need to insert a test strip into the meter and use a button to set the code to what is noted on the strip package. Or you might simply have to insert a chip, key, or special test strip that “tells” the meter its code number. On this kind of meter, the first step in troubleshooting inaccurate readings is usually to double-check that you coded the device properly.

Size and shape. You can see the variety of meter shapes in the photos in the blood glucose meters chart. Most meters fit easily in your hand. A few, particularly the dual blood glucose/blood pressure monitors, are larger, while others are quite compact (usually those with “micro,” “mini,” or “compact” in the name). If you’re an athlete or a frequent traveler, or you just want to be able to put a meter in your pocket, check out its size and shape in person before buying. But don’t forget that you’ll also be carrying your lancing device and test strips with your meter, which adds a bit of bulk. Another option is a meter that screws onto the top of a test-strip vial, like the True2Go or the disposable Sidekick, giving you less to carry around.

Sample size. Most people draw a drop of blood for glucose testing using a spring-loaded device that lances the skin at the push of a button (graphic, left). Today’s meters generally require only a small amount of blood to perform a test, from 0.3 to 1.5 microliters, making testing less painful. The blood glucose meters chart includes the different sample sizes for each meter, while the graphic below gives an idea of how blood drops of various sizes look. 

Storing and reviewing data. Most meters hold from 100 to 450 test results, though some save far more (chart, below right). In addition to storing your blood glucose values, some meters may track the averages of those results over seven-, 14-, 30-, or 60-day periods and graph them on the screen, making it easy to monitor your overall control. If you are so inclined, you can do more with that data by using software programs designed for tracking trends. Many meters come with compatible diabetes management software available on the manufacturer’s website. “Plug-and-play” meters, like the Contour USB, plug directly into your computer’s USB port; the gDrive is inserted into your BlackBerry smart phone. (You can’t use this meter without a BlackBerry, though, because it doesn’t have its own screen for displaying results.) The MyGlucoHealth Wireless and Fora D15 meters communicate information using wireless Bluetooth technology. Meters that can transfer data directly to a computer program or website are marked with a “C” on the chart. (For more on applications for smart phones, click here.)

Operation in hot and cold temperatures. Most meters are guaranteed to work in 50- to 104- degree temperatures. A few meters operate in somewhat colder or warmer conditions (chart, left and right) and may be of interest to hikers, campers, construction workers, or anyone else who spends a lot of time outdoors. Be sure to check the temperature range on any meter. But keep in mind that you can buy heating or cooling packs to keep your meter and strips at a moderate temperature.

Travel ready. It’s good to take an extra meter with you when you’re on the road or vacationing. You might buy one just for travel or for use as a backup. Make sure to pack extra batteries, too. Before you leave, investigate your destination, especially if you’re headed abroad. Are meters and strips sold in pharmacies where you’re going? Are they affordable? Be sure to take your meter manufacturer’s customer service number with you; if you’ll be out of the country, remember that a toll-free number might not work. If you have to buy a meter on the fly, your best bet may be the cheapest one available where you are. Most meters cost from $15 to $70 in a retail pharmacy, but Walmart, Target, and Kroger all sell store-brand meters for less than $10. Make sure to buy all the supplies you need to test (strips, control solution, or batteries may not be included with a meter). 
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Blood glucose monitoring is key for good diabetes management. You should discuss your needs with your doctor or diabetes educator, and see if you can try out different meters. Compare notes with a friend or others in an online community like the American Diabetes Association message boards. If the meter you use is not listed in this guide but works well for you, there’s no need to switch. Most manufacturers pull older models off the market to make way for new products but continue to make test strips and offer customer support for them.

Once you have your meter in hand, the real work begins. If you haven’t already, you’ll need to perfect the practice of testing, record and review your results with your doctor, learn what they mean, and find out how to alter your diet and exercise routine, if need be, to improve your control. Today’s meters have many new capabilities; they can be lightning-fast, communicate wirelessly with your computer, or even plug into your Nintendo DS. But a meter can’t control your blood glucose—that’s all on you.