Evelyn Schommer can bounce from her pogo stick to a quick blood glucose check with her pocket-sized meter.

The information gleaned from a pinprick of blood placed on a test strip inserted into the meter helps you prevent blood glucose highs and lows, and learn how diet, exercise, stress, illness, and other things affect your blood glucose levels. That knowledge is a powerful instrument in controlling your diabetes. But how can you know which meter is right for you?

Enter this guide, which is designed to help you sort through more than five dozen meters that were on the U.S. market as of Oct. 1, 2011. Over the next few pages, you’ll learn about the different features of individual meters, from the blood sample sizes they require to the calibrating they might need. Armed with that information, you’ll be able to start on the process of making an educated decision about the meter that best suits your needs.

For many people, cost is the first question that comes to mind about blood glucose meters. Their prices vary (many doctors’ offices hand out free meters, and some companies will send you one on request), and insurance can cover all, some, or none of the cost of the meter itself. Check with your insurance plan or Medicare or Medicaid to see what might be covered for you. Some people prefer lower-priced store-brand meters. Many meters sold under the brands of large chains are made by major manufacturers. Just check the product packaging to find out. (The Food and Drug Administration requires all blood glucose meters to be accurate within a 20 percent margin of error for readings of 75 mg/dl or higher compared with lab readings.)

The one-time price of a meter, however, is not as important as the continuing cost of test strips. Test strips can run from about 40 cents to well over $1 apiece. So if you test before and after every meal, strips alone could cost you more than $2,000 a year. Each meter requires particular test strips, so picking a meter marries you to whatever its strips may cost. Your insurance may cover fewer strips than your doctor says you’ll need. If that’s the case, your doctor can ask your insurer to cover more strips. If more strips aren’t approved, you may need to pay for them out of pocket.

Beyond its operating cost, you’ll need to look at the meter’s functions. Many “auto-code” or “no-code” meters require no calibrating, or coding, which involves manually programming the meter to recognize a specific group of test strips. If your meter needs coding, follow the manufacturer’s instructions to ensure accuracy for the tests you do with that batch of strips. Those steps might include inserting a test strip, chip, or key and setting the code to what’s noted on the package of strips. You’ll also need to see if your meter comes with lancing devices, control solution, and other accessories, or whether you’ll have to buy them separately. 

Picking a meter is a matter of finding the functions and features that are right for you. Diabetes Forecast doesn’t test or recommend products (Consumer Reports tested 17 meters in its November 2011 issue). But we can help you sort through the confusion and technical terms to decide what to look for in a meter. Here are some key questions:

Is this meter the right size for me?
Most meters will fit comfortably in your hand. Others, some with “micro” or “mini” in their names, are smaller. They could be good for children with smaller hands or for anyone who wants to just throw the meter in a pocket and go—but don’t forget that you’ll also need a lancing device and test strips.

How much memory do I need in a meter?
Most meters hold from 100 to 450 test results, though a few save well over 1,000 (see "Thanks for the Memories," above). In theory, the more results you have to look at, the more precisely you can monitor your control over time. Your doctor or educator may have ideas on how much memory is likely to be useful for you.

Can I download readings from this meter to my computer? What if I use a Mac?
Many meters on the market have computer download capability, often through a USB connection. Those that do come with their own software or download directly to your desktop on both Mac and PC computers, but you can chart your results in a Microsoft Excel file on your own. Check with the manufacturer or owner’s manual to ensure that the download-ready meter of your choice is compatible with your computer. To see your results in an Excel file or similar program, look for meter software with an “export” function.

I don’t see well. Which meters would help me test?
Meters with a backlight can help make the numbers on the screen clearer, especially if you’re testing in the middle of the night. Meters with an audio component (see "Hear Me Out" above) can also help those with vision problems or difficulty reading.

I’m looking for a meter for my child. What features should I focus on?
Children with small hands might prefer a smaller meter—or maybe a bigger one with large buttons. Some meters, like Arkray’s Glucocard 01-mini and Diabetic Supply of Suncoast’s Advocate Redi-Code Dash, come in fun colors and patterns that young children and teens might enjoy. Ask your child’s health care provider or diabetes educator for suggestions.

I have arthritis in my hands. Are there meters and test strips that are good for me?
Arthritis, neuropathy, and injuries can all lead to problems with dexterity. The best way to find out if a meter will work for you is to test it first (friends with diabetes might let you try their meters—with your own lancing devices, of course—and your pharmacy may help you as well). Check your ease with the lancing device and lancets, test strips and their packaging, and meter features before committing to one. That said, some meters have features you may find helpful. Bayer’s Breeze2 holds a disk that lasts for 10 tests. Roche’s Accu-Chek Compact Plus is loaded with a drum of test strips, and one is dispensed each time you test. Using a meter and a lancing device that don't need to be loaded for each use can be convenient.

Is there a meter that requires no finger prick to get a blood sample?
A blood sample is always required, but many meters boast the ability to give you a glucose reading using alternate site testing, which allows you to draw blood from places on the body other than the fingers. However, drawing blood from alternate sites, such as the forearm or the fleshy part of the palm, can result in different glucose readings. There is a delay between what is happening in the blood and what is measured at the alternate sites. When glucose levels are changing rapidly, your best bet is to use a finger stick. Talk with your health care provider about your options.

How often should I replace my meter?
Your meter should work for you as long as it is clean, not damaged, used with in-date test strips, and checked as recommended with control solution (order from your pharmacy). Read your owner’s manual to see what the manufacturer recommends. If you use it properly and treat it with care, it should last for years.

Some of the main features mentioned above are listed on the chart you can find here. Take a look, talk to your health care provider, and decide what works best for you.