Glucose-monitoring equipment for someone with type 2 diabetes

4. What should I consider when helping someone with diabetes choose glucose-monitoring equipment?

A primary healthcare provider, diabetes educator, or pharmacist can help you select equipment that's right for her. Some things to consider: Fine-gauge needles for lancets are available for fragile skin. Some devices combine a blood glucose meter with a lancing device; the convenience of such a gadget may appeal to her.

Over two dozen meters are available, and they differ in several ways, including size, speed, cost of the meter, cost of the test strips used, amount of blood needed, and ability to store test results. Some meters are very compact; if she has dexterity problems, she may find a larger one more helpful. Likewise, meters with bigger result displays may be easier to read if eyesight is an issue. Some meters have a large memory, which could be useful if she forgets to jot down test results. Some models connect to computers to store or print test results; check with her doctor to see if it would be useful for her to get her test results this way.

Some meters allow users to add blood if getting an adequate sample the first time is a challenge. In addition, some allow the person to take blood from places other than the fingertip, which is the usual pricking point for a blood sample. This is known as alternative site testing and may involve getting a sample from the palm, forearm, or abdomen.

5. What factors can affect glucose meter accuracy?

The reliability of glucose meter test results depends, in part, on the quality of the person's meter and test strips, as well as her ability to use the equipment correctly, which is why training on the device is important. Always check expiration dates on blood testing strips before use. Other factors that can cause unpredictable or unreliable test results include altitude, temperature, and humidity, as well as other substances -- from vitamin C to glucose tablet residue to uric acid (a natural body chemical that tends to be more concentrated in people with diabetes) to hematocrit (the amount of red blood cells in the blood).

6. How often should someone with type 2 diabetes test herself?

Frequent monitoring offers her the best chance at keeping her blood sugar in her target range. Her healthcare provider will make a recommendation on how often she should test based on a number of factors, including the medications she takes and how often she experiences symptoms that her blood sugar is too high or too low. It's recommended that people with type 2 diabetes check before meals, two hours after meals, at bedtime, and first thing in the morning. Testing just once or twice a day is better than not testing at all. Of course, she should test any time she experience diabetes symptoms, and she should check more often if she changes medications, feels ill, is under greater stress, or experiences any other out-of-the-ordinary circumstances.

7. How do we check the accuracy of glucose monitoring equipment?

It's wise to perform quality control checks about once a month. Meters that have been dropped may malfunction, for instance, batteries or electrical components may have worn out, or humidity or heat may damage test strips.

• Control solutions Manufacturers generally offer two kinds of quality control checks: Test quality control solutions allow you to check the reliability of the meter and strip and may also give some indication of how well you or she use the system by substituting a test solution -- with a predictable result that's known to you -- for a blood sample. Some manufacturers include quality control solution with their meters; if not, order it from the manufacturer or her pharmacist. The solution typically expires within a month, so check the "use by" dates.
• Electronic controls Alternatively, some meters use electronic controls to make sure the device is working properly. This method requires that a cartridge or special "control" test strip be inserted into the meter; a signal will appear if the meter is working correctly.

It's a good idea for you or the person you're caring for to bring her glucose meter along on routine visits to her healthcare provider, who can watch her technique to make sure she's using the meter properly.

Her provider will also take a blood sample and have it evaluated in a lab to make sure the self-management measure matches the lab test results.

8. What should she do with the results?

If her blood sugar readings are routinely above or below her target range, then she should consult with her main diabetes healthcare provider, as she may need to revise her treatment plan. These numbers could be a sign that complications are brewing, that she's not following her treatment plan, or that the plan needs adjusting. Equally important, if she regularly meets her blood sugar goals, she should take comfort in knowing she's on track to maintain her health.