Testing blood sugarA blood sugar meter, also called a glucometer or a meter, is a hand held device that determines the amount of sugar, or glucose, that is in your blood. It does this by using a small sample of blood taken from your finger tip.

There are many different meters available from name brand meters such as ACCU-CHEK Aviva or OneTouch UltraMini to generic store brands. Meters can range from very basic to having many special features.

The first step to determine which meter you should get is to ask your insurance company which meter is “preferred” and will cost the least to you when buying supplies such as strips and lancets. For more help on choosing which meter is right for you, see our list of blood sugar meters and their benefits.

 

Note: In no way is Health Management and Education promoting one meter over the other on our website. This is for informational use only.

 

Blood Sugar wordsChecking your blood sugar can give you helpful information. It can help you determine how being active, having stress, taking medication and eating may cause your blood sugars to rise and fall. Testing your blood sugar levels will help you control your diabetes and keep your blood sugar levels on target. It will help you recognize feelings of high and low blood sugars, reduce the risk of diabetes related complications and improve overall health.

The amount you should check your blood sugar varies for everyone. Your healthcare provider might ask you to check your blood sugar once a day or up to 4 times a day. If you are starting on a new diabetes medication then your provider might ask you to test more often to see how that medication is affecting you. Also, if you have unexplained high or low blood sugars, you may want to test more frequently to try to determine what might be causing your variations in blood sugar. How many test strips you are prescribed a month will also determine how often you check your blood sugar. Talk to your healthcare team to determine how often you should be checking your blood sugar.

If you would like to learn more strategies about checking blood sugar, classes are available for free. Click here to see our schedule for our Diabetes In Charge and In Control: Tips and Tools class and call 916-734-0718 to schedule the class.

blood sugar meter kitNote: Companies may provide different items in their kits than the list below.

  • Blood Sugar Meter – This is the actual meter
  • Test Strips – Inserts into meter. A blood sample is placed on the strip for machine to read. Each strip is used only once.
  • Lancets – Tiny needle that is used to prick your finger to obtain blood sample
  • Lancing Device – Holds the lancets. Most have adjustable depths for the amount to prick your finger
  • Control Solution – Vial of liquid that is used in place of your blood sample to calibrate your meter. Check your test strip vial to determine what the “control range” should be.
    • Control solution expires 90 days after opening
    • Not all kits include the control solution. Control solution can be ordered at your pharmacy.
  • Carrying Case
  • User Guides which includes toll free phone numbers to customer support lines

Steps to Checking Blood Sugar Levels

  1. Wash hands with warm soapy water. This cleans as well as helps blood flow to finger tips. Dry your hands thoroughly. 
  2.     *Alcohol wipe not recommended for home testing.

  3. Insert lancet in lancing device (if necessary).
  4. Place strip in meter - (this turns the meter on).
  5. Wait for ready signal (usually a picture of a strip and flashing blood drop).
  6. Press lancing device against side of fingertip and press release button.
  7. Squeeze finger as needed to obtain blood drop.
  8. Touch edge of strip to edge of blood drop.
  9. Wipe blood off finger with tissue.
  10. Read results from meter screen.
  11. Record results in your logbook.
  12. Throw away used test strip in garbage. Used lancets will need to be disposed of properly.

Noquestion markt enough blood?

If you have problems getting enough blood try washing your hands with warm water. The rubbing motion and the warm water will help to get your blood flowing. Sometimes calluses can form on your fingertip, which makes it harder to get blood, so try to test different fingers each time. Try using the sides of your fingertips to get more blood. Another suggestion is to increase the depth gauge on your lancing device for a deeper prick.

Tips for Proper Storage of Test Strips

  • Avoid storing your strips in extreme temperatures
  • Do not leave strips in your car where it can get hot or cold
  • Check the expiration dates of your strips; do not use expired test strips because they may not give you an accurate reading
  • Avoid getting the test strips wet

Proper Disposal of Lancets and Other Sharps (Needles)

It is illegal in California to throw any sharps in the trash or recycling containers. The lancet from your glucometer kit is considered a sharp and will need to be taken to a collection center in an appropriate sharps container.  This container can be an official “sharps” container or it can be any hard plastic bottle such as an old bleach container. If using an old container, label the outside with the word “SHARPS” and cap tightly. Click here for more information.

Keeping a log book is a very useful tool. Even though many meters save the readings in the memory, it helps to have a paper copy of your numbers. It will help you see blood sugar patterns and it can also help you track other variables such as how many carbohydrates eaten or if the reading was taken before or after a meal. If you do keep a log book, make sure to bring it with you to all diabetes related appointments. Many health care providers like to review log books to see how well you are controlling your blood sugar and identify areas for improvement.  

Most meters also have the ability to download the meter information onto a computer for analysis. To do so, you may need to contact the manufacturer to get a cable to plug your meter into your computer and to get the needed software. Many companies provide this for free. Check your user guide for more information.

You can download the needed software here:

  1. ACCU-CHEK
  2. Bayer
  3. Freestyle
  4. OneTouch

 Blood sugar log book (pdf)

log book

Too Low:

orange juicea.  A low blood sugar is less than 80 mg/dL. (Note: Check with your healthcare provider to see if this target is appropriate for you)If you are below this number, you will follow the Rule of 15:

  • Eat or drink 15 grams of a simple carbohydrate. The following are examples of 15 grams of carbohydrates (choose only ONE)
  1. 4 oz. fruit juice
  2. 3 packets of sugar
  3. 3-4 glucose tablets
  4. 1 tablespoon of honey (Note: Do not use honey if taking Precose or glyset)
  5. 8 oz. fat free or 1% milk (Note: Do not use milk if taking Precose or glyset)
  • Wait 15 minutes and then test your blood sugar again. If it is still less than 80 mg/dl, eat or drink another 15 grams of simple carbohydrates and retest your blood sugar in another 15 minutes
  • Once your blood sugar is higher than 80 mg/dl, eat a small snack within 30 minutes such as a half a sandwich.

b.   An extremely low blood sugar is less than 50mg/dL. If you are below this number, take 30 grams of a simple carbohydrate (TWO choices from above list) and test your blood sugar in 15 minutes.

Too High:

couple walking

  • The best strategy to help decrease your blood sugar is to do something active and drink a glass of water. Going for a walk will help your body use up the extra sugar in your blood. Also, try to determine why your blood sugar might be high. Did you eat a little bit too much at the meal before? Did you forget to take your medications? Thinking about the events leading up to a high blood sugar will help you learn and prevent a high blood sugar in the future.
  • If you have an extremely high blood sugar contact your primary care physician or your endocrinologist and report your high blood sugar.

Testing in pairs is a strategy to help you track your blood sugar before and after a specific event to see how that event affects your blood sugar levels.

To test in pairs, first determine what you want to learn. Some examples are: how activity affects blood sugar level or how meals affect blood sugar level. Focus on one idea at a time. Once you know what you want to learn, test your blood sugar before the activity or meal. Write this number in your log book.
Next, check it again at a specific time after the activity or meal. For meals, test blood sugar 2 hours after the start of the meal. Write this number in your log book.
Now, determine how your blood sugar changed. Is it higher or lower? How much? What does this tell you?
This can be very useful information to help determine if you are eating the right amount of carbohydrates at a meal; or to see how a certain type of activity, such as riding a bike, can affect your blood sugar.
Example of how to test in pairs:

Testing in pairs

control solutionControl solution can be used to check the accuracy of your meter. If your blood sugar readings do not seem correct, it is a good idea to calibrate your meter. The control solution comes in a small bottle and contains a sugary liquid. This liquid is used in place of a blood sample. Your meter will test the solution and the results should match the control range that is printed on your test strips vial. The control solution expires 90 days after opening so write the date the bottle of control solution when you open it.
 If the results are not within the control range, then the strips or the meter may have a problem. 
Possible problems:

  • The test strips are expired
  • Test strips have been exposed to extreme heat, cold or moisture
  • The meter is not working properly
  • The control solution has expired

Possible solutions:

Alternate site testing (AST) is when you use another part of the body other than the fingertip to get blood for blood sugar testing. Many meters come with an adapter you must attach onto the lancing device to get blood from an alternate site. The fingertip is the most accurate place to get blood for testing, but if you have problems doing so you can try AST. If you are interested in AST, please talk to your doctor to see if he/she feels this is right for you.
Some typical alternate sites are

  • Palm of hand
  • Upper forearm
  • Abdomen
  • Calf
  • Thigh

Important facts of AST

  • Results from alternate sites usually have a lag time of 20-30 minutes, so your results may be inaccurate. This could be dangerous if you are experiencing low blood sugars.
  • Palm of hand will be the most accurate of all the alternate sites.

The U.S. Food and Drug Administration give these guidelines:

  1. People with hypoglycemia unawareness should not use alternate site testing at all.
  2. Don't use alternate sites when a seriously low blood glucose might go undetected:
    • When you have just taken insulin, or any time during or after exercise.
    • When there are unknown variables occurring in your day, such as illness.
    • Any time you just feel "low".
    • Whenever you are about to drive.

What if I can't afford test strips?

  1. Check with your insurance – Many insurance companies have “preferred” meters where they will cover a larger portion of your costs. Call your insurance company to determine which meter they “prefer” you to have. You can ask your healthcare provider to then prescribe you that meter to help keep your out of pocket expenses down. You will likely still have to pay the co-pay.
  2. Co-pay assistance programs – Many meters offer a co-pay assistance program where they help cover any additional costs above your normal co-pay. Some meters will have a card attached to the box that you will take to your local pharmacy to sign-up for the program. Other companies have the information on their website.
  3. Generic Meters available – If you don’t have insurance, store brand meters are available at many large drug stores like Wal-Mart ReliOn meter or Walgreens TRUEtrack meter. The strips for these meters are much more affordable and range from $18.00-$50.00 for 100 strips.

Are the generic meters reliable?

Yes, generic meters are just as reliable as the name brand meters. Most meters follow the International Organization for Standardization (ISO) range of accuracy on blood sugar readings:

  • When glucose range of blood sample is Lower than 75 mg/dl: 95 percent of the results must fall within +/- 15 mg/dl
  • When glucose range of blood sample is 75 mg/dl or Higher: 95 percent of the results must fall with +/- 20 percent

Examples of Acceptable Accuracy:

  • If the lab result is 70 mg/dl: The meter reading must be within 55-85 mg/dl
  • If the lab result is 100 mg/dl: The meter reading must be within 80-120 mg/dl
  • If the lab result is 200 mg/dl: The meter reading must be within 160-240 mg/dl

(source)

Blood sugar meters

man checking blood sugarThere are many different brands of blood sugar meters. The type you choose will most likely be based on your personal preference and your insurance coverage.

While there are many different brands to choose from, we have listed the most popular ones below. Browse through the brands to check out the many different features that are offered.

Once you decide on the meter you would like, check with your insurance and or pharmacy to make sure you have chosen the least expensive option.

Aviva plus meterAccu-Chek Aviva Plus

  • ACCU-CHEK Softclix lancing device 
  • 5-second results
  • Small 0.6 microliter sample size
  • Stores 500 results
  • Calculates averages for 7-, 14-, 30- and 90-day
  • Can mark results as “Before Meal” or “After Meal” 
  • Can set reminder alarm to alert you to test blood sugar
  • No coding needed

Product support information page

Watch a video about the Aviva Plus  

 

Nano meter

Accu-Chek Nano

  • Smaller size than the Aviva Plus
  • Backlight screen
  • Comes with the Fastclix lancing device, contains multiple lancets in 1 drum. 
  • Small, 0.6 microliter sample size
  • Stores 500 results
  • Calculates averages for  7-, 14-, 30- and 90
  • Can mark results as “Before Meal” or “After Meal” 
  • Can set reminder alarm to alert you to test blood sugar
  • No coding needed

Product support information page

Watch a video about the ACCU-CHEK Nano

  • ACCU-CHEK has a comprehensive YouTube page containing many videos about how to use their meters. If you need help using your meter, click here to view videos.

Contour Next EZContour Next EZ

  • Support “Second Chance” Sampling. If you don’t get enough blood on the strip the first time, you can reapply blood for another chance.
  • Calculates averages for 14 day, 30 day, 90 days
  • Low price for strips if having to pay out of pocket
  • No coding needed

Product support information page

Watch a video about the Contour Next EZ

 

Contour Next USBCounter Next USB

  • Can plug directly into your computer to offload data and to charge the battery.
  • Support “Second Chance” Sampling. If you don’t get enough blood on the strip the first time, you can reapply blood for another chance.
  • Low price for strips if having to pay out of pocket
  • Can mark results as “Before Meal” or “After Meal” easily
  • Easy to log carb intake and insulin dosing for better tracking
  • No coding needed

Product support information page

Watch a video about the Contour Next USB

Freestyle liteFreestyle Lite

  • Small and portable design
  • Backlight display and test strip port light
  • Small sample size of 0.3 microliter
  • Results in 5-second average test time
  • Stores 400 results
  • Ability to set alarms to remind you to test blood sugar
  • No coding required

Product support information page

Watch a video about the Freestyle Lite

 

Freestyle Freedom Lite

Freestyle Freedom Lite

  • Large display
  • Larger meter than the Freestyle Lite meter
  • Small sample size of 0.3 microliter
  • Results in 5-second average test time
  • Stores 400 results
  • Ability to set alarms to remind you to test blood sugar
  • No coding required

Product support information page

Watch a video about the Freestyle Freedom Lite

 

Insulinx meterInsulinx

  • Large touch screen
  • Log insulin doses with a few simple taps
  • Mark pre- and post-meal blood glucose results
  • Small sample size of 0.3 microliter
  • Up to 60 seconds to re-apply blood
  • No coding required

Product support information page

Watch a video about the Freestyle Insulinx

OneTouch Ultra 2OneTouch Ultra 2

  • Large screen with backlight
  • Can mark results as “Before Meal” or “After Meal” easily
  • Blood sample size 1 microliter
  • Stores up to 500 test results
  • Calculates averages for 7, 14, and 30 days
  • Coding required

 

Product support information page

Watch a video about the OneTouch Ultra 2

 

OneTouch Ultra miniOneTouch Ultra Mini

  • Small meter that can fit in your pocket
  • Multiple colors available
  • Blood sample size 1 microliter
  • Stores up to 500 test results
  • Does not calculate averages
  • Coding required

Product support information page

Watch a video about the OneTouch Ultra Mini

 

OneTouch VerioOneTouch Verio

  • Large screen, well lit and large font
  • Small blood sample size of 0.4 microliter
  • Results are color coded to let you know if you’re within range
  • Stores 500 results
  • Calculates 7, 14, 30 and 90 day averages
  • Longer time to apply blood on test strip before meter “times out”
  • No coding required

Product support information page

Watch a video about the OneTouch Verio

Blood sugar meter class schedule

Educational opportunities are offered at varying times at UC Davis Medical Center as well as UC Davis Medical Group offices throughout the greater Sacramento region.