Making the best of a bad situation... Which BG meter?

acron^

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Diabetes?
Hi guys,

So, I've started sort of 'collecting' BG meters in an effort to find "the best" (most accurate), if there even is such a thing. Today I decided to compare three of my favourites and see which one was seemingly the better. Considering I've never done a side-by-side comparisson like this before, I was pretty disappointed with the results:

NB. The results in general indicate a higher-than-acceptable BG reading and this is down to a larger-than-normal breakfast, so please no comments about that. All results were taken from a single prick, approximately 2 hours after breakfast.

Optium Xceed
1# - 9.8
2# - 10.1
3# - 8.4

GlucoMen LX
1# - 10.3
2# - 7.1
3# - 7.3

Breeze 2
1# - 8.3
2# - 11.2
3# - 12.1

As I say, I was pretty shocked by the variety in these results, showing a range of up to 5.0 mmol! I think I'll continue to use the Optium Xceed as my main meter, as I can't reliably justify going to another meter based on its accuracy. What do other people use? And what are other people's experiences regarding meters and their "accuracy" ?
 

sugarless sue

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Rude people! Not being able to do the things I want to do.
I think the best advice is to just stick to one meter then the variances are the same test by test.If you try and go by several different meters you will only get totally confused!
 

tubolard

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Fasteddie; Richard K Bernstein; William S. Atkins; Rosemary Bloody Conley;
You'll need to be aware that external will affect each reading, that, and there's a 10% accuracy tolerance.

The Xceed and new Breeze's report a plasma blood glucose figure (by taking a whole blood reading and multiplying by 1.12 - or 1.13 in the Breeze's case). Not sure about the GlucoMen LX.

Different meters will use slightly different technologies to determine a value.

The surest way to determine the accuracy of your meter is to ask each manufacturer for a control solution.

Regards, Tubs.
 

hanadr

Expert
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Unless you know how to make a glucose solution of a standard molarity, what you are doing isn't much help. Look on David Mendosa's website. I think he's ealuated some meters there.. There's a permitted tolerance, which I can't remember.
 

jopar

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Meters of different makes, and of identical make can give slightly different readings for many reasons...

Some of it can be down to as Tubs mentioned whether they are using a whole blood or plasma to calculate the reading, along side any conversion software to calculate into a figure with a 10% tolerance to consider of accuracy…

But other factors can lead to different readings...

The process of determining what the BG is is based on electrical resistance within the test strip… Factors such as squeezing the finger, which causes more fluid to be mixed with the blood can, alter the resistance of the sample… Even using the same blood sample doesn’t over-come this, as even with the seconds that it take to either change the meter strip and prepare for a new test, or the time it takes to get another meter plonked into the blood, the blood as already started to dry out, and this can change the resistance of it… And effect the final reading...

I think the only chance of getting a near accurate comparison of two different meters would involve at leas a two man or 3 man efforts… So that you prick finger to get the blood sample, then have two people retrieve a test at the same time off the blood sample, with great speed and timing to ensure blood pick up is timed to perfection…

But best advice is to stick with one meter as much as possible and to a certain extent trust how your body feels…. If you think that what you are feeling isn’t what the meter is suggesting, then wash hands and retest… if this still suggests it’s inaccurate, then check the meter with a test solution from the manufactures...
 

Trinkwasser

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A good plan would be to take your meters in when you get an official blood test and see which one is closest to the lab values. General opinion seems to favour One Touch and the Accuchek for accuracy, but apart from the individual variations as Jopar et al. point out there are manufacturing tolerances on both meters and strips and environmental factors like temperature and even sometimes altitude
 

ians1

Member
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Most home testing kits should yield an accuracy of within +/- 5% of the actual value (1). The problem is that without expensive laboratory equipment that is calibrated you will never know what the "real" value is/was for a particular sample.

Many meters require you to "calibrate" them using control solutions and/or calibration chips etc. There are limitations on the use of many meters, eg some cannot be used at high altitude or at high temperatures or low temperatures. By far the biggest variance is the blood sample itself, it needs to be fresh and used within 30 seconds. Blood is very sensitive to being handled and can change its composition radically if bashed about even slightly. Thats the main reason the same sample would give different readings on different meters or even a variance of more than +/- 5% on the same meter.

Some meters and associated test strips have been rigorously tested against more accurate laboratory equipment and have yielded results as accurate as +/- 3% (1)

Unless readings are far outwith what is expected and can be repeated, there is little cause for concern. In any case clinical diagnosis is not advised from just home test results. But it is of concern if say Insulin levels are to be adjusted on the strength of it.

ian 8)

Ref (1) http://www.abbott.co.in/optium2.htm
 
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For me I look for convenience and ease of use in a blood glucose monitor. It doesn’t matter how close or accurate it is IF I don’t like it I won’t use it. Personally, I hate mucking about with the individually sensors. I kept dropping them. They took up a lot of space and were an extra time consuming step in my busy life.
I found the Accu-chek compact Plus and the Bayer Breeze2 and love both of them. I do have to say they both have their pros and cons. The Accu-chek is bigger, bulkier and the drum is a bit big but it has a much better finger pricker. I like the Breeze2 much better; the disk is easier to carry. It’s also no coding and it tells me on the face how many tests I have left. Thankfully, I won an Accu-chek Multi Clik and use it with my Breeze2.

I haven’t noticed much different in the values when I use these but I’ll have to use them/test with the same blood sample and see what happens.

All in all I think as long as you have a BG monitor you are happy with and will use it doesn’t matter which one you have. You don’t want one you hate that just gathers dust like my One Touch.

Just my humble opinion. :O)

Smiles, Obloomingthistle :D
One month on NovoRapid & Lantus - Blood sugars now normal
Possible LADA
Being tested for gluten intolerance/Coeliac Disease
 

ians1

Member
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Thinking about this there could also be the possibility that putting the same sample, ie a finger with a blob of blood, to several different types of test strip could actually contaminate the blood, after all they do state a fresh sample is required for each test.

We have always had the Accu Chek machines, I have not compared them to others because we don't have any other machines but they seem to be consistent across the two of them.

ian

:D
 

acron^

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Thanks for all your informative replies :)

I'm gonna stick with my Optium Xceed for the time being, but I will try and get myself a OneTouch UltraSmart I think -- they seem to have a lot of the features I would be interested in. Also, considering the genreal consensus seems to be 'use which ever one you're most happy with', I suppose I should abandon the quest for 'absolute accuracy'. It appears quite unobtainable :/ Oh well.
 

qrp

Active Member
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Hi, Acron, I've been trying to get the same answers you want ever since diagnosis (Type 1, June 2007).
My meter of choice would be the Optium Xceed but for the fact that it reads up to 20% high compared with the One Touch Ultra. Always. Consistently. The One Touch I have checked against routine blood checks at Clinics and it's virtually spot on.The Optium is neat, has foil wrapped strips, needs lower sample etc etc BUT it has to be the One Touch in the end. My Consultant said to use the one that gave the lowest results. Obvious why, really.
What about when driving? The Optium could kid me into thinking that I was over 4mmol/l when I was, in fact, on or below. That's potentially dangerous, is it not?
Next time you go for a routine clinic blood test, take your meter along and test right away after blood is drawn. In a few days, you'll have a comparison. Keep on doing it, see what difference there is over time.
I have an Ultra Smart, too, and its readings are very consistent with the plain Ultra - reassuring. Hope this helps and I'll follow your results with interest. all the best qrp
 

ians1

Member
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Having a "calibrated" meter does not mean the same as an accurate meter, it just means the errors are within limits.

With this in mind it may be that all the meters and all the readings are "accurate" within the calibrated limits for each type of meter and test strip.

With things such as temperature, humidity and altitude influencing the results it can be easy to incur quite large errors that deviate more than the manufacturers specification.

There is not really an accurate way to compare these meters with a single blood sample, a known standard solution of sugar could be used and divided up into samples for each meter to avoid contamination. The solution could be measused using laboratory standard equipment (which should be at least an order of magnitude more accurate than the meter under test).

The whole test would need to be under controlled conditions of temperature, humidity etc to be of any value.

As these meters use differing chemistry to measure blood glucose I think I would expect differing results for the same sample anyway.

ian 8)
 

diabolic

Newbie
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3
I was very interested to see that other users are having the same problems as I am with assessing
the accuracy of BG meters. I am also also surprised at the casual attitude some people are taking to
this problem.
I was unfortunate enough to come under the so called care of a different consultant 18 months ago
who's only role in life seemed to be examining my test results and drawing a ring around anything under 4.0

She had decided that a reading of 4.0 was good and a reading of 3.9 was bad allowing no
explanation from myself and certainly not considering any possible inaccuracies in the meter. She
persisted in her obsession with low readings to the exclusion of all other aspects of diabetes care
and eventually wrote to the DVLA telling them that I was experiencing frequent hypos together with reduced awareness. The DVLA revoked my license .I have since seen two different consultants who I am pleased to say disagreed with her and I am now about to get my license back.
I have had diabetes for 46 years and with the exception of this particular consultant I have always had
good comments from the doctors at the clinic regarding my ability to control the condition.
Because this doctor was assessing me by totally relying on the results from the meter with no regard to my history or explanations, I started to test the meter alongside a meter of a different make - the results were alarming with variations between the meters of from 0% to 30%!. I have tried to get the
tolerances of these meters from the manufacturers but they will not commit themselves.I have since
been advised by a consultant who also has diabetes that they should be thrown away when 2 years old as they are even more inaccurate than when new.
The moral of this story is to use these meters but consider the results in conjunction with your own
experience and the way you feel.
Hopefully, one day, the manufacturers will have the honesty to publish the tolerances and life expectancy of these machines which are netting them very handsome profits