Helping Patients Select the Best Blood Glucose Meter

While continuous glucose monitoring (CGM) is increasingly common, self-monitoring of blood glucose (SMBG) with a meter remains an essential tool for many people with diabetes. Insurance coverage, cost, access, or clinical need may make SMBG the most practical option. Blood glucose meters (BGMs) are also critical as a backup to CGM, for confirming unexpected results, and for specific patient groups.

The diabetes care and education specialist (DCES) plays a key role in helping patients select the right meter, use it safely, and apply the data to daily management. With meters typically lasting 3–5 years, the right choice can have a long-term impact on safety, accuracy, and patient confidence.

Key Considerations for Meter Selection

Choosing a meter involves more than coverage or convenience. Educators should help patients match device features to their needs:

• Visual support: high-contrast displays or talking meters for low vision.

• Dexterity support: larger strips, easier lancet handling, or alternate site testing for those with limited hand function.

• Portability: small, lightweight meters for frequent daily testing.

• Connectivity: smartphone app integration, cloud upload, or clinic download options.

• Affordability and access: insurance coverage, copays, and availability of strips.

• Insulin support: some meters provide bolus calculation or active insulin tracking.

Educators should also assess physical abilities, cognitive status, and patient preferences to ensure that meter choice supports long-term adherence.

Ensuring Meter Accuracy and Safety

Accuracy is central to safe SMBG. Current FDA standards require:

• 95% of results within ±15% of comparator values across the claimed measuring range.

• 99% of results within ±20% of comparator values.

Still, real-world use can introduce errors due to strip storage, improper technique, or lack of training. Practical strategies to support accuracy include:

• Comparing meter data with A1C and looking for discrepancies.

• Encouraging routine use of control solution to check meter–strip function.

• Teaching correct handwashing and sample collection techniques.

• Reinforcing the need to re-check when results are inconsistent with symptoms.

Safety reminder: meters and lancets should never be shared. Patients should follow manufacturer instructions for cleaning and infection control to prevent bloodborne pathogen transmission.

Common Sources of SMBG Errors and Interferences

For a more comprehensive list of potential errors and interferents, see [Downloadable Guide: Troubleshooting SMBG Accuracy and Safety] (PDF).

Turning Data Into Decisions

Numbers alone are not enough. The educator’s role is to help patients interpret results in context:

• Targets: fasting, pre- and post-meal ranges.

• Medication effects: insulin action, steroid use, or other drugs that alter glucose.

• Lifestyle factors: diet, exercise, illness, stress, alcohol, or hormonal changes.

Encouraging patients to connect SMBG results with behaviors deepens engagement and prevents insulin stacking or misinterpretation.

Data Sharing and Technology Integration

Modern meters increasingly support data transfer through apps, Bluetooth, or cloud upload. This allows patients and providers to:

• Save time at visits by reviewing data in advance.

• Identify patterns between appointments.

• Make timely therapy adjustments with remote support.

Clinics may use proprietary software, universal download stations, or patient-shared app data. Educators should be comfortable guiding patients on how to download or share their information, and when needed, practice with demo meters.

Why Meters Still Matter in the CGM Era

CGM is now considered the standard of care for many people with diabetes, but a blood glucose meter remains essential, even for those using CGM. Patients need a reliable meter to:

• Confirm unexpected CGM readings.

• Measure glucose during times of rapid change when CGM may lag.

• Provide backup if a sensor fails, is removed, or is not covered by insurance.

Because of these needs, every patient using CGM should also have access to a BGM and know how to use it correctly. The educator’s role is to reinforce this message and ensure patients are comfortable switching between devices when needed.

Summary

SMBG remains a vital tool in diabetes care, especially when CGM is not available or as a backup. The DCES is central in:

• Matching meter features to patient needs.

• Teaching proper use for accuracy and safety.

• Guiding interpretation of results in the context of daily life.

• Supporting integration of meter data into clinical care.

By combining technology knowledge with patient-centered education, diabetes care and education specialists help ensure that meter use leads to safer, more effective self-management.