Checking Blood Glucose Levels - Brief History

On September 14, 1971 the first patent for a blood glucose meter was received by Anton Hubert Clemens, it was called the Ames Reflectance Meter. Richard K. Bernstein a physician, who was insulin dependent, became one of the first people to use a glucose meter to monitor his blood glucose from home. He kept track of his records and published his experiences in an early volume of the medical journal called Diabetes Care. Later he also wrote a book on his experiences "Dr. Bernstein's Diabetes Solution: A Complete Guide to Achieving Normal Blood Sugars."

Early articles in medical literature showed that patients could reliably use a blood glucose monitoring devise to accurately measure glucose levels from home and improve their personal management.

In 1986 the American Diabetes Association, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institute of Health agreed that blood glucose self-monitoring devises were both important and effective to diabetes management. They recommended that the self-monitoring devises be used to keep track of glucose levels over a period of time, assist in making day-to-day decisions for glucose management, help to recognize emergency situations, and to educate on blood glucose management.

The self-monitoring devises were originally used because healthcare providers and researchers believed they would control glucose and therefore reduce or eliminate complications from the diabetes disease. In 1993, the expectations were proven to be true when the results of a large conclusive study were presented by the National Institute of Diabetes and Digestive and Kidney Diseases.

This study was called the Diabetes Control and Complications Trial involving twenty-nine medical centers in the United States and Canada. It determined that for patients with type 1 diabetes the rate of diabetic complications reduced by 76% for eye disease, 60% for nerve disease, and 50% for kidney disease through intensive treatment for blood glucose management. Many of the patients in this test group however, had an increased risk of hypoglycemia.

This was a breakthrough in the glucose monitoring technology and today the market for glucose meters is billions of dollars yearly worldwide and continues to grow rapidly.

Today there are several glucose monitoring devises on the market. Below is a list of some brands available.

MediSense - Optium
The Optium is designed not to begin testing until there is enough blood on the test strip. This reduces errors and test strip waste. The Optium allows you to test from your forearm or your fingertip. It features the TrueMeasureTM test strip technology that makes testing more accurate. This advanced technology reduces the effects of substances such as aspirin, acetaminophen, and vitamin C to provide a glucose specific test result. The Optium requires a blood sample size of 1.5 micro liters and provides a test result in ten seconds. It features an easy to read display, 450 test result memory with weekly and monthly averaging, and downloads to a data management program on your personal computer.

MediSense - Precision Xtra
The Precision Xtra was designed to make advanced diabetes management simple. It also features the benefits of the TrueMeasureTM test strip technology. The Precision Xtra is a small meter that requires a blood sample size of 0.6 micro liters. Test results are produced in five seconds. The Precision Xtra stores 450 test results, has the capability of testing blood ketone, and is downloadable to your personal computer.

TheraSense - Freestyle
The Freestyle is an easy to hold and easy to read meter. It offers alternative site testing and only requires a blood sample size of 0.3 micro liters. The Freestyle can be used from beginning to end in 3 easy steps. It has auto on/off features, audio signal when test strip is full, and test results are produced in seven seconds. The Freestyle downloads to a data management program on your personal computer.

TheraSense - Freestyle Flash
The Freestyle Flash is ideal for people who are on the go. The carrying case is designed so that the meter does not have to be removed for testing. The Freestyle Flash test strip requires the smallest blood sample in the world of 0.3 micro liters. It will produce a test result in seven seconds. The Freestyle Flash has four programmable patient reminder alarms, stores 250 test results with a 14-day result average, and downloads on your personal computer.

TheraSense - Freestyle Freedom
The Freestyle Freedom features alternative site testing on your fingertip, hand, upper arm, forearm, calf, or thigh. It has a large easy to read display, comfortable easy to hold shape, and easy to use test strips. The freestyle Freedom requires a blood sample of 0.3 micro liters and produces results in five seconds. It also has four programmable patient reminder alarms, stores 250 test results with a 14-day result average, and downloads on your personal computer.

Prodigy Talking Diabetes Meter Kit
The Prodigy is an affordable talking diabetes meter. The test strip requires a blood sample of 0.6 micro liters and produces results in six seconds. The Prodigy will store 450 test results and will download to your personal computer.

BD Logic
The Logic requires a blood sample of 0.3 micro liters and produces results in five seconds. The required test strips are designed specifically for this monitoring device. It will store 250 test results; give 7 and 14-day averages, and record the date and time of each test.

ACCU-Chek - Active
The Active requires a blood sample size of 1 micro liter and provides test results in five seconds. The test strips are touchable and easy to use. It features alternate site testing, stores 200 test results, and is downloadable to your personal computer.

ACCU-Chek - Advantage
The Advantage requires a blood sample size of 4 micro liters and provides test results in twenty-six seconds. The test strips have a unique curve to fit your finger for easier blood application. It stores 450 test results and is downloadable to your personal computer.

ACCU-Chek - Aviva
The Aviva test strip requires a blood sample size of 0.6 micro liters and provides test results in five seconds. It features alternate site testing, stores 500 test results, and is downloadable to your personal computer.

ACCU-Check - Compact
The Compact provides test results in seven seconds. The test strips requires a blood sample size of 1.5 micro liters. It features alternate site testing, stores 100 test results, and is downloadable to your personal computer. The Compact Test Strip Drum holds 17 test strips.

LifeScan/OneTouch - Basic
The Basic is a simple and accurate user-friendly meter. It shows you your last test result before providing a new result. The Basic produces a test result in 45 seconds and stores 75 date and time recorded test results.

LifeScan/OneTouch - Ultra 2
The Ultra 2 features alternate site testing on your finger, forearm, or palm and the test strip requires a small drop of blood. It will provide test results in five seconds.

LifeScan/OneTouch - Ultra Mini
The Ultra Mini is a very small-uncomplicated meter. It will easily fit in a pocket or purse for those who are on the go. The Ultra Mini will produce a test result in five seconds. The test strips are easy to use.

Ascensia Breeze
The Breeze features an easy load AUTODISC that holds ten test strips. It requires very little blood and stores 100 test results. The Breeze offers alternate site testing on the finger, palm, forearm, thigh, abdomen, etc. It is downloadable to your personal computer.

Ascensia Contour
The Contour adjusts automatically for variables that can affect accuracy. The test strips are convenient and easy to use. It requires a blood sample size of 0.6 micro liters and produces test results in 15 seconds. The Contour stores 240 test results and is downloadable to your personal computer. It offers alternate site testing on the finger, palm, forearm, thigh, or abdomen.

Checking Blood Glucose Levels at Home

The proper care needs to be taken to manage diabetes and prevent future complications. This care begins at home. The basic steps for testing your glucose at home are:

1. Wash and dry your hands thoroughly.
2. Wipe the area where you will take the blood sample with alcohol.
3. Use the lancet device to prick our finger or alternate site.
4. Use the test strip to collect the blood sample.
5. Place the strip in the meter.
6. Wait for the meter to produce the result.
7. Record the result.
8. Dispose of used test strip and lancet.
9. Wash hands thoroughly.

Typically people with type 1 diabetes are required to test glucose three or more times daily. Pregnant women with gestational diabetes need to test twice daily. Most self-monitoring devises recommend that you check your glucose before meals, two hours after a meal, at bedtime, at three o'clock in the morning, and any other time you detect signs or symptoms.

Alternate Site Testing
Many devices now offer alternate site testing including the abdomen, upper arm, forearm, thumb, palm, calf, or thigh. There are several people who prefer alternate testing sites because they tend to be less painful or more convenient. This method may have some limitations, because there are still some controversies over the accuracy of alternate site testing and the proven fingertip testing. Your fingertips show changes in glucose levels quicker than other areas of the body. Further testing needs to be done to determine the overall impact of these test value differences on the health of diabetics.

Whole Blood vs. Plasma
Plasma glucose is generally up to 15% higher or more after eating than whole blood measurements. Home glucose testing devises measure the glucose in whole blood. Most lab tests measure the plasma equivalent. This is just how the information is presented to you and the plasma results are usually converted to whole blood measurements.

Glucose Meter Performance
There are some factors you need to consider that may affect the accuracy of your glucose meter. One is the quality of your meter, test strips and your education. Several other factors that may affect you results is hematocrit (amount of red blood cells), uric acid, glutathione, ascorbic acid, altitude, temperature, humidity, and use of third party test strips.

Additional Diabetes management Tests
Hemoglobin is present in all red blood cells and when glucose levels are high your red blood cells store large amounts of glycosylated hemoglobin. Measuring glycosylated hemoglobin will determine your blood glucose levels.

Fructosamine
High values of fructosamine mean you have high levels of blood glucose.

Urine Glucose
These tests are only for people who are unable to use blood glucose testing and are not really an accurate alternative.

Urine and Blood Ketones
When the body does not produce enough insulin it uses fats for fuel instead of glucose. Fat burning produces ketones. Ketones are eliminated through urine and therefore can be detected through an urine test. Some tests measure a specific ketone the diabetics with ketoacidosis have.

Micro albumin
Micro albumin begins to spill into urine when kidneys fail to filter properly. Testing can detect kidney failure in the early stages before damage occurs. Adults with diabetes are encouraged to test every three to six months for micro albumin. Children with diabetes should test at puberty or five years after having diabetes.

Cholesterol
With diabetes a person is at higher risk of heart and blood vessel disease. Routine cholesterol measurements and control will reduce your risk for these diseases.

Take Control of Your Health
The main purpose for checking your glucose is to assist you in making day- to- day decisions for glucose management and help you recognize emergency situations.

If you have been diagnosed with diabetes it is important that take care of yourself. Find out your treatment options and your diet and lifestyle requirements. Be consistent in taking your medicines and monitoring your blood glucose levels.

It is critical that you follow the advice of your doctor and take responsibility for your own health. Your healthcare provider can help you determine what glucose self-monitoring devise will best fit your lifestyle needs. Having diabetes can be overwhelming at times, but it does not have to control your life. You do not have to lose any quality of life just because you have diabetes. If you take proper care of yourself then you can live a normal, happy, active and rewarding life.

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