Patient Factors To Consider When Selecting A Meter
This page is intended for healthcare professionals who are determining the best meter to recommend to a patient who will be self-monitoring their blood glucose. The recommendations made here are based on practice experience rather than clinical evidence.
Before following these recommendations please read the disclaimer.
Before following these recommendations please read the disclaimer.
Age
Very young patients who have a need for blood glucose testing will not likely be able to perform a blood glucose test on their own and will need the assistance of a parent or care provider to help them test. Owing to the complexity of some meters it is likely best to select a simpler meter in this population, which will allow the young patient to more easily learn the functions of the meter and possibly graduate to a more advanced meter as they age. In situations where a parent or care provider is testing for the patient it may be best to select a meter with a longer testing window and one which allows blood to be reapplied to strips during the testing process so that failed tests are minimized.
Adolescent and young adult populations are increasingly familiar with complex technological devices and would most likely benefit from a device that allows for advanced functions to be performed. These advanced functions will provide more for the patient to learn and will be more stimulating for them as compared to a simple meter with limited functionality.
Adult middle aged patients have highly varied in their preferences and needs so it is difficult to recommend a specific type of meter to this population. Presenting the characteristics of all meters and determining which are more valued to the individual patient will aid in recommending an appropriate meter.
Elderly patients more commonly suffer from comorbid illnesses but may also prefer a simpler or an all-in-one meter that requires less coordination to manipulate. While this may be appropriate for some elderly patients there is also a trend of increased technological familiarity amongst the elderly so an approach similar to that recommended for middle aged patients may be most appropriate. Allowing the patient to be involved in the decision is a great way to improve satisfaction in the device selected.
Adolescent and young adult populations are increasingly familiar with complex technological devices and would most likely benefit from a device that allows for advanced functions to be performed. These advanced functions will provide more for the patient to learn and will be more stimulating for them as compared to a simple meter with limited functionality.
Adult middle aged patients have highly varied in their preferences and needs so it is difficult to recommend a specific type of meter to this population. Presenting the characteristics of all meters and determining which are more valued to the individual patient will aid in recommending an appropriate meter.
Elderly patients more commonly suffer from comorbid illnesses but may also prefer a simpler or an all-in-one meter that requires less coordination to manipulate. While this may be appropriate for some elderly patients there is also a trend of increased technological familiarity amongst the elderly so an approach similar to that recommended for middle aged patients may be most appropriate. Allowing the patient to be involved in the decision is a great way to improve satisfaction in the device selected.
Diabetes History & Experience
Patients with newly diagnosed diabetes may be overwhelmed by all of the new medical advice they are receiving and may be more comfortable selecting a simpler meter while they learn the testing process . That being said, newly diagnosed individuals may also be highly motivated and may express an interest in the advanced functions of some meters. It is important to determine the comfort level of these patients before recommending a meter and to fully explain the testing process and the reasons why testing is required.
Patient with a longer history of diabetes who understand the testing process and are familiar with their recommended blood glucose targets may prefer a meter that provides calculated averages right on their device. Also, some devices offer logging features beyond blood glucose results that may be of interest to patients who are looking for ways to better manage their diabetes. Unfortunately, patients with a long history of diabetes may have also developed comorbidities that make using a meter more difficult and this situations is discussed below.
Patient with a longer history of diabetes who understand the testing process and are familiar with their recommended blood glucose targets may prefer a meter that provides calculated averages right on their device. Also, some devices offer logging features beyond blood glucose results that may be of interest to patients who are looking for ways to better manage their diabetes. Unfortunately, patients with a long history of diabetes may have also developed comorbidities that make using a meter more difficult and this situations is discussed below.
Comorbidities
Patients with comorbid illnesses and particularly those with complications of diabetes may have difficulties coordinating their testing equipment or simply operating their meter. Two important complications of diabetes in which these issues may arise are retinopathy and neuropathy. In addition, patients may have cognitive deficits that have developed over the course of many years and may no longer be able to properly use their meter as they once could.
Patients with retinopathy or other visual impairment would benefit from a meter with an auditory feedback system such as spoken directions or acoustic mode. It is important to ensure that the patient has adequate support to learn the functions of the meter in order to ensure that testing and results reporting are successful.
Patients with peripheral neuropathy affecting their dexterity may have difficulties coordinating all of the testing equipment or using their meter interface. In this case a meter with a simple interface and fewer buttons may be more appropriate. Also, a meter with a strip system that permits re-addition of blood to a test strip and has a long testing window would decrease the risk of failed tests and wasted test strips. Another appropriate suggestion may be a meter with an integrated multi-strip system so that the patients does not have to insert a strip each time they test. Some meters also come with integrated multi-lancet systems to reduce the burden of inserting a new lancet for each test and risk pricking a finger accidentally. It is important to ensure that the patient has adequate functionality to operate their meter successfully before beginning to test independently.
Patients experiencing cognitive decline may, at one point, fully understood how to use their meter but they could have lost that ability over a long period of time. This could also be compounded by other comorbidities related to vision and dexterity. It is important to reassess patient functionality periodically, depending on each patient's circumstances, in order to confirm that they are still able to use their meter correctly. If a patient is deemed to no longer have the ability to effectively use their meter they may be able to operate a simpler meter, however it is more likely that they will require assistance to test their blood glucose.
Patients with retinopathy or other visual impairment would benefit from a meter with an auditory feedback system such as spoken directions or acoustic mode. It is important to ensure that the patient has adequate support to learn the functions of the meter in order to ensure that testing and results reporting are successful.
Patients with peripheral neuropathy affecting their dexterity may have difficulties coordinating all of the testing equipment or using their meter interface. In this case a meter with a simple interface and fewer buttons may be more appropriate. Also, a meter with a strip system that permits re-addition of blood to a test strip and has a long testing window would decrease the risk of failed tests and wasted test strips. Another appropriate suggestion may be a meter with an integrated multi-strip system so that the patients does not have to insert a strip each time they test. Some meters also come with integrated multi-lancet systems to reduce the burden of inserting a new lancet for each test and risk pricking a finger accidentally. It is important to ensure that the patient has adequate functionality to operate their meter successfully before beginning to test independently.
Patients experiencing cognitive decline may, at one point, fully understood how to use their meter but they could have lost that ability over a long period of time. This could also be compounded by other comorbidities related to vision and dexterity. It is important to reassess patient functionality periodically, depending on each patient's circumstances, in order to confirm that they are still able to use their meter correctly. If a patient is deemed to no longer have the ability to effectively use their meter they may be able to operate a simpler meter, however it is more likely that they will require assistance to test their blood glucose.
Medications
Patients using medications with a high risk of hypoglycemia, such as insulin or some oral antihyperglycemic medications, may benefit from a meter that includes an alert when a test result is below their target range. In addition, some meters offer a pattern identification function which highlights when a trend of either high or low blood glucose has occurred at a specific testing time. For patients mealtime insulin or insulin secretagogues this feature may be useful in considering dosage adjustments.
Patients using multiple daily insulin injections may benefit from a meter that allows for insulin doses to be recorded and stored as part of their electronic log book. Certain meters also include rapid acting insulin calculation functions that allow patients to input certain parameters that are then used to calculate the recommended dose of insulin to administer.
Patients using multiple daily insulin injections may benefit from a meter that allows for insulin doses to be recorded and stored as part of their electronic log book. Certain meters also include rapid acting insulin calculation functions that allow patients to input certain parameters that are then used to calculate the recommended dose of insulin to administer.
Intended Use
It is important to ascertain from the patient what their expectations and intended functions of their meter are and which features they feel would be most useful. Using our Comparison Charts in combination with the patient specific factors above and your knowledge of your patient's situation you can make a confident recommendation as to the best meter for your patient.