What is the best kind of glucose monitor?

What is the best kind of glucose monitor?

Since insulin became available, probably nothing has more revolutionized the day-to-day management of diabetes, especially type 1 diabetes, than the arrival of the capillary glucose monitor. So successful has this technology been that this is a difficult question to answer specifically because there are up to 20 approved glucose monitors for use at any one time, with new or updated models appearing frequently. Also, different features are important to different individuals, depending on their needs.

Probably the best way to answer this question is to discuss some of the available features. Size is one of the first that springs to mind. Monitors have been getting ever smaller since they first appeared more than 30 years ago. It is now possible to get a monitor that is about the same size as a standard lipstick (e.g., One Touch Ultra-Mini®) and is yet highly functional. Memory size is not as important as it might at first seem. A memory of about 100 readings is probably sufficient, although almost every monitor now has more. There is limited practical usefulness of going back too far, since treatment decisions should be based on recent information, rather than distant data. Sample size is sometimes important and most available meters now use much smaller blood samples than was previously the case. Microsample meters such as some Freestyle® and One Touch® models use samples less than 1/50th the size of an actual droplet of blood. Many monitors will permit sampling from sites other than the fingertip, such as the forearm (most) and palm, which is useful for those with sensitive fingers or for people who are heavily involved in manual or delicate work. The speed of obtaining the reading is now usually around 5 seconds after the blood sample is applied, although some models (such as the Prestige IQ®) can take up to 50 seconds. This is much shorter than models in the early days, which could take from 1 to 2 minutes. Most meters can now be linked by cable, Bluetooth, or broadband to a computer and their contents are downloadable, including to the Internet. Some meters have multistrip cassettes that dispense between 10 and 20 test strips, such as the Accuchek Compact Plus®, for added convenience. Other features include the ability to display results graphically (e.g., One Touch Ultrasmart®), to function at high altitude (e.g., Advocate Duo®), and to speak the results for those with limited vision (e.g., Prodigy Duo®). The features of 10 available glucose

Table 11 Features of 10 Available Capillary Glucose Monitors

Name	Vol	Site	Time	Mem	DL	Other
One Touch Ultra 2	1.0	F, A	5	500	+
One Touch Ultrasmart	1.0	F, A	5	3000	+	Graphs
One Touch Ultramini	1.0	F, A	5	50	-	1.2 oz
Accuchek Compact+	1.5	F, A	5	300	+IR	Drum, no code
Accuchek Advantage	4.0	F	26	480	+
Advance Microdraw	1.5	F, P	15	250	+
Freestyle Flash	0.3	F, A	7	250	+IN
Advocate Duo	0.7	F, A	7	450	+	To 10,742 ft
Prodigy Duo	0.6	F, A	6	450	+	Talks, 5 oz
Prestige IQ	4.0	F	50	365	+	WB/plasma

Vol: Sample vol in _L; F=finger; A=arm; P=palm; Time=time to results in seconds; Mem=memory
capacity; DL=downloadable; IR=infrared; WB=whole blood.

monitors are shown in Table 11 and an example of a typical data printout can be seen in Figure 6.

Finally, those with longstanding or complicated diabetes might want to consider the option of continuous glucose monitoring, which is discussed in. However, bear in mind that you will still require a conventional capillary glucose monitor.

Figure 6 Example of a data printout from contemporary glucose monitor.