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Expenses for supplies can be a significant barrier to consistent SMBG testing. Costs for meters and supplies vary widely based on features. Still. market competition and rebates can dramatically reduce or eliminate the actual cost of the meter. It is usually more important to evaluate the cost of test strips.

Comparisons of widely used SMBG Meters



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Start out right and troubleshoot

Regardless of the patient’s educational level, every meter has a learning curve. Patients need initial education that includes return demonstrations to ensure proficiency. Of course, education must also include machine calibration, maintenance, and cleaning, if required. Don’t forget universal precautions and sharps disposal. Many companies provide videotapes to assist in patient training.

Patients experiencing problems with glucose meters must know how to contact the manufacturer. Most manufacturers offer 24-hour, toll-free assistance, and company representatives can guide patients through many problems, often in many languages. Serious problems concerning the glucose meter can be reported directly to the Food and Drug Administration at www.fda.gov/diabetes/glucose.html.

How nurses can help

Feedback is an important aspect of SMBG. Sometimes, patients are expected to self-monitor with little or no input about their readings. Encourage patients to record and track their readings and bring their logbooks with them whenever they visit their diabetes care provider or any other health care provider.

The most common reason for inaccurate SMBG testing is user error. Some of the more commonly reported reasons for errors are insufficient blood samples, incorrect meter calibration, a dirty meter, or defective or expired strips. Nurses can troubleshoot these problems and assist patients to use their machines properly.

Close monitoring of blood sugar is important to control diabetes and reduce the risk of long-term complications. Meters are not perfect, so remember to teach patients the warning signs and corrective actions for hypo- and hyperglycemia. A variety of testing meters and devices are available, each with unique features that can meet individual needs and preferences. Patients often seek advice from their nurses about routine care and equipment, and nurses who care for people with diabetes, must become familiar with several different meters and resources.

For additional information, visit “Glucose Meters and Diabetes Management” — a component of the U.S. Food and Drug Administration’s diabetes website at www.fda.gov/diabetes/glucose.html.

Susanne J. Pavlovich-Danis, RN, MSN, ARNP-C, CDE, maintains a private adult health practice in Plantation, Fla. She is also a professor and area chair for nursing at the University of Phoenix, Fort Lauderdale, Fla.

References

1. U.S. Food and Drug Administration website. Glucose meters and diabetes management. Available at: www.fda.gov/diabetes/glucose.html#11. Accessed October 27, 2004.

2. Havas S, Mayfield J. Self-control: a physician’s guide to blood glucose monitoring in the management of diabetes [American Family Practice Monograph]. Leawood, KS: American Academy of Family Physicians; 2004.

3. David Mendosa website. 10 reasons you love your meter so much. Available at: www.mendosa.com/10_reasons.htm. Accessed October 27, 2004.

4. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH. Noninvasive blood glucose monitors. Available at: http://diabetes.niddk.nih.gov/ dm/pubs/glucosemonitor/. Accessed October 27, 2004.