Expert Linda Siminerio Gives Advice About Home Blood Glucose Monitoring


Linda Siminerio, RN, PhD, is a certified diabetes educator, the executive director of the University of Pittsburgh Diabetes Institute, and a past editor in chief of Diabetes Forecast.

Q: Can products like skin cream affect my reading?

A: Yes, they certainly can. Lotions, creams, and other substances on your hands can cause your meter to give an inaccurate reading. Even handling a sandwich can leave glucose on your fingertips, which would provide an abnormally high reading when you draw blood from your finger.

Q: How often should I test my blood sugar?

A: That's an individual issue that you should decide with your health-care team. Some people—like those with type 1 diabetes or people with type 2 who are using insulin—need to test more frequently than people who are handling their type 2 diabetes with lifestyle changes or oral medications. Talk to your doctor or diabetes educator about how often and when to test your blood sugar.

Q: Can I reuse lancets?

A: You shouldn't. People with diabetes are at higher risk of developing infections, especially if their blood sugar is out of control, and using the same lancet to poke yourself multiple times exposes you to germs. In addition, you don't want to accidentally jab yourself—or allow others to do so—on your used lancets. So use a lancet once, then dispose of it safely.

Q: Should I wash my hands before I draw blood?

A: Every time. Cleaning your fingers before testing is absolutely critical. This helps prevent infection, and it also ensures that substances on your hands won't affect your reading. Washing with soap and water is all you need to do. However, if you use alcohol or an alcohol-based hand sanitizer to clean your hands, make sure you let it dry completely before you poke your finger—wet alcohol can affect the reading.

Q: Should I bring my meter with me to diabetes checkups?

A: Yes. Meters often store a trove of valuable blood-sugar records that your health care provider can review. Some people also connect their meters to their computers to download their results so they can be printed out; if you go this route, bring these printouts with you. This is also a good time for your provider to check your meter's accuracy, if necessary, and answer any questions you have about the process.

Q: Should I be concerned about "coding"?

A: Some meters require you to input a code number or insert a coded test strip when you open a new box of strips, which calibrates the meter to properly use the strips. If you don't code the meter or do it improperly, you can get incorrect results. However, many newer meters don't require coding, so if you want to make the process simpler—and your insurance company will cover it—consider one of these meters. If yours does require coding, read the directions carefully to make sure you're doing it right.

Q: What should I consider when choosing a monitor?

A: With all sorts of meters available these days, you'll need to take a close look at the different features each meter offers to choose one that fits your lifestyle. Do you have trouble with your vision? Pick one with a larger digital readout for easy reading. Are you a businessperson who wants to be discreet about your diabetes when you're in the office? Try a meter that looks like a cell phone and slips easily into your pocket. You can also select a simple meter if you're not tech-savvy, or a complex meter if you want an orchestra of bells and whistles. Just remember, though, that your insurance company may require you to choose from certain models. Also, find out how much the test strips cost that the meter requires before you buy the meter—those can add up to a major expense.

Q: How long should I keep my meter?

A: The two-year mark is a good time to upgrade your meter. It's not that meters stop working after two years, but at this point, errors and malfunctions are more likely to happen. In addition, technology is always improving, and manufacturers make other upgrades—such as requiring a smaller drop of blood—so this is a good time to pick up a meter with better features. Find out which meters your insurance company will pay for, and talk to your health care provider—your diabetes educator may be able to give you a free meter and show you how to use it.

Q: How should I clean my blood glucose meter?

A: Different meters require different cleaning methods and schedules. Check the information that came with your meter and follow the directions carefully. However, cleaning your meter regularly isn't as important, in general, as it was years ago. Blood doesn't have as much contact with the meter now that the drop of blood is put on a test strip before being inserted in the meter.

Q: What should I do if I get a reading that seems too high?

A: If you get a high number but you don't feel like your blood sugar is high, recheck it. If you're consistently getting results that don't seem correct, it's time to check your meter to make sure it's working properly. Also, let your doctor or diabetes educator know about the results. Health-care providers do this for patients all the time; just make a call and ask if you can bring in your meter to test its accuracy.

Q: Can I use generic test strips?

A: These are less expensive strips that aren't made by the manufacturer of your meter. If you want to use generics, check to ensure that they're intended to work with your meter, and also call the toll-free number on your meter to ask the maker if a particular strip will work for your meter. It's also wise to discuss using generic strips with your health-care team. Your meter is an important tool for tracking your blood sugar, and using generic strips that don't provide accurate information can add confusion to the process.

Q: How can I make sure my meter is properly calibrated?

A: Different meters require different methods to check their accuracy. Some require you to put a special liquid onto a strip, which the meter reads and then provides a number that should match a number listed in the liquid's packaging. Other meters require you to insert a special strip or cartridge for testing purposes. You can also bring your meter with you to the doctor's office, and your physician can test your blood in the meter and at the lab to see if they provide the same results. If you have any questions about getting accurate results from your meter, talk to your health-care team or your pharmacist.

Q: Is there anything I can do to make the "poke" less painful?

A: Sure—people have found many favorite methods for less painful blood drawing. Some people always prick a particular finger, so it builds up a callus that's not as sensitive during pokes. Many people say that it's less painful to poke the side of the fingertip rather than the pad since it doesn't have as many nerve endings.

Q: Can I draw blood from an "alternate site" or should I use my fingertip?

A: Some meters will allow you to use a drop of blood from your forearm, thigh, or other non-fingertip location. Most people tend to use their fingertips, but there are other sites. You should discuss this with your educator. A lot more research has gone into assuring the accuracy in using alternative sites and you want to make sure that what you are doing provides the most accurate result. Again, it's a good idea to carefully follow the instructions with your meter and to talk with your health-care provider when choosing the site for your blood test.

Q: Can I share my meter with a family member?

A: That's not a good idea. Nowadays many meters keep records of your blood sugar levels so you can track their changes electronically. When people share a meter, you can lose track of whether a particular reading was yours or the other person's. Meters are relatively inexpensive these days, so it's better for each person with diabetes to have his or her own.

Q: What meter issues do I need to consider while traveling?

A: Meters may not work the same in cold temperatures or at high altitudes, which could affect their accuracy on a ski trip. Heat and dampness can affect test strips, so you may want to leave your gear in the hotel room instead of bringing it out on the beach. Check your meter's directions for information on using it in these settings.

Q: Can I use strips past their expiration date?

A: That's not a good idea. Test strips contain chemicals that only stay "good" for so long, so using expired strips may lead to inaccurate results.

Q: Where should I store my strips?

A: In general, store them in a cool, dry place (the bathroom is a bad place due to humidity). If they come in a bottle, make sure to put the cap back on the bottle after you take out a strip. Strips can quickly go bad if you store them improperly, which means they won't work—or even worse, will give you an inaccurate reading.

Q: Should I bother setting the clock on my meter?

A: Yes. If the date and time weren't set at the factory, set them before you start using the meter. If you don't, any records you keep of your blood sugar will have inaccurate times and dates, which makes the data less useful. You may need to reset the clock twice each year due to daylight savings time, and after you replace the battery.

Q: I have anemia—will that affect the way my meter works?

A: It can. If you have low hematocrit—your red blood cell count—some meters may not provide accurate information. If you have anemia or other conditions that cause a low hematocrit, talk to your health-care provider or diabetes educator about which meter will work best for you.