Every year millions of people worldwide suffer from diabetes. Diabetes is a condition in which the level of blood glucose or sugar increases. A high level of blood glucose in the body can have negative impacts on the human body. The patients may have to face kidney, eye, heart, or dental-related diseases.
Thus, they need to maintain their blood glucose all the time. So, venipuncture may not be possible all the time. Instead of that, a new technology known as a glucose meter (glucometer) has been developed to track the level of blood glucose all the time. Here we will be talking about some of the features, costs, and contact lists to purchase the blood glucometer for you. Besides that, we will also talk about the Continuous Glucose Monitor (CGM) system.
A glucometer is a handheld device that is used to measure blood glucose levels. Nowadays the approximate range of blood samples that are needed for the measurement, ranges from around 0.5 µl to 3.0 µl.
Different companies have developed different kinds of glucometers. So, there is a minor variation in the size and features. The general parts of the device include the display unit, power supply unit (battery), test strips port, memory unit, measurement unit, and control buttons.
You will be able to set the date and time in the meter. Besides that, you will also be able to set the blood sample volume for measurement.
Glucose Test Strip
Generally, glucose test strip is coated with an enzyme such as glucose oxidase. The oxidase is capable of catalyzing the oxidation reaction of blood glucose to gluconic acid and hydrogen peroxide. Hydrogen peroxide is an indicator that changes its color during the process of oxidation. In other words, the intensity of the color formation is directly proportional to the intensity of the blood glucose level.
The test strip should not be exposed to an outer environment for a long period of time. Else, the moisture and the sunlight will ruin its chemical composition. Thus, the accuracy of the measurement of glucose will decrease.
The test strips are designed for single use. Also, before you use the test strip, you need to see its life span. Generally, the life span of the strips is about six months. But, I personally suggest you not use it for more than four months.
Each company provides you with its own test strips. So, using the test strip of any other company can give you an incorrect result.
The lancing device consists of the disposable lancet in it. The lancet is used for drawing out the blood. The video shown below gives you a general idea of how you can load the lancet inside the lancing device.
How to use a blood glucose meter?
The blood glucose meter is generally not designed to use on neonates.
Follow the following steps while using the glucometer.
- Load the lancet inside the lancing device.
- Take out the glucose test strip from the container and insert it into the glucometer. On proper insertion, the machine will turn on automatically.
- Wash your hand with warm water. It will increase the blood flow in the finger.
- Rub the tip of the finger with an alcohol swab. It will reduce the chances of contamination.
- Then prick at the side of the fingertip with the help of the lancing device.
(Note:- Glucometer is not suitable for testing arterial blood and serum. Pricking the same finger multiple times can leave scars on your finger. Hence you need to keep on changing the finger for blood sample collection )
- If the blood is not sufficient, then apply gentle pressure around the wound.
- Raise the glucometer and touch the blood sample to the test strip.
- After 5 to 10 seconds, it will show the value of glucose in the display.
- Note down the result in a notebook or phone. The glucometer will also be able to store a few hundred of the result.
- Remove the strip from the machine and the lancet from the lancing device. Then safely dispose of them.
(Note:- The result of glucometer can differ from one company to another. So, never use more than one glucometer. Else, there can be minor errors while monitoring the glucose level.)
Why finger stick blood sugar test is used?
Besides the fingertip, blood can be drawn from other alternative sites such as the forearm, palm, etc. But, in those cases, the level of glucose in the blood may vary due to various conditions such as meals, drinks, medications (such as insulin), and exercise.
There are other reasons as well, where the result from the finger stick blood test becomes superior. Some of them are as follows.
- The rate of reaction of blood to the enzymes of the test strips drawn from the fingertip is higher. So, the result can be achieved quickly.
- You do not need a high volume of samples for the measurement.
- You can get a good flow of blood at the fingertips. So, you do not need to prick the finger deeply. But, in the case of the other alternative sites, you may even need a different lancing set. You also may need to prick deeply which can be more painful.
- The alternative sites are not suitable in the case of hypoglycemia (low blood glucose).
Factors affecting the glucose measurement
A number of factors may affect the value of the glucose measurement. Some of them are as follows.
- Diet and medication can alter the level of glucose in the blood.
- Improper handling of the machine, low blood sample, etc can give an error during measurement.
- Humidity and sunlight can affect the quality of the glucose strips. Date expired test strips can give fault reading.
- The machine may give inaccurate results at a high altitude of above 10,000 feet from sea level.
- A hematocrit above 60% or below 30% can give a fault result.
- The value can also alter from one manufacturing company to another. This is because each company may apply a slightly different technology for glucose measurement.
What is a normal reading on a blood glucose meter?
The level of glucose in the blood can differ due to various factors such as habitat, geographical location, method of testing of blood glucose, etc. The unit of measurement can be either mmol/l or mg/dl based on the countries. In Nepal, it is generally, mg/dl. If the value is shown in the decimal form, then it is in mmo/l form. Similarly, if the value is shown without any decimal, then it is in mg/dl form.
Here we will be looking at the approximate range of blood glucose.
- Fasting blood glucose:- 70 mg/dl to 110 mg/dl (3.88 mmol/l to 6.11 mmol/l)
- Post-prandial blood glucose:- 110 mg/dl to 150 mg/dl (6.11 mmol/l to 8.33 mmol/l)
How accurate are the glucometers?
The glucometers are accurate to some extend. But, the result can alter from one model to another. This is because different companies use different protocols during the manufacturing of the glucometer. The technology of glucose measurement can be different. Similarly, the chemicals used in the diabetic test strips can vary. Thus, the result of one glucometer may differ from the other glucometers.
The glucometer uses the capillary blood. Similarly, the laboratories use veinous blood. Researches have shown that the result of glucose obtained for the glucometer is about 5 percent higher than that of the pathology lab.
Thus the result that you obtain from the glucometer should only be used for the reference purpose for the treatment of diabetes. So, you need to consult with your doctor to know more about this matter.
Blood glucose meter price in Nepal
The price of the blood glucose meter can vary from one company to another. So, the approximate price range of the glucometer is from Rs 1200 to Rs 2000. In a new packet of the machine, you may even get few pieces of test stripes and the needles.
Once you purchase the machine, you need to periodically buy the test stripes which are quite expensive in comparison to the machine. The price of 50 test stripes can approximately cost you about Rs 1400- Rs 1600.
Similarly, the needles (lancet) can cost you about Rs 3 per piece.
The cost price may be even greater if you are buying it online.
What is the best blood glucose meter 2021?
On the basis of quality, price, and availability in the Nepalese market, I prefer the glucometer of Contour Company.
Contour has two models in Nepal. They are Contour TS and Contour Plus. Both of them have a warranty of 1 year. They provide highly accurate results. They meet the ISO standards. Besides that, they provide fast readings and operate for a low blood sample.
For more precise specifications and the price of the Contour model please click on the link to contact the supplier. The supplier is available within Kathmandu Valley.
What is Continuous Glucose Monitor (CGM)?
The person suffering from diabetes may need to take readings several times a day. So, in the case of a blood glucose meter, you need to prick your finger for every single test. Pricking your fingers often can cause pain and can leave permanent scars on the fingers. So, to overcome this problem, a needle-free blood sugar testing system has been developed. This is generally referred to as the Continuous Glucose Monitor (CGM) system.
As stated before, CGM measures the blood glucose level continuously. The unique feature of this system is that it is a glucose meter without blood in it. Thus, unlike the blood glucose meter, this system does not need any lancet or test strips for measurement.
How does CGM work?
There have been many attempts to continuously measure the blood glucose level.
One of the researches done in a rat has shown that there could be a direct relationship between saliva and blood glucose level. Some other researchers are also trying to establish a relationship between earwax and blood glucose. Even mobile applications are found in the app/play store for sugar measurement.
Many companies have already developed sugar testing machines without blood. For example, most of them make use of sensors. Some of the sensors are fixed on the outer skin of the arm or abdomen. While other kinds of sensors go beneath the skin layer to collect the data. The sensor collects the signal from the interstitial fluid and sends it to the transducer. The transducer may be connected to your mobile phone. It will send the signal to your mobile phone, every 5 mins.
Some other companies have a machine that allows you to scan your sensor or transducer. So, you can get the reading whenever you want.
You may be interested in the following CGM system. They are some of the best glucose monitors that do not need blood samples or test strips for measurement.
Drawbacks of CGMs
Even though the CGM system is non-invasive in nature, it has also got some problems. Some of them are as follows.
- You need to replace the sensor from time to time. Placing the sensor inside the skin can be painful.
- The sensors may sometimes fail to transfer the signal to the transducer.
- It may cause skin irritation and allergies.
- Lower accuracy in the result, in comparison to that of the blood glucose monitor.