Key considerations when choosing a blood glucose monitor
Selecting an appropriate blood glucose monitor is an important part of supporting effective diabetes self‑management. While all Therapeutic Goods Administration (TGA)–approved meters meet minimum accuracy standards, devices vary considerably in their features, usability, and suitability for different patient needs.
Pharmacist and Credentialled Diabetes Educator, Donna Itzstein, outlines key considerations when recommending a blood glucose monitor and compares a range of National Diabetes Services Scheme (NDSS)‑subsidised options commonly used in Australia.
Key features explained
Ketone monitoring
Blood ketone testing is particularly relevant for people with type 1 diabetes and for those at risk of diabetic ketoacidosis. Meters such as Freestyle Optium and CareSens Pro Dual allow both blood glucose and blood ketone testing, using separate test strips. Clinicians should note that ketone strips are required in addition to glucose strips.
Connectivity and data management
For people who benefit from reviewing trends over time, meters with Bluetooth or USB connectivity can support data sharing with apps or desktop software. Glucokey, CareSens Pro Dual, Accu‑Chek Guide, and Contour Next offer varying levels of digital integration, which may assist with pattern recognition, clinician review, and patient engagement.
Ease of use
Ease of use is influenced by factors such as required sample volume, strip handling, and lancet device design.
- Freestyle Lite requires the smallest blood sample, which may be helpful for people with difficulty obtaining capillary blood (e.g. arthritis or reduced peripheral circulation).
- Accu‑Chek Guide and Contour Next are well regarded for accuracy and overall usability.
Memory and reminders
Meters with larger memory capacity and reminder functions can support people who test frequently or benefit from prompts. CareSens N and CareSens Pro Dual offer higher storage capacity and programmed alerts.
Design and portability
Device size and physical design may influence adherence.
- CareSens N is among the most compact meters available.
- Accu‑Chek Guide features a spill‑resistant strip port, which can reduce handling difficulties during testing.
Test strip design
Strip size and colour can impact usability, particularly for people with reduced dexterity or vision.
- Smaller strips (e.g. Freestyle Lite, Glucokey) are portable but may be harder to handle.
- Wider strips (Accu‑Chek Guide) can be easier to manipulate.
- Standard slim black strips (CareSens range, Contour Next) offer a balance between handling and portability and improve visual contrast.
Vision support
For people with significant vision impairment, CareSens N Voice provides audible results, a large display, and a strip ejector, improving accessibility and independent use.
Accuracy of capillary blood glucose monitoring
All blood glucose monitors supplied through the NDSS must comply with ISO 15197:2013 accuracy standards, as required by the TGA. These standards specify that at least 95% of readings must fall within defined limits of laboratory reference values across a range of glucose concentrations.
Blood glucose monitors are intended to guide day‑to‑day management decisions rather than replace laboratory testing. Using the same meter consistently is recommended, as readings can vary slightly between devices. Additionally, physiological glucose fluctuations occur minute to minute and contribute to normal variation in results.
Factors affecting accuracy in practice
Even with compliant devices, user technique and external factors can significantly affect readings. Clinicians should reinforce the importance of:
- Proper hand washing and ensuring hands are dry before testing
- Using recommended testing sites
- Correct storage of meters and strips, avoiding heat, humidity, and expired consumables
- Awareness of medical conditions that may affect capillary blood flow or results
- Recognition that some medications or supplements (e.g. vitamin C) may interfere with readings
Choosing a blood glucose monitor should be individualised, taking into account the person’s type of diabetes, risk of ketosis, vision or dexterity issues, digital literacy, and preferences around data tracking. While all TGA‑approved meters meet accuracy requirements, optimal outcomes depend on selecting a device that fits well with the person’s daily routine and ensuring appropriate education on correct use.