Our pediatric endocrinologist only wants his patients using one brand of blood glucose monitor, but this machine uses a large drop of blood and takes 45 seconds to get the reading. We would like to switch to a different monitor because these monitors give the reading so quickly and the blood sample is so small. However, he claims his choice is the most accurate monitor available for home use and that speed and blood sample size are not reasons to switch to another monitor. Actually, he insists that we do not switch.

It sounds like your physician is very concerned about accuracy and does not have faith that the other meters can match up to his “gold standard.” Is he willing to look at data about the other meters? Each meter company has very complete information from tests they had to perform to obtain FDA approval. Maybe some of these scientific studies would convince him of the accuracy of other meters.

Maybe he has had experiences with meters in the past that did not meet his standard of care. It might help to approach your discussion from the accuracy standpoint, rather than the comfort and convenience standpoint. Maybe he would let you run a simple comparison at home with a new meter and your current meter.

One other consideration is that the newer meters are adjusted to plasma glucose values. That means the results better match to blood sugars done in a lab. Your current meter is not plasma referenced. That means values on your current meter may vary from the lab values by 10-15 %.

Good luck – there are many fine meters out there that should meet your physician’s expectations.

BS
Additional comments from Lois Schmidt Finney, diabetes dietitian:

I suggest you check with the other members of the diabetes team. I can certainly see why you wish to use the other meters. Maybe he has other reasons for using the meter, such as the data that can be available and downloaded.

LSF
Additional comments from Craig Broadhurst:

Personally, I think you are able to choose the meter that best suits your lifestyle and preferences. It may be that your doctor has a reason for preferring one meter — perhaps he can download a bunch of results in the office using IT technology of that particular meter. He may have an incentive from the meter folks as well. However, I have been and remain a patient advocate, and I think you should be able to pick your own meter. Reasonable people may disagree with me.

CMB
Additional comments from Jane Seley, diabetes nurse specialist:

I stopped recommending these meters when technology brought us sensor technology (The older meters use the older method of light reflectance.) and a much smaller drop of blood. Another issue with these meters is that they are calibrated (or adjusted ) to measure in whole blood instead of plasma (like the laboratory and most other meters today), and therefore reads much lower than the meters that match the lab.

If I were recommending a meter for your child today, I would want a very small drop of blood (1 microliter or less), good data management software to print out reports, portability (meter should be lightweight and easy to carry), no cleaning (sensor meters don’t require cleaning) and alternative site testing capability (approved for use in forearm, etc., by FDA). If I were caring for your child, I would recommend the Therasense FreeStyle or One Touch� Ultra because of the small sample size and all the others things I mentioned. Either your child’s pediatric endocrinologist supports your decision or not, but your child’s comfort must come first. A 10 microliter drop is no longer acceptable when there are so many other choices!

JS