Selecting a blood glucose meter is a daunting task for many patients with diabetes, especially those with a new diagnosis. Yet routine self-monitoring of blood glucose levels remains the most effective tool to monitor diabetes. All patients with diabetes must have an easy-to-use and reliable blood glucose meter to detect and prevent episodes of hyperglycemia or hypoglycemia, track blood glucose patterns and daily blood glucose targets, and monitor the glycemic response to certain foods, medications, physical activity, or therapy changes. Results from a plethora of clinical studies have validated the critical nature of maintaining tight glycemic control to effectively manage diabetes as well as avert or lessen the numerous health-related complications associated with poorly controlled diabetes.

A host of self-testing blood glucose meters are available to suit the needs of most patients with diabetes. Thanks to technological advances, products can alternate site testing and provide rapid testing results, have the ability to test without interrupting the patient’s daily routine, are less invasive and painful when testing, and require a smaller sample size.1

Patients and practitioners alike should ensure they understand and follow the proper technique for blood glucose monitoring. Below are recommended steps (table).1,2
  • Prior to testing, gather all necessary supplies. Always check expiration dates on testing strips.
  • Wash hands thoroughly with soap and warm water, and dry hands with a clean towel. If using alcohol-based hand sanitizer instead, wait at least 1 minute to allow hands to dry before testing.
  • Hang hand below heart for 30 to 60 seconds to increase blood flow to fingers.
  • Use a lancet device to obtain a sample on the side of the finger. Try to alternate fingers for each test. Always prick the side of the fingertip, as the side of the finger is less sensitive than the flat side of the fingertip and is less likely to bruise.
  • Place the blood sample on the test strip immediately after obtaining the sample. Because methods vary with each meter, refer to manufacturer instructions for proper technique.
  • If necessary, apply pressure to the finger stick or the alternate site using a clean cotton ball to stop the bleeding.
  • Wait for the results, and keep a record of them to review with the primary health care provider.



CONCLUSION
A blood glucose meter is a vital tool for the monitoring of diabetes, and pharmacists are in a pivotal position to act as patient advocate and educator. Pharmacists should remind patients to follow these steps: 
  • Monitor blood glucose levels throughout the day.
  • Adhere to therapy, and discuss any concerns with the primary care provider.
  • Follow up with the primary health care provider to effectively control diabetes.
  • Maintain tight glycemic control to help avoid or lessen the occurrence of diabetes-related complications such as cardiovascular disease, foot issues, nephropathy, neuropathy, retinopathy, and skin conditions.
  • Select a meter that best suits individual needs and is simple to use, to increase adherence to daily blood glucose checks.
  • Check blood glucose levels as directed by the primary care provider, and be aware of factors that may alter or affect levels, such as certain foods, illness, medications, physical activity, and stress.
  • Seek guidance from the primary health care provider regarding the recommended number of tests per day.
  • Recognize the signs and symptoms associated with hypoglycemia—such as chills, confusion, dizziness, lightheadedness, nausea, and sweating—and hyperglycemia—such as elevated glucose levels, excessive thirst, and frequent urination. Consult the primary care provider for recommendations on managing symptoms.

Yvette C. Terrie, BSPharm, RPh, is a consulting pharmacist and a medical writer in Haymarket, Virginia.

REFERENCES
  1. Ulbrich T and Krinsky D. Self-care components of selected chronic disorders. In: Krinsky D, Berardi R, Ferreri S, et al, eds. Handbook of Nonprescription Drugs. 18th ed. Washington, DC: American Pharmacists Association; 2015.
  2. The big picture: checking your blood glucose. American Diabetes Association website. diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/ checking-your-blood-glucose.html. Accessed August 5, 2019.