My favourite BG meters

There are many blood glucose (BG) meters available in the Australian market, but this isn’t a review of all of them. If you want to see the range of meters and strips subsidised in the Australian market at the moment, have a look at the “Testing Strips order form” over at the NDSS Product and Supply website. There are some meters not on the list but use the same strips. By my count there are currently 30 different strips, and over 50 models of meter. As mentioned in an earlier article, the list of NDSS-subsidised strips is currently under review.

The strips for all of these meters are subsidised to the same cost, so decisions about which meter to use aren’t affected by strip cost. The meter cost, and meter and strip features (and sometimes availability) should be the deciding factors.

Because I’m repeatedly asked about the meters I use, here’s my summary.

Please note that these are just my own personal observations and opinions based on my experiences. I have no interest in any of these meter suppliers, and none of the meter companies have influenced my opinions or statements.

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Favourites

These are the meters I use all the time. They have been my primary meters for almost a year now.

Accu-Chek Guide

Features:

• Back-lit display. Test strip port lights up for night-time testing.
• Consistent results (see Do you trust your meter?).
• Compact and spill-proof test strip container.
• Eject button (on the side) neatly pushes out the used strip.
• Bluetooth to upload to Accu-Chek Connect, MySugr, or xDrip+ (see Connected BG meters).

The Guide uses two CR2032 batteries. I use old Guide test strip containers to store used strips from all my meters (they don’t take up much room).

Contour Next One

Features:

• Back-lit display.
• Double-tap the button before inserting the strip to light up the port at night.
• Consistent results (see Do you trust your meter?).
• Certified for use up to 6301m altitude. Good even for the Himalayas!
• Bluetooth to upload to Contour Diabetes or xDrip+ (see Connected BG meters).

Unfortunately because the Next One meter isn’t supplied in Australia yet, neither is the Contour Diabetes phone app. Without the app we can’t set low/high thresholds (so the light goes yellow or red instead of green after a test) but the default thresholds of 3.9 and 10 mmol/l are fine for me.

It’s such a nice meter that I have wished for a long time that it would come to Australia. I have two of these meters: one from Germany and one from the US. Its shape allows it to slip neatly into my diabetes kit pouch. I use the meter either standalone, or linked via Bluetooth into xDrip+ where it can calibrate my CGM. The meter uses two CR2032 batteries.

EDIT: This meter is now supplied in Australia and so is the partner app.

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Almost-favourites

I’ve used these meters, and have some around the house with strips which are gradually getting used up. But I generally prefer the meters above.

Accu-Chek Mobile

This meter is very convenient (it made regular testing possible for me back before I set up a CGM). The integrated Fast-Clix lancer and internal 50-test cartridge just make everything simple.

The results from this meter are quite consistent (discussed in Do you trust your meter?) although poor technique can skew the results.

Night-time testing does need an external light to see the test area to put the blood on it. The meter uses two AAA batteries.

Accu-Chek Performa, Performa Combo

The Performa strips are quite consistent (see Do you trust your meter?).

The Performa Combo meter is integrated with the Accu-Chek Spirit Combo insulin pump, acting as the remote controller. Mind you, if you use the Spirit Combo in a DIY closed-loop setup, the Performa Combo is left over (it can still be a standalone BG meter). With its size and weight (it uses 3x AAA batteries) it’s not likely to be a meter many people would choose when looking for a meter, unless they wanted it as the remote for the Combo pump.

The basic Performa meter doesn’t have a backlit display, but it only needs a single CR2032 battery. I wrote about it recently.

Contour Next

This little meter uses the same strips as the Contour Next One. It doesn’t have the light for night-time testing, or the fancy Bluetooth link, but is cheap and works well. It uses two CR2032 batteries.

The Contour Next Link meters supplied with recent Medtronic pumps use the same strips, have the same night-light function as the Contour Next One, but don’t have Bluetooth to link with your phone. They have an internal battery which is recharged via USB. I don’t have one of those pumps, and didn’t feel like spending AU$150 for a meter which might be why I opted for the Next One from overseas.

Not my favourites

I have some of the below meters and have used them a lot in the past, but for various reasons prefer not to now.

I’ve used some Accu-Chek Aviva meters in the past (particularly the Aviva Connect) and although the accuracy seems good, it hasn’t tested quite as well as the Contour Next for example. In terms of other features the Accu-Chek Guide is a refined version of the Aviva Connect, so I passed my Aviva meters on to relatives. The Aviva Expert meter is physically similar to the Performa Combo, just without the link to the insulin pump. It’s well-regarded as a meter partly because of its comprehensive bolus calculator. Incidentally, in the UK the Combo pump uses the Aviva Combo meter. The Avivas are decent meters, but in the end didn’t suit me.

The Abbott FreeStyle Optium strips are claimed to meet the ISO 15197:2013 standard for accuracy, but in my own testing their results seem to often vary by more than the target 15%. Thus I prefer to not use these for calibrating my CGM (which is mostly what I use BG tests for these days). They also need a lot of blood compared to the above meters, and I like to save my fingertips.

The FreeStyle Optium Neo and FreeStyle Libre Reader do basic BG testing using the Optium strips. They don’t have the fancy port-light or Bluetooth upload features. If you’re on MDI then the Libre Reader has a bolus calculator built in (in fact it’s essentially a next-gen Insulinx meter with a back-lit display).

One feature of the Optium meters is their ability to test for ketones using Optium ß-ketone strips. I haven’t found this important in my own diabetes management: whenever I’ve tested for ketones (for example when sick and with high BG) they’ve not shown up. Interestingly, there is also another meter currently available in Australia for testing ß-ketones: the LifeSmart LS-946. I haven’t used that one yet, but it also supports Bluetooth and I hope to test it soon.

How many meters does one person need?

I would say at least two. At some point your meter will fail you. Either because it’s broken somehow, or because you simply can’t find it. And when you’re hypo, you don’t have time to wander around in a daze and “find it later”. Have a spare!

For a long time I’ve had one in the kit of gear I carry every day, and another on my bedside table so I know where to find it in the middle of the night. And another in a kitchen drawer where everyone in the family knows where to find it in case of emergency.

Different meters have different features, and you may want more than one model. For example the LifeSmart and Optium meters can test for ketones, but they might not be the ones you want to carry around all the time. But having more than one model of meter in the house does introduce a complication: you’ve now got more than one of strips to keep buying.

This almost caught me out once: the kitchen-drawer meter was an Optium Neo, but I had changed my main meters to Accu-Chek Guides and hadn’t bought new Optium strips for a while. Luckily it wasn’t an emergency at the time, but when I pulled the Optium Neo out of the kitchen drawer to have a look I noticed the strips had expired several months before! Now the kitchen-drawer meter in my house is the basic Contour Next model.

Tips for CR2032 batteries

A tip for anyone dealing with meters that use CR2032 button cells (i.e. most of them) especially if the meter uses TWO cells. Be very careful when inserting fresh batteries: don’t let them touch. It is alarmingly easy to accidentally short-circuit the positive and negative terminals.

I have seen some complaints from some users of the Accu-Chek Guide for example, saying that the batteries didn’t last long. One possible explanation of that is batteries which lost a lot of their charge through accidental short-circuits while handling the batteries. My own Guide meters don’t seem to run through batteries too quickly, although Bluetooth transmission does reduce battery life a bit.

When carrying spare CR2032 batteries either keep them separated, or sometimes you can tape a small stack together carefully. I wrote about carrying CR2032 batteries a while back.

Other meters

There are of course many other meters out there at the moment. But I’ve used only a few of them, and my preferred meters are above. When the NDSS re-contracting process completes, we might be looking at a smaller set of test strips and thus meters. I do suspect that the above meters will still be around, but time will tell.
I seem to be saying that a lot lately.