Meters designed to hold multiple test strips eliminate the need for the user to handle individual strips. Some meters use a 10-strip “wheel” cartridge, and one has a 17-strip “drum” cartridge. The cartridge is inserted into the meter according to the manufacturer’s directions and replaced when all the test strips have been used. When it is time to monitor, an individual strip slides out to accept the blood sample; when the test is done, the strip is ejected from the meter. Also available is a disposable meter that comes preloaded with 100 test strips. After the 100th test, the entire meter is simply discarded and replaced.
Like test strips, your meter — whether it is preloaded or uses individual strips — should always be kept away from extremes of temperature. For instance, do not leave your meter in your car, which can become very hot or very cold.
Lancets are considered “used” after one use. Manufacturing companies recommend using a lancet once and then discarding it to prevent infections as well as dulling of the tip once used.
Fingertips have traditionally been used for obtaining blood samples for monitoring, but some meters work with blood samples from other sites, including the fleshy parts of the hand, arm, thigh, or calf. The meters that work with alternative sampling sites are approved by the US Food and Drug Administration (FDA) specifically for this use. Before you buy one of these meters, find out which alternative sites you can use with it, since not all meters are approved for the same sites, and some sites may not be right for you. These meters can usually be used with the fingertips in addition to the alternative sites.
Discuss with your diabetes care team whether alternative-site testing is right for you. If it is, be sure you are instructed in the proper use of your meter with the sites you are planning to use, because the procedure and equipment may be different from what you are used to. For example, when obtaining a blood sample from the arm, you may need to set the lancing device for a deeper puncture to obtain a large enough blood sample. You may also need to rub the area to be lanced or apply heat to increase blood flow before lancing.
It is generally best to use the fingertips when rapid changes in blood glucose level may be occurring. Because blood flow to the finger or palm at the base of the thumb is 3–5 times faster than to the arms and legs, samples from the fingers or palm may show changes in blood glucose level sooner than samples from other areas. For this reason, using blood samples from alternative sites is often recommended only for checks performed either just before or two hours or more after meals, insulin doses, or exercise. If you think that you may be experiencing low blood glucose, or if you have a history of hypoglycemia unawareness (lack of symptoms of hypoglycemia even when blood glucose levels are low), it is best to use your fingers for monitoring.
Record keeping is a vital part of the blood glucose monitoring process. Records can help you identify patterns in your blood glucose levels. For example, knowing that your fasting (prebreakfast) blood glucose level is high, but that your prelunch and presupper values are within the recommended range allows you and your diabetes care team to make changes that target the out-of-range values without upsetting the values that are meeting your goals. Or if your premeal blood glucose values are reasonable but your postmeal values are outside of target range, reviewing carbohydrate intake and/or evaluating need for, or changes in, drug or insulin therapy to target postmeal blood glucose levels may be in order.