Diabetes Self-Management Blog

I feel the urge to write about meters. It all began last week when I got a phone call and — for a little while — thought I’d found you a deal.

The offer? A free meter and free strips. The company just wants people to be able to manage their diabetes, the caller said. Poor guy didn’t know who he’d called: A former newspaper reporter who has a tendency to ask a lot of questions.

No, there was no cost, he said. The meter and strips were paid for by the company. Media rep and phone number? Why, it was he, he said, giving me a name and phone number. (He was calling from Florida: The phone number he gave me had a West Virginia area code.)

Finally, I decided I would bite and gave him the information he needed to send me a free meter and strips. Then came the “catch.”

“What’s your Medicare ID number?” he asked.

“I’m not on Medicare.”

“It’s usually your social security number,” he responded. “Do you know that offhand?

“Yes,” I replied, “but I’m not going to give it to you.

End of “free” meter and strips offer.

I reported him to my state’s attorney general’s office.

What would we do without our meters? My Type 2 diagnosis came after meters were beginning to become common, so I have no history of managing my blood glucose without one. Wait a minute: Yes, I do. The doctor who diagnosed me did not tell me to check my glucose. It was nine years before I got to a doctor who told me to check. At that point, my HbA1c was 17.4%. I’d hardly call that managing my blood glucose.

I was supposed to follow a “diabetic diet” to keep my glucose in range. Like that lasted more than about two weeks. I like it better today, when I can count carbohydrates and adjust my insulin dose based on what I eat and what my beginning number is.

But I digress. Let’s talk about accuracy. After all, if we don’t have a somewhat accurate number displayed on our meters, we could make a serious error — such as correcting for a high that doesn’t exist.

Several things can affect the accuracy of that number on your meter. Food on your hands probably is the first thing that comes to mind.

At the American Association of Diabetes Educators meeting in Washington, D.C., in August 2008, a certified diabetes educator (CDE) who does not have diabetes checked her blood glucose with nice, clean hands and registered 80 mg/dl after washing her hands with soap and water.

With lotion on her hands it was 87 mg/dl. With milk and with raspberries, 92 mg/dl; peanut butter got her a 94 mg/dl; red peppers, 117; sweet wine, 122; grapes, 447 (which went down to 132 mg/dl after wiping — but not washing — her hands).

Make sure you wash with soap and water, too, and not that hand gel stuff: One of her clients was getting higher readings during the week than on weekends. The difference? He used hand gel at work and soap and water at home on weekends.

Where you store your test strips can make a difference, too. Somewhere in my notes of interesting things I run across and store in my computer or write down (on everything from real paper to napkins and chewing gum wrappers) is the following from a few years ago that comes from a meeting of the American Diabetes Association:

In a study using Accu-Chek strips, researchers found that strips stored in a plastic bag or some other container instead of the vial they come in registered 122 mg/dl when a new strip was used. After one day of exposure it was 125 mg/dl. Fast forward to seven days, when a strip from the exposed batch showed 228 mg/dl. After 14 days, that number increased to 321 mg/dl.

That said, you might not want to store your strips in a baggie. The vials they come in are pretty airtight. They’d probably be good to keep matches in for camping.

And, finally, something you might not even know about can affect your numbers: Your hematocrit, or HCT.

So, you ask, what’s a hematocrit, how do I find out what mine is, and what’s the big deal, anyway?

Your hematocrit is the percentage of your blood that’s comprised of red blood cells. Each meter has a hematocrit range and, if your HCT is out of range for your meter, it could affect the results. Anemia and dehydration are two things that can affect HCT. Another is chronic obstructive lung disease (COPD). Too much squeezing can, too.

How can you tell what your HCT is? Ask your doctor. Chances are your physician has ordered a complete blood count, or CBC, at some point. Your hematocrit is a part of the CBC.

And how do you find out what your meter’s HCT range is? Look through the literature that comes with the meter, do an Internet search for [meter name] and “hematocrit,” or call the meter company. The number is usually on the back of the meter.

LifeScan says hematocrit levels of less than 30% may cause falsely high readings, and hematocrit levels of more than 55% can result in false lows.

While I was at the AADE meeting in Washington, D.C., in August, one meter company representative was anxious to tell me that the WaveSense Presto compensated for differences in hematocrit levels, even if they were out of range. (He brought it up, not me.)

Oh — one more thing. In case you didn’t know (I didn’t for a long time), your insurance will kick in for meters and strips. Just ask your health-care professional to write a prescription for them. Yes, I know they’re not prescription items, but you won’t get reimbursement if you don’t have a prescription.

While there’s no such thing as a free lunch (or meter — even with the free ones, you’ll pay for it in the cost of strips), you can get one by watching for coupons, asking your CDE, or even calling a meter company and begging. Whatever you do, however, don’t give out your social security number to strangers.

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Comments
  1. When I was first diagnosed with Type 2 diabetes in November 2005, I immediately ran out and bought a glucose meter and strips. I got the meter almost free with a discount coupon but paid $99.00 for 100 strips. After buying the second box of 100 strips, I said there must be a better way and spoke with my pharmacist. He told me my medical insurance would pay for the strips with a prescription from my doctor. Since then I have my doctor prescribe the strips just like a medication. The only caveat I have to offer is that in my case, the prescription must be written specifically for the strips used by my brand of meter, not just a generic strip.
    Larry
    El Paso, Texas

    Posted by lscroggs |
  2. When I was diagnosed in 1995 my family doctor sent me to diabetic education class almost immediately. One of the things they told us was to be sure to get our doctors to write prescriptions for those test strips. Depending on your insurance coverage that could be a difference of $75 per month or box. My strips are not generic and so my co-pay for them is $25 per box. Compared to the first box I bought at $100 a box I was more than happy to pay the $25. Now anytime I meet someone who is diabetic. Whether they are newly diagnosed or an old survivor I try to remember to ask them if they are getting prescriptions for those most important items. I have had many friends and family thank me for this information. It really helps. You can get a meter for free or for less than $20 because the companies know they will make up their money on test strips. I am happy to say that I have only paid full price for 1 box. I don’t know about the cost with Social Security but it would be well worth it to check it out.

    Posted by Cathy |
  3. Most of the companies that say they have a free meter and test strips are usually trying to pass of older type meters and strips and after a certain time you would probably have to get a new meter because those strips have been discontinued. I think most insurance will pay for strips with the RX and if you need 200 strips they will adjust their guidelines and you can get the amount of strips your doctor says you need. You would just pay copays like for your other RX items. I’am not on medicare so do not know if it will pay as good as regular group insurance.

    Posted by Mrs Jim Bly |
  4. I’ve never paid for meter or strips. My 1st meter was given to me in the Drs office, along with a few strips in the starter kit, and a prescription for strips. I registered the meter with the company (Bayer) and they have sent me offers for new meters twice since then. All I’ve had to do is accept the offer, and they send me a new meter. They also provide free log books and control solution on request. I would guess most other companies do the same, but I’ve been really happy with my Bayer meters.

    Posted by Ephrenia |
  5. Medicare will pay for test strips in the quantity prescribed by your doctor.

    Every three months I ask for a 150 strip prescription as the original prescription is for 100.

    This allows me to to have extra test strips for use when ill, traveling or having trouble keeping levels as desired.

    Medicare will only allow you the 100 stripes per month and if you need more you will have to pay yourself.

    This is not a way to beat the system but a method to use to control your blood glucose levels and not end up with unused strips if you received 150 per month.

    Posted by Ben |
  6. You’ve touched upon a lot of sensitive issues in this post, Jan.

    First, there was the issue of “social engineering”, in which the “sales rep” was trying to steal your identity. Sadly, the population most needing the free testing equipment — senior citizens — is also often the population least able to resist being scammed.

    Then there was the issue of testing. My doctor never told me to test; however, my Other Half had been told he had “borderline diabetes” several years previously, and his insurance carrier provided him with a meter, strips, and testing regimen even though his doctor did not… so I’ve been testing since diagnosis. My mother — who was diagnosed about a decade before me — still has not been told to test. She says she’s the only one of her peers (senior citizen, reduced income, etc.) who has not been instructed to test and she’s not going to start unless/until her doctor tells her to. Frankly, even with Medicaid/Medicare the co-pay for strips (at maximum coverage for 1 test/day as she is not on insulin) would be more expensive for her than buying name-brand strips outright — and even purchasing the cheapest store brand, she would have to balance that against having *some* food in the house.

    Regarding contaminants and testing: I’d suspected this sort of behavior for some time and finally got to do some testing over the summer. Not only does handling your food change your reading, but even the meters whose manufacturers say they can tell the difference… can’t. To top that off, I find that if my fingers are cold, they will often run 10-20 points lower than my forearms.

    Regarding strip containers: I’m not as certain about air-tightness as I am about dampness: the old Accu-Chek Active containers had a granular dessicant in its pop-off top. (BTW, the Active is no longer listed on Accu-Chek’s site, but it and its strips are still available for purchase through pharmacies.) I believe the current generation of strip vials has the dessicant in the vial liner.

    AND… back to free meters and insurance coverage… a number of meter manufacturers offer free meters, but only if you switch your prescription over to them. These are the newer meters with more expensive strips, and if you don’t like the new meter or can’t use it (some of those “arthritis-friendly” are difficult for those *without* arthritis to operate!), you’re stuck. Once again, the elderly get shafted.

    <cue the “BOHICA” song from NJ1015.com>

    Posted by tmana |
  7. is there any way to get free control solution? my insurance will not pay for it. and cvs wants 12.00+ for it with a rx. you would think that if your insurance is willing to fork out the money for the strips, they would want to make sure that your meter was working properly and the results were accurate.

    Posted by srtasa |
  8. srtsa, I have gotten control solution (free) from my meter company. There should be a toll-free number on the back of your meter. It’s been awhile, so it may have been that they asked me during a phone call on another matter if I had cheked the meter with control solution and admitted I didn’t have the solution. I don’t recall the circumstances, but it doesn’t cost anything to ask.

    Jan

    Posted by Jan Chait |
  9. Does anyone know if the generic glucose monitors like walgreens, kroger,walmart compare favorably to the more expensive one touch, accucheck etc?

    Posted by Ginny Scaglione |
  10. Ginny, as I recall, the stores do not make their own meters: The meters are made by a “regular” meter company, but carry the store’s brand. It’s akin to Wal-Mart’s ReliOn insulin — which is really made by Novo Nordisk.

    That said, all meters have to meet the same standards when it comes to accuracy. Usually, the difference between store brand and name brand meters is that the store brands don’t have all the “bells and whistles” of the name brands.

    Using the ReliOn/Novo Nordisk analogy again, ReliOn only offers Regular, NPH, and 70/30 insulin, whereas the name brand Novo Nordisk includes the newer insulins, such as NovoLog and Levemir.

    The Diabetes Mall has a list of meters and their features at http://tinyurl.com/29hjb2a, but it does not rate them.

    Jan Chait

    Posted by Jan |

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