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We assayed 100 capillary whole blood specimens from 50 adults on the Precision QID blood glucose testing system (MediSense, Waltham, Mass) and in duplicate on a whole blood reference method. We centrifuged aliquots of each specimen and analyzed the resulting plasma in the clinical laboratory. The Precision QID achieved maximum total error of 15.5% at a glucose concentration of 42 mg/dL, 12.3% at 83 mg/dL, and 6.4% at 280 mg/dL. The amount of error demonstrated satisfies the performance requirement established by the 1986 Conference on Self-Monitoring of Blood Gluco

Well-designed evaluations of blood glucose meters are fundamental to determining the acceptability of meters. Unfortunately, no standard guide exists to evaluate these meters. In this article we outline the meter evaluation process from establishing objectives to generating final recommendations with results that are statistically significant. Proper planning and execution of an evaluation can mitigate or even eliminate problems associated with glycolysis, hematocrit, and blood collection, and thus permit valid inter study comparison.

PURPOSEthis study was conducted to evaluate patients' proficiency in self-monitoring of blood glucose (SMBG).METHODSDiabetes nurse educators in 4 suburban Minneapolis clinic sites surveyed the SMBG training/cure practices of 280 patients with type 1 and type 2 diabetes. Participant SMBG technique was measured by direct observation. Participants performed a finger puncture and used their own meters to measure the first blood sample. A second sample was measured on the HemoCue B Glucose analyzer, and a third sample was used to measure hemoglobin. The series of tests were then repeated. If either of the 2 glucose tests was more than 15% from the HemoCue value, participants were reeducated about the manufacturer's suggested procedure.RESULTSOf the 280 participants, 19% had blood glucose test results greater than the 15% limit for meter accuracy. After reeducation, 69% of those who had initially failed achieved acceptable results. The most significant problems were lack of periodic meter technique evaluation, difficulty using wipe meters, incorrect use of control solutions, lack of hand washing even when observed, and unclean meters.CONCLUSIONSAs a result of the study, guidelines were subsequently developed to evaluate meter accuracy in an outpatient setting. Further effort is needed to establish standards for evaluating SMBG.