Advice on Safe Glucose Meter Usage
DALLAS - What’s the key to the safe use of the glucose monitor?
“Our culture is so fast paced, the simpler the better,” says Mary W. Frank, RN, CDE (Registered Nurse Certified Diabetes Educator) at the Outpatient Diabetes Program based at Methodist Charlton Medical Center. Frank teaches patients at the Texas hospital’s diabetes education center, training patients on how to monitor and live with the disease.
Millions are affected. The International Diabetes Foundation estimates that some 285 million worldwide have diabetes; the American Diabetes Foundation estimates that in the U.S. there are about 23.6 million with the disease, with only 18 million or so of them diagnosed.
For those who work professionally to educate the public, the main issue, after treatment, is making sure that patients can both afford the equipment and are able to use the equipment safely. For instance, with a 75-year-old patient, Frank is happy to have him find his count through a simple glucose monitor, rather than a more complex monitor that is not used regularly.
“I just want him to test, and write in a log book,” says Frank, who mainly works with Type 2 and gestational patients, as well as the occasional Type 1 patient. “This is what the number is, and done.”
For many patients whose affinity for technology is greater, there are numerous glucose meters that come with software and connection cables in order to download results over time. The new Bayer model Contour USB ditches the cables altogether and plugs right into the USB port of a computer. With the more advanced products, users can then plot their numbers on a graph, which Frank says is the most helpful way to manage the disease.
Diabetes supplies such as blood glucose monitors and insulin pumps are sophisticated devices that require the patient to perform frequent calibration and maintenance, as well as check for recalls. The devices also have many components and supplies such as lancing devices, docking stations, test strips, control solutions, tubing, batteries and an operations guide. The strips are the area where there can be the most problems, says Frank. She reminds us that they are made, transported and sold by “real people. ”
“Strips can be damaged by heat, cold and humidity,” says Frank. The key to success is to understand their limitations; most home meters test within a 10 to 15 percent accuracy rate. “It’s not the lab,” says Frank, “but a whole lot better than not testing.”
To ensure consistent results, most meters have a small bottle of control solution for the strips. A patient should test the meter using the solution, and if the results are not correct, they should shake the solution and test it again. The bad news; in some states, and where test trips are often sold as prescription items, you cannot take them back to where you got them, says Frank. Instead, you need to contact the manufacturer, which will often supply replacements overnight.
One other area of problems with strips is with coding. In some models, the user must tell the meter which batch of strips they will be using. Newer models have eliminated this, but each step puts in the possibility for error.
Patients often assume that calling the company’s 1-800 number will be time consuming, but Frank says she has found that major manufacturers have been very responsive with customer service. “Brand names have people 24/7,” says Frank. “Then they overnight them new strips.” In addition, because the money is made with strips, not meters, manufacturers often send out free meters.
Frequent Recalls, Safety Notices
Recalls are common, with 11 recall notices for meters and infusion pumps in 2010 so far, many from the nation’s best-known makers. While a user may become proficient in the maintenance and use of these devices, they should be aware of any manufacturer notifications of operational changes, maintenance changes, and device recalls due to defect. Recalls generally fall into three areas; below are a few types of recalls that have come out this year:
- Software issues: Johnson & Johnson’s Animas recalled their “ezManager” Max, a type of diabetes management software. It would not load onto Apple Macintosh computers. In addition, Animas’ OneTouch Ping Insulin Infusion Pump had a software malfunction that disallowed users to download, view and print information.
- Possible Inaccurate Results: During testing, Abbott Diabetes Care discovered that there were FreeStyle Lite Blood Glucose Test Strips that could generate low blood glucose readings.
- Design issues: Nipro Medical Corporation recalled their GlucoPro Insulin Syringes because needles could detach from the syringe. If the needle became detached, it could become stuck in the insulin vial, and push back into the syringe, or remain in the skin after injection.
In recent years, tens of dozens of recalls and bulletins that cover several million devices and their supplies have been released by the FDA and manufacturers. RASMAS keeps track of these recalls for hospitals. These recalls and bulletins cover operational warnings, calibration, device defects or potential malfunctions, user manual changes, calibration problems, and device supply defects. The consumer also has a resource, the FDA:
- FDA Recall Page: The FDA’s Recalls, Market Withdrawals, and Safety Alerts page has a searchable box where you can type in the name of your product to find out if it has been recalled.
- The American Diabetes Association has excellent resources on glucose monitors and infusion pumps, including a download of manufacturers, models and features.
Learn About Your Glucose Monitor
The individual websites of manufacturers provide information on safe operation in general, as well as any of the latest safety warnings. Below is a list of some of the top manufacturers in the U.S. market. Note that there are some manufacturers that sell store-branded diabetes equipment to grocery, drug and discount chains.
1. Call the manufacturer with ANY concerns or questions about safety, operation or recalls. They are very responsive.
2. Poke the side of the finger, not the tip, because it is less painful.
3. With all strips, you don’t put the blood on the strip. The strip sucks the blood up like a straw.
4. Wash your hands with warm water before testing.
5. Hold your hands below your heart.
Major monitor manufacturers/brands/models include:
- Abbott Diabetes Care
- AgaMatrix, makers of the WaveSense line
- Arkray, maker of the Glucocard
- Bayer Diabetes Care, makers of the Contour and Breeze
- Bionime, makers of the Rightest
- Diabetic Supply of Suncoast’s Advocate Duo
- Diagnostic Devices, maker of the Prodigy Meter
- Entra Health Systems
- Fifty50 Medical
- GlucoCom’s Codefree
- Infopia USA makes brands that include Eclipse, Envision and GlucoLab
- Lifescan makes the OneTouch
- Nipro Diagnostics
- Nova Biomedical makes the Nova Max
- Roche, maker of Accu-Check
- U.S. Diagnostics, maker of Acura, EasyGluco, Infiniti and Maxima
- Walmart, distributor of the ReliOn
For more information: Methodist Health System has a whole section of resources and information on diabetes on their website. See www.methodisthealthsystem.org
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