Blood glucose monitoring at home (adults)

DIABETES – BLOOD GLUCOSE MONITORING AT HOME (ADULTS)
Clinical Guideline
Type 2 Diabetes
Self-monitoring of blood glucose should be offered to all newly diagnosed type 2 diabetic patients as an integral part of self-management education. Discuss purpose
and agree how it should be interpreted and acted upon. Frequent testing is not required in stable well-controlled individuals. Assess the following at least annually:
Self monitoring skills
Quality and appropriate frequency of testing
Use made of the results obtained
Impact on quality of life
Continued benefit
Equipment used
To determine an appropriate frequency of testing, the following criteria should be followed for patients with type 2 diabetes:
1 All newly diagnosed patients should initially monitor frequently in order to provide them with information in relation to their activities and the effect of dietary
measures and treatment prescribed.
2 For patients who are stable, monitoring should be done between once and twice monthly (fasting, pre-breakfast).
3 Patients taking sulfonylureas should monitor at least twice weekly (fasting, pre-breakfast). This applies particularly to patients on longer acting agents.
4 Patients who experience the following should monitor their blood glucose levels more frequently:
(a) Inter-current illnesses
*Glycosylated haemoglobin may be unreliable in
(b) Change in oral hypoglycaemic treatment
the following situations:
(c) Co-prescription of systemic steroids
(i) Patients with anaemia;
(d) Exercise
(ii) Patients with polycythaemia;
(e) Carbohydrate counting
(iii) Patients with haemoglobinopathies;
(f) If there are difficulties in venesection or if glycosylated haemoglobin is unreliable*.
(iv) Patients in whom venesection is not possible
Type 1 Diabetes (and type 2 diabetes using insulin therapy)
For patients who are stable, blood glucose should be tested four times a day (pre-meals and pre-bed) on two days per week.
Patients may need to adapt the frequency of their blood glucose testing due to numerous factors. These include:
1. Inter-current illnesses
2. Carbohydrate counting
3. Pregnancy
4. Before driving
5. Exercise
6. Poor control (plus other advice as per point 4 under Type 2 Diabetes section)
Access to testing strips MUST NOT be restricted for patients using insulin or for paediatric patients (excluded from this guideline).
Class 2 driving licence (Lorries & Buses) advice for patients with diabetes – new recommendations
Since November 2011, patients with insulin treated diabetes can apply for a class 2 driving licence. These applicants must meet standards specified by the DVLA
including evidence of adequate control of diabetes by regular blood glucose monitoring (at least twice daily and at times relevant to driving). For these patients only, a
blood glucose meter with a memory function to measure and record blood glucose levels for at least three months prior to submitting their application must be used.
Diabetes – blood glucose monitoring at home (adults) – clinical guideline, v1 Principal author: Prof D Bowen-Jones & Dr KS Leong (WUTH), Mrs V Vincent (NHS Wirral)
Approved by Medicines Clinical Guidance Subcommittee Jan 2013 Review by: Jan 2016

Best for … Type 2 diabetics Type 2 diabetics /
visually impaired
Meter Name
GlucoRx
Nexus
GlucoRx
Nexus Mini
Patients using insulin /
frequent testers
Supercheck 2 Aviva Aviva
Nano
Frequent testers /
those requiring large
memory
Patients using
insulin / frequent
testers
Patients requiring
ketone testing
BGstar Contour XT FreeStyle Optium
Testing Strips
(price correct as of
November 2012)
Shelf life once
opened
Special
features
GlucoRx Nexus
£9.95 / 50
3 months (but comes as 2 x
25 strips)
Ketone
warning
Small,
portable
device
SuperCheck 2
£8.49/50
Accu-chek Aviva
£15.41/50
3 months Until printed expiry date
even if pot opened
Talking meter as
recommended by
RNIB (this function
can be turned off)
Battery
backup
Small,
portable
device
BG Star test strips
£14.73/50
Contour Next
£14.85 / 50
3 months Until printed expiry
date even if pot
opened
Sister meter iBGStar
(using same strips)
can be attached to
iPhone and iPad (must
be purchased)
No coding, quality
control testing
sensitive
Memory 1000 1000 500 500 500 1865 480 450
Compatible
Lancets and
Lancing Device
Company /
Customer Care
Line
Quality Control
solution shelf
life once open
GlucoRx Lancing Device and
Lancets
Dime
01483 755 133
Supercheck 2
Lancing Device and
Lancets
Apollo Medical
Technologies
01636 831 201
Accu-chek FastClix Finger
Pricker and FastClix Lancet
Drum
Roche Diagnostics
0800 701 000
BGstar Lancing Device
and Lancets
Sanofi Aventis
0800 0352525
Microlet 2 Device and
Microlet Lancets
Bayer Diagnostics
0845 600 6030
FreeStyle Optium
£15.33/50 /
FreeStyle Optium
β Ketone
£20.63/10
Until printed expiry
date as individually
wrapped
Blood glucose
testing with the
added function of
ketone testing
Easy Touch
Lancing Device and
Lancets
Abbott Diabetes
Care
0500 467 466
3 months 3 months 3 months 90 days 6 months 90 days
Consumables (e.g. batteries, Quality Control solution, USB cables etc.) are available free of charge from the Company Customer Care lines. Software download is
available for all the meters listed. When changing a patient’s meter please help reduce waste where possible by ensuring test strips for the previous meter are used
before ordering the new strips.
Diabetes – blood glucose monitoring at home (adults) – clinical guideline, v1 Principal author: Prof D Bowen-Jones & Dr KS Leong (WUTH), Mrs V Vincent (NHS Wirral)
Approved by Medicines Clinical Guidance Subcommittee Jan 2013 Review by: Jan 2016

For Bolus Advisor Systems, Insulin Calculators and/or Carbohydrate Counting
Either the Accu-chek Aviva Expert (Aviva test strips) or the FreeStyle InsuLinx (FreeStyle Lite test strips) may be used.
Diabetes – blood glucose monitoring at home (adults) – clinical guideline, v1 Principal author: Prof D Bowen-Jones & Dr KS Leong (WUTH), Mrs V Vincent (NHS Wirral)
Approved by Medicines Clinical Guidance Subcommittee Jan 2013 Review by: Jan 2016