The Journal of the American Board of Family Practice, Vol 15, Issue 1 1-6, Copyright © 2002 by American Board of Family Practice

ARTICLES

Assuring the accuracy of home glucose monitoring

W. A. Alto, D. Meyer, J. Schneid, P. Bryson and J. Kindig
Maine-Dartmouth Family Practice Residency, Fairfield 04937, USA.

BACKGROUND: An estimated 2.5 million diabetic patients in the United States practice self-monitoring of blood glucose (SMBG). The validity of the glucose values they obtain is in doubt. An American Diabetes Association consensus panel reported that up to 50% of SMBG determinations might vary more than 20% from their true value. Accurate glucose values are an integral part of intensive treatment and reduction of long-term complications. The objective of this study was to determine the technical skill and accuracy of SMBG in an outpatient population. METHODS: This study was conducted in two family practice residency sites where 111 patients with type 1 and type 2 adult diabetes were observed testing their blood glucose values on their own glucose monitors. Patient-measured glucose levels were immediately compared with a laboratory value obtained from a calibrated hand-held glucose monitor. RESULTS: Fifty-three percent of patient glucose values were within 10% of the control value, 84% were within 20% of the control value, and 16% varied 20% or more from the control value. Two patients had dangerously inaccurate glucose determinations. Four glucose monitors required replacement. The patients were observed using a 13-point checklist of critical steps in calibration and operation of their glucose monitor. Only 1 patient made no errors in testing. CONCLUSIONS: Despite multiple technical errors when using SMBG, most patients obtained clinically useful values. This project can be easily introduced into a medical office.

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