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The Impact of Human Error on Meter Accuracy

The Impact of Human Error on Meter Accuracy

Many individuals with type 2 diabetes monitor their day-to-day diabetes control with the help of a blood glucose meter. Blood glucose monitoring is typically recommended for those who have insulin treated diabetes. However, blood glucose monitoring may also be recommended for those managing their diabetes with oral medications and/or lifestyle changes (i.e. diet and exercise). As stated by the American Association of Diabetes Educators, “Self- monitoring of blood glucose (SMBG) provides feedback on the effectiveness of the treatment plan…”1

A diabetes educator can play an important role in helping with meter selection as well as teaching proper blood glucose monitoring technique. According to a recent article from the Journal of Diabetes Science and Technology, “Inappropriate handing of SMBG (i.e. human error) has been identified as the most common factor affecting BG (blood glucose) results; more than 90% of overall inaccuracies result from incorrect use of BG meters.”2

Over-the-counter blood glucose meters are regulated by the Food and Drug Administration (FDA) and are required to meet strict accuracy criteria. The most recent accuracy standards (as of 2013) are as follows:

  • “95% of all measured blood glucose meter values must be within 15% of the true value (a lab measurement)
  • 99% of meter values must be within 20% of the true value.”3

However, there is a greater risk of both improper storage and handling of blood glucose meters and test strips when used for personal use in comparison to use in a professional setting thus potentially having a negative impact on the above stated accuracy standards.

Human error responsible for inaccurate blood glucose results

The following is a list of “Human Errors” that can result in inaccurate blood glucose results:

  • Contaminated blood sample due to not cleaning hands properly
    • Wash hands with soap and water before checking blood glucose
    • If no soap or water is available, use alcohol or hand sanitizer
    • Make sure hands are completely dry before testing
    • If none of above are available, use the second drop of blood, which is less likely to be contaminated than the first drop. Apply the second drop of blood to test strip after first drop of blood has been wiped away.4,5
  • Not applying enough blood to test strip
    • Many meters now use test strips that have “second chance sampling” that allow the user to apply additional blood (usually within 60 seconds of the initial sample).
  • Using expired test strips
    • Expiration date can be found on test strip container
  • Improper storage of test strips
    • Keep test strips in container until ready to use and avoid exposure to temperature extremes and moisture.
  • Applying blood to test strip before test strip is placed into meter
  • Using test strips that are not compatible with the meter you are using
    • Compatible test strips are usually found on the meter box, user guide, and/or meter website
  • Squeezing your finger to get a sufficient blood drop may result in unreliable blood glucose readings.4,5
    • To help ensure an adequate blood drop wash hands with warm water or hang you hand at your side for a few seconds (before finger poke). Both options can help improve blood flow to finger tips.
  • Using a blood sample from an alternate test site not been approved by the manufacturer of the meter.
  • Misreading meter results
    • Choose meter with a large color screen and large text (this may only be necessary for those who are visually impaired)
  • Improper storage and/or handling of meter
    • Avoid exposing meter to temperature extremes
    • Some meters may also be impacted by changing altitudes
  • Using an old meter
    • The average life of a meter is 3 to 5 years

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Type2Diabetes.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. American Association of Diabetes Educators. Diabetes Educator Guide to Blood Glucose Meter Selection and Monitoring for Accuracy and Safety 2017. https://www.diabeteseducator.org/docs/default-source/practice/practice-documents/practice-papers/diabetes-educator-guide-to-blood-glucose-meter-selection-and-monitoring-for-accuracy-and-safety.pdf?sfvrsn=0. Accessed June 19, 2017.
  2. Erbach M, Freckmann G, Hinzmann F, et al. Interferences and Limitations in Blood Glucose Self-Testing: An Overview of the Current Knowledge. Journal of Diabetes Science and Technology. 2016, 10(5): 1161–1168.
  3. FDA Publishes Final Recommendations on Blood Glucose Meter Accuracy 2016. https://diatribe.org/fda-publishes-final-recommendations-blood-glucose-meter-accuracy. Accessed June 19, 2017.
  4. Diabetes Forecast. 10 Ways to Master you Blood Glucose Meter 2012. http://www.diabetesforecast.org/2012/apr/10-ways-to-master-your-blood-glucose-meter.html?referrer=https://www.google.com/. Accessed June 19, 2017.
  5. Hortensius J, Slingerland R, Kleefstra N, et al. Self-Monitoring of Blood Glucose: The Use of the First or the Second Drop of Blood. Diabetes Care. 2011; 34: 556-560.

Comments

  • Shelley, TheLongPointGirl moderator
    2 years ago

    Great article. I have been caught many times with testing, for example, after preparing strawberries…whoa! No wonder the value was through the roof. Wash and do again. Ah, normal range (for me).

    I would add three things.

    One company in Canada told me my meter never expires. Sounded odd when I heard that because I, like you, understood they expire. Might be worth another call to company if people are unsure. I’ll replace in 3-5 yrs.

    Secondly, here in Ontario, our labs recommend bringing in my meter once a year at the same time I’m getting my blood work done so it can be compared to be sure it’s staying within that 15-20% range. Just within minutes before they take my blood, they have me test. They write my value on the lab slip then they take my blood. When the value comes back, then it verifies that the meter is staying in range. Easy peasy.

    Third, it doesn’t hurt to check your meter periodically with control solution especially if you’re a little like me and drop it. (I’m a tad on the clumsy side). I’m sure these meter companies are the same world wide, they will send it for free if you call customer service. At least it’s worth the ask!

  • Margot moderator
    2 years ago

    Hi thelongpointgirl,

    Thank you so much for sharing these tips!!

    Best,
    Margot, Type2Diabetes.com Team

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