An Evaluation of Patient Performance of and Their Satisfaction with Various Rapid Blood Glucose Measurement Systems

We evaluated the performance of 50 insulin-dependent diabetic patients in the measurement of their own capillary blood glucose concentrations using Chemstrip bG, Dextrostix-Dextrometer, and StatTek systems. With all systems, patient performance was suboptimal when compared with the accuracy of paramedical personnel. The percentage of patient determinations that differed from the laboratory value by more than 20% was 37%, 30%, and 14% for the Chemstrip bG, Dextrostix-Dextrometer, and StatTek systems, respectively. Only 39 of the patients (78%) could perform accurately with any system. Youth, lack of a higher education, and lower income status contributed significantly to the patients' inaccuracy with the Chemstrip bG technique, whereas these factors had no effect on patient performance with the reflectance meter techniques. Nearly all of the patients were enthusiastic about the value of home glucose monitoring as a means to assess their glycemic control. However, only 30% of the patients selected for home use a technique at which they were suitably adept. In part, this selection error appeared to be due to the greater cost and inconvenience of the reflectance meter techniques compared with the Chemstrip bG technique. These data indicate that unless proper instruction is provided, home glucose monitoring should only be used by a fraction of insulin-requiring diabetic patients and the choice of a particular system for use by an individual patient should be predicated upon his or her demonstrated proficiency with that system.