Last updated: August 9, 2021

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As a diabetic, you need to watch your blood glucose level every day. This is true not only for type 1 and 2 diabetics, but also for temporary diabetes, such as some pregnant women.

To measure blood glucose levels, a suitable blood glucose meter is essential. However, there are some big differences between the various devices and before you buy a glucose meter, you should thoroughly research the topic.

In our blood glucose meter test 2021, we want to help you do just that. For this purpose, we have summarised the advantages and disadvantages of invasive blood glucose meters, non-invasive blood glucose meters and intelligent blood glucose monitoring systems and added corresponding product recommendations.

You will also find a lot of useful information in this article about the costs of a blood glucose meter, how accurate these devices actually are and which criteria you should pay particular attention to when buying.

Contents




Summary

  • Blood glucose meters are electronic devices that show glucose levels in the blood. People who have diabetes type 1, diabetes type 2, gestational diabetes or prediabetes use BG devices.
  • Depending on the type, there are invasive glucose meters, non-invasive glucose meters and smart glucose meters.
  • You should choose a blood glucose meter based on criteria such as measurement accuracy, ease of use, price and follow-up costs.

The Best Blood Glucose Meter: Our Choices

Guide: Questions you should ask yourself before buying a blood glucose meter

What methods are there for measuring blood glucose?

You can measure your blood glucose level at home with the help of a blood glucose meter.

A glucometer is an electronic device that helps you know the levels of glucose in your blood and what is causing changes in them.

Blutzuckermessgerät auf einem weißen Tisch mit Zuckerdose

Blood glucose meters are real lifesavers because a quick pick and a small drop of blood is all it takes to determine how high the concentration of sugar is in your blood. (Image source: stevepb / pixabay.com)

The most common invasive device sets contain an electronic glucose meter, lancets, a lancing device (i.e. a mechanism that holds the lancets), blood glucose test strips, a cable for data transmission, batteries, and a bag or case for storage.

There are also different methods of blood glucose testing, which we explain in more detail below.

Invasive random blood glucose testing

Invasive blood glucose meters offer high measurement accuracy and allow you to plan the measurement times yourself. They are often cheap to buy and you can take as many measurements as you like, partly independent of location.

Such devices offer freedom especially to diabetics who depend on frequent blood glucose testing. These devices often have a clock and a memory card and can transfer the data to other devices.

However, especially with daily testing, the risk of infection increases and some devices need to be coded. You need additional utensils, which cause additional costs, e.g. for lancets or test strips.

Also, the sensors may fail from time to time, for such (rare) cases one should have a manual meter as a substitute.
Failures can be caused by excessive heat exposure or insufficient maturation of the technology.

Non-invasive blood glucose measurement

With non-invasive BG meters, you don't have to draw blood and you don't need a sensor implant. Non-invasive glucose meters are good for on-the-go use.

They allow data transmission and, if necessary, continuous blood glucose monitoring. However, this technology is still under development. The measurement accuracy is lower than with invasive BG devices, but the purchase costs are higher.

Due to the cost of the test strips, the amount of testing is limited by the financial resources of the users. During other activities, such as sports, it is (usually) not possible to take a measurement.

Continuous blood glucose monitoring/intelligent blood glucose monitoring systems

Continuous or intelligent blood glucose monitoring systems do not require a blood sample to be taken. The blood glucose can be measured continuously and is well suited for on-the-go use.

Data can be transferred directly to other devices. However, you need to have a sensor implanted under your skin to use it, which may need to be replaced at some point.

Some people do not tolerate the sensor implant. The accuracy of the measurement is lower than with invasive BG measurement devices. Smart blood glucose monitoring systems are usually more expensive.

Which blood glucose meters are the most accurate?

Since invasive blood glucose meters measure sugar levels using a blood sample, they are the most accurate.

Invasive blood glucose meters are the most common type of blood glucose meter and have become accepted as an accurate and reliable way to measure blood glucose.

Because the glucose measurement in these blood glucose tests is taken from a blood sample, they are the most accurate.

The most accurate meters currently on the market comply with the DIN ISO 15197:2013 standard. According to this standard, deviations in the measured values of ±15% are permitted.

With the other types of measuring devices, the sugar test is carried out using other substances, such as sweat on the surface of the skin or liquid from the intercellular spaces.

In these substances, the levels of glucose are lower than in blood. This can lead to inaccuracies in the measurement.

What is the latest generation of blood glucose meters?

The latest generation of blood glucose meters are the non-invasive testing devices. These meters work without the need to draw blood or implant a sensor.

The non-invasive blood glucose meters can be based on two types of technologies: optical technologies and transdermal technologies.

Glucose meters based on optical methods measure glucose levels through the skin, based on changes in colour and temperature of the skin appearance.

Transdermal-based glucose meters, on the other hand, measure glucose levels on the surface of the skin based on sweat samples.

These devices often come in the form of a patch on the skin. Non-invasive blood glucose monitoring is a new technology that has not yet caught on as well as the invasive methods.

Which blood glucose meter has the cheapest test strips?

Test strips are designed for disposable use. Therefore, you should also consider the cost of sugar test strips.

Generic test strips are usually cheap, but you may experience difficulties while the meter is reading them. Some BG devices, such as OneTouch, are pre-programmed to read different types of blood glucose test strips.

However, most BG devices can only read one brand of test strip that matches them. Brands like AccuSure, GlucoOne and OneTouch offer relatively inexpensive test strips.

How much does a blood glucose meter cost?

The prices of blood glucose meters vary depending on their brands and integrated features.

Currently, the prices of conventional invasive blood glucose meters range from about €10 to €80. Non-invasive blood glucose meters are much more expensive. A starter set costs about 170 €.

Where can I get a blood glucose meter for free?

In some cases, the cost of a blood glucose meter is covered by your health insurance.
Find out if your health insurance covers the cost of a blood glucose meter and which devices they are.

Basically, the cost of a blood glucose meter depends on the type and duration of the underlying disease.

  • Type I diabetics, as patients with an absolute insulin deficiency whose metabolic condition is influenced by many factors, depend on regular blood glucose measurement
  • Type II diabetics, whose insulin is still available but often limited in effect or insufficient, are entitled to the approval of a blood glucose meter depending on their metabolic situation.
  • Gestational diabetes: An optimally adjusted blood sugar level is absolutely necessary for the healthy development of the baby. Women who develop diabetes during pregnancy, usually towards the end, are provided with the necessary medical aids as part of their pregnancy.

Therefore, if you are a diabetic, enrolment in a DMP programme (disease management programme) makes it easier for your health insurance to cover the costs.

The costs for more expensive non-invasive glucose testing devices are usually not covered by the health insurance funds.

Health insurance companies usually provide a list of blood glucose meters that they will cover. You should also find out whether your health insurance covers the costs of diabetic accessories, such as test strips and lancets.

For everyone else, it is never wrong to check your blood glucose levels every now and then. The earlier diabetes is diagnosed, the better the long-term prognosis!

Decision: What types of blood glucose meters are there and which is the right one for you?

There are currently three technical options for blood glucose measurement, depending on whether you want to perform a physical intervention, i.e. blood sampling:

  • Invasive random blood glucose monitoring
  • Non-invasive blood glucose monitoring
  • Continuous blood glucose monitoring/ Intelligent blood glucose monitoring systems

Depending on your individual lifestyle, your disease symptoms and your needs, one of these types of glucose measurement is more suitable for you. With the following overview, we would like to help you find the right blood glucose meter for you.

We will introduce you to the types of glucose meters available on the market and explain their advantages and disadvantages.

When choosing a meter, you should consider its consistency and accuracy, as well as whether you can afford the meter and its accessories.

What are the features of an invasive blood glucose meter and what are the advantages and disadvantages?

Invasive blood glucose meters are the most common way to measure glucose.

These BG devices perform blood glucose tests based on a blood volume check at a certain time. Users of the device perform the measurement daily or several times a day.

Invasive random blood glucose meters show the concentration of blood glucose at a certain point in time based on chemical analysis of a small amount of blood. This is the most common method of measuring blood glucose.

To draw blood, you need to perform a minor physical procedure - a light prick with a medicinal lancet into a skin site i.e. test site. The most common test site is the fingertips.

You then need to drop the small blood sample onto a test strip. The meter reads the glucose values from the blood glucose test strip. There are also less-invasive blood glucose lancets with micro-needles that are hardly felt when taking the blood sample.

Invasive blood glucose meters are usually accurate and relatively inexpensive. In addition, you have the option of timing your glucose measurement yourself.

The latest invasive glucose meters have a built-in clock and a memory where you can store your test results.

Most users find the need to draw blood and the associated risk of infection to be the biggest inconvenience of this type of glucose measurement.

Alternatively, if you don't want uncomfortable needle sores on your fingertips, you can take blood from other skin sites, i.e. alternative test sites (ATS), such as the upper arm.

If you are unable to collect a sufficient amount of blood for the sugar test, you will need to prick the skin again.

Advantages
  • high measurement accuracy
  • plan measurement times yourself
  • low prices
  • unlimited number of measurements (always and everywhere)
  • measurement also possible in active situations, e.g. during sport, walking, standing or driving
  • freedom for diabetics who depend on frequent blood glucose measurement
  • watch and memory card
  • if necessary. Data transmission
Disadvantages
  • daily performance
  • risk of infection
  • coding of meter if necessary
  • usually not very suitable for travelling
  • additional utensils
  • additional costs for accessories
  • sometimes sensor failures, a manual BG meter should be available for safety
  • ! Failures are the exception rather than the rule, but can be caused by: excessive exposure to heat, e.g. sauna, direct UV radiation in summer, lack of maturity of the technology, but the manufacturers are constantly working on this

You also need to take care of your meter by maintaining its hygiene, changing the lancets and keeping the test strips clean.

While an invasive blood glucose meter itself is relatively inexpensive, the accessories, such as the test strips, can be costly.

There are different brands of test strips and each has its own code for measuring blood glucose levels. You often have to adjust the glucose meter manually or with the help of a chip according to this code.

If you do not code the glucose meter correctly, it will not give you an accurate blood reading. However, modern BG meters have automatic coding of the test strips as a built-in function.

The invasive blood glucose meters can be further classified into two different types:

  • Single strip blood glucose monitoring systems and
  • Integrated blood glucose monitoring systems

Single strip blood glucose monitoring systems read glucose values using blood glucose test strips. The user must insert the test strips individually into the slot of the BG device and store them separately from the device in a container.

Since the individual utensils for blood glucose measurement, such as the lancing device and test strips, are separate from the meter, single-strip blood glucose meters are smaller and lighter.

Thanks to the simple mechanism, single-strip blood glucose meters are also easy to use. However, some users find the handling of blood glucose test strips cumbersome.

Inserting each individual test strip into the device's insertion slot, as well as disposing of individual blood glucose test strips and lancets after they have been used, involves extra effort. Sometimes the individual test strips can also become contaminated, leading to inaccurate measurement results.

Integrated blood glucose monitoring systems, on the other hand, have strip-free technology. Individual test sites are built into a cassette drum within the BG device.

The lancets are also integrated into a drum mechanism within the lancing device. The lancing device is also built into the meter in most cases.

This makes the device easier to use than single strip blood glucose monitoring systems and saves the user from having to handle multiple blood glucose monitoring utensils.

One disadvantage that arises from this is that integrated blood glucose monitoring systems are somewhat larger and heavier.

After use, the individual test sites and lancets remain in the drum mechanism and are disposed of with it. In this way, the user is spared the time-consuming disposal of individual test strips and lancets.

Furthermore, with these strip-free BG devices, there is less risk of the test sites becoming contaminated because they are stored in a drum.

Thus, glucose measurement with a strip-free BG device is much faster, more flexible and more discreet than with the single-strip blood glucose monitoring systems.

For this reason, integrated blood glucose monitoring systems are well suited for people who have an active lifestyle and are often on the go.

What distinguishes a non-invasive blood glucose meter and what are the advantages and disadvantages?

Non-invasive blood glucose meters are based on blood glucose monitoring technologies that do not require blood sampling or sensor implants. These are the newest methods of glucose measurement and are therefore not as well established as the invasive glucose meters.

Non-invasive glucose meters are based on novel optical or transdermal technologies. No intervention, such as a blood draw or implanting a sensor, is necessary with this type of measurement.

Transdermal blood glucose meters measure blood glucose levels through the skin based on the concentration of substances, such as urea, protein, haemoglobin and water, in sweat on the surface of the skin.

Since the sugar level in these substances is lower than in the blood, these devices are sometimes less accurate than the traditional invasive BG devices.

Advantages
  • no blood sampling
  • no sensor implant
  • well suited for on-the-go
  • data transmission
  • continuous blood glucose measurement if necessary
Disadvantages
  • Technology still under development
  • lower measurement accuracy
  • higher prices
  • number of BG measurements is limited by the test strips (cost factor)
  • measurement not feasible in active situations

Optical blood glucose meters react to the colour and temperature spectrum of the blood glucose under the skin. However, differences in skin density, as well as in the density of fat layers, can lead to inaccuracies in the measurement.

Some non-invasive glucose meters can be worn on the skin like bracelets or patches, and they measure your glucose levels continuously.

Because non-invasive glucose meters are a new technology, they are also more expensive.

What are the features of a smart blood glucose monitoring system and what are the advantages and disadvantages?

Smart/continuous glucose monitoring systems give you the ability to measure your blood glucose levels continuously without the need for a daily blood draw.

If you don't have the option of taking blood samples daily, there is also the option of implanting a sensor under your skin that continuously measures your glucose levels.

The sensor is wirelessly connected to a display that shows your glucose levels. However, you will need to replace the implant after a few days or weeks.

Advantages
  • no blood sampling
  • continuous blood glucose measurement
  • good for on-the-go
  • data transmission
Disadvantages
  • implanting a sensor under the skin
  • replacing the sensor
  • lower measurement accuracy
  • risk of sensor incompatibility
  • higher prices

Since the sensor does not measure the blood glucose values directly from the blood, but from the interstitial fluid, deviations in the measured values can occur. These occur especially in the first time after the installation of such a blood glucose measurement system.

In some cases, intolerance to the sensor or certain materials has been observed, which in most cases manifests itself in skin symptoms.

This can affect the glucose measurement and the benefits should be weighed up.

Purchase criteria: You can use these factors to compare and evaluate blood glucose meters

To help you choose the right blood glucose meter for you, we have compiled a list of buying criteria. You can use these factors to evaluate blood glucose meters and find the right device for you.

You should consider which of these criteria is most important to you based on your individual needs.

You should consider the following criteria when buying a blood glucose meter:

  • Operation
  • Measuring accuracy
  • Measuring time
  • Blood sample quantity
  • Measuring unit
  • Mass
  • Weight
  • Memory
  • Extras

In the following paragraphs, we will explain what is important for each criterion to make your purchase decision easier.

Operation

Operation as a purchase criterion refers to the ease of use of the blood glucose meter.

It is very important that the device is easy for you to use. You need to be able to take care of your BG meter and read its readings accurately.

Sometimes you also need to understand and use the diabetes management software that comes with it. This is the only way you can interpret your sugar readings with the software.

If you cannot use the device properly, you will not get accurate test results. The device should make your daily life easier, not more difficult.

Accuracy

Accuracy gives you an idea of how accurate your BG test results are.

The accuracy of a BG meter is probably one of the most important selection criteria. It determines whether the results on the display correspond to your actual sugar levels.

The accuracy of blood glucose meters is currently assessed according to the international standard ISO 15197: 2013. Since 2016, only BG devices that comply with this standard may be sold.

This standard specifies that there must be a deviation of no more than ± 15% from the actual sugar value when measuring blood sugar.

This is the case with the invasive BG devices on the market. This deviation of ± 15% is known as the tolerance range. At least 95% of the measurement results of a BG device must be within the tolerance range.

Non-invasive BG devices are usually less accurate because they do not take their measurements from a blood sample but from other substances, such as sweat or interstitial fluid.

Therefore, the deviations of non-invasive blood glucose monitoring systems vary more. According to the American Food and Drug Administration (FDA), these measurement deviations are often ± 30% or even ± 40%.

Measuring time

The criterion "measuring time" gives you an idea of how long the measurement takes after you have inserted the test strip into the insertion slot of the device. Measurement frequency, on the other hand, is how often the measurement is taken.

The measurement duration is displayed in seconds. With most devices, the glucose values are measured within a few seconds.

In the case of continuous flash glucose monitoring systems, it is not a question of measurement duration but of measurement frequency. The device measures the glucose values every few minutes and automatically stores them for later evaluation.

Blood sample quantity

To measure glucose with an invasive BG meter, you need to take a small blood sample and drop the blood drop onto a test strip.

Each BG device model requires a different amount of blood sample to read the blood glucose values.

The amount of blood needed to measure blood glucose is measured in microlitres (µl). Most BG devices require a blood volume that is between 0.3 µl and 0.9 µl.

Measuring unit

The results of the blood glucose test are displayed in a certain unit of measurement, depending on the BG device. This can be either mg/dL (milligrams of glucose per litre of blood) or mmol/L (millimoles of glucose per litre of blood).

These measurement units show the concentration of glucose per litre of blood. Most blood glucose meters have this unit of measurement preset and cannot be changed. However, some blood glucose meters offer the option to switch between mg/dL and mmol/L.

Mass

Mass information helps you estimate how big the blood glucose meter is. The mass of the meter is displayed in centimetres. The mass is calculated from the height, width and depth of the blood glucose meter.

Knowing the mass of your BG meter will help you decide where to store it and whether you can take it with you when you go out.

Smaller glucose meters are more convenient and you can carry them with you when you are out and about.

Weight

Weight information helps you estimate how heavy the blood glucose meter is.

The weight of the meter is measured in grams. If you know the weight of your blood glucose meter, it will be easier for you to assess whether you can carry it with you when you travel.

Storage space

The size of the memory space gives you an idea of the capacity of the memory card of the BG device. You can store all your readings in the memory.

It is important to save the results of your glucose measurements on the memory card. This way you can access and analyse them later. The size of the memory also tells you how many results you can store on your BG device.

Extras

Under the category "Extras" you can see the additional functions that the BG device comes with. If you have special needs, you should pay attention to the additional functions of the device.

Most blood glucose meters come with an alarm function that reminds you when you need to take your measurements.

Many BG meters have a backlit LCD display. This makes the results easy to read even in low light conditions.

Some BG devices allow you to take blood samples not only from your fingertips, but also from alternative test sites (such as your upper arm). This function is called ATS (alternative test sites).

Many BG devices have an automatic coding function. You don't have to code these devices according to the code on the test strip package. Other device sets have a microchip that contains the code.

Often a USB cable for data transfer is included in the device package. Some blood glucose meters also have wireless network or Bluetooth functions. In this way, measurement results are transmitted wirelessly to a PC or smartphone.

BG meters that have a mobile phone module are generally compatible with mobile phones. Many meters also come with corresponding diabetes management software and apps for PC and mobile phone.

With this software, you can evaluate and manage your blood glucose values. There are matching Healthmanager programmes for every meter.

Examples of such applications are Diabass, SiDiary, Accu-Check Smart Pix, med-import, mySugar Companion, GlucoLog and others.

Facts worth knowing about blood glucose meters

How do I measure my blood glucose?

Before checking your blood glucose levels, you must thoroughly clean and dry your hands and the area where you are taking blood.

Then insert a new test strip into the insertion slot of the electronic blood glucose meter. Then insert a new lancet into the lancing device and prick the skin with it.

Take a small drop of blood and carefully place it on the test strip. You will see the result of the blood glucose test within a few seconds on the display of the BG meter.

Who needs a blood glucose meter and which blood glucose meter is right for me?

Doctors prescribe a blood glucose meter in cases of diabetes to check blood glucose levels. This way, your doctor can get an overview of your symptoms.

On the other hand, you can check yourself whether you have hypoglycaemia or hyperglycaemia and take medication accordingly.

The use of a blood glucose meter may be prescribed for type 1 diabetes, type 2 diabetes, gestational diabetes or prediabetes. Diabetes is a very common disease in older people.

For seniors, ease of use and readability of the display are the most important criteria when choosing a meter.

Visually impaired people should prefer measuring devices with a voice output. Speech output and displays are available in different languages.

If a child suffers from diabetes, the parents usually take over the control of his or her sugar levels.

However, easy-to-use meters with colourful displays and entertaining apps for mobile phones are well received by young people. An increase in blood sugar levels is also very common in pregnant women.

Pets can get diabetes just like humans. Blood glucose devices suitable for dogs and cats are also available on the market. Veterinarians advise against measuring glucose levels in animals with a BG device for humans.

The concentration of glucose in the blood is different in animals and humans, as well as in different species of animals. A well-suited measuring device for pets is the Wellion Vet Gluco Calea.

What standard values does a blood glucose meter show?

In the case of diabetes, it is crucial to measure the levels of glucose in the blood.

Blood glucose meters primarily show you the level of sugar-containing haemoglobin (HbAc1). HbAc1 is the percentage of haemoglobin molecules that are biochemically linked to blood glucose.

The normal values of HbAc1 in healthy people are about 5%. Acceptable levels of HbAc1 in diabetics are between 4% and 6.9%. If your glucose levels are below or above these limits, you may have hypoglycaemia or hyperglycaemia.

Some blood glucose meters also offer the option of measuring the levels of ketones in the blood. When the body is hypoglycaemic, it breaks down fats to provide itself with enough energy. Ketones are by-products of the breakdown of fats.

Ketones make the blood acidic and this can lead to serious complications. People with type 1 diabetes in particular should measure the levels of ketones in their blood.

When and how often do I need to measure my blood glucose levels?

Your doctor will tell you when and how often to measure your glucose levels. It is important that you have a routine that fits your lifestyle.

As a rule, most people with diabetes measure their glucose levels twice a day before or after eating. If you experience symptoms of hypoglycaemia or hyperglycaemia, you should also measure your glucose levels.

If you have chosen a smart glucose monitoring system, your glucose levels will be continuously monitored by the system and you will not have to worry about it yourself.

What does it mean when the blood glucose meter shows an error?

Sometimes the blood glucose meter shows Error. This means that the test could not be performed correctly and you have to repeat it.

The blood glucose meter may show Error if, for example, there is not enough blood to do the test. This can also happen if the test strips are dirty or if you have not coded the meter correctly.

How should I care for and clean my blood glucose meter?

Hygiene and care of your BG meter are very important aspects of daily glucose monitoring. You need to take care of the power supply of your meter, as well as the cleanliness of your lancets and blood glucose test strips.

You must change the blood glucose lancet every time you take a blood sample.

If you use a lancet more than once, it can become blunt or dirty. This can lead to sores, infections and scarring of the skin. Always dispose of used lancets.

You should also check the expiry date of the test strips regularly. It is also important to check that the code on the meter matches the code on the test strip package.

If this is not the case, you will need to recode your blood glucose meter accordingly. You should also make sure that your meter is adequately powered by replacing the batteries regularly.

Picture source: Pixabay.com / Stevepb

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