Proposed strategies for reducing user error in capillary blood glucose monitoring

For individuals with diabetes mellitus, CBGM provides a more accurate picture of daily glucose fluctuation than urine glucose testing (1-9). As a result, CBGM is the preferred method to assess short-term glucose control and provide data for management decisions and insulin adjustment (10-16). Moreover, the wide availability of glucose monitoring systems designed for patient use has made SMBG the standard of care in diabetes management for all capable persons with insulin-requiring diabetes and an appropriate management tool for persons with non-insulin-requiring diabetes (13-20). In spite of the relative accuracy of current CBGM systems in measuring blood glucose levels, a recent study by the FDA suggests that user-procedural errors can cause inaccurate results (21). Inaccurate data affect patients efforts to achieve good metabolic control and, if used as the basis for regimen adjustment, may endanger health (21-42). Therefore, until reliable, technique-free systems are available, the accuracy of data with this technology must be improved through reduction of user error. This article presents strategies to accomplish this goal recommended by a national group of experts, the NSCQA in CBGM.