Finally, an algorithm (formula) in the meter converts the current into a concentration of glucose. That current then speeds through the strip. The greater the glucose concentration, the greater the current. Another agent on the strip, called the “mediator,” turns these electrons into an electrical current. Here’s the process as simply as I can put it: glucose interacts with an enzyme on the strip, releasing electrons. In fact, the biggest contributor to inaccuracy is the strips. Some factors have to do with the meter, some with the strip and some, with us PWDs. There are many factors that go into producing a blood glucose reading at home, and so there’s a lot of room for variability in the final result. Second, laboratory tests eliminate virtually all variation, except for manufacturing variation, from their testing. That said, to some degree we’re already on two different playing fields. Home meters are calibrated to give results as though they are measuring glucose in plasma only (called “plasma-equivalent” results). The standard reference lab test measures glucose in plasma (about half to two thirds of the volume of blood). The percentage of red cells is called the hematocrit. Whole blood consists of a liquid, called plasma, and cells, mainly red cells. Most home meters measure glucose in so-called “whole blood” (blood as it comes out of our body). To better know how accurate your own meter is (in percentage terms), you can “check the package insert that comes with the strips and look online at prescribing information,” says Shawna Gvazdauskas, Head of Devices at Sanofi Diabetes U.S. To better understand the science behind meter and strip technology, you can google “meter accuracy” for white papers and posts that would delight even the geekiest engineer.
I talked with a number of Chief Medical Officers, MDs and Medical Safety Officers at several meter manufacturers and I’m going to tell you what I learned in layman’s terms.
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