Meters have come a long way since 1969, when the first meter went on the market. The meter measured the amount of light reflected off a Dextrostix, a paper strip that turned various shades of blue, depending on blood glucose level, after a large drop of blood was placed on it and then washed off.

The meter had a swinging needle that gave a numerical readout. It was called the Ames Reflectance Meter, weighed three pounds, and cost a month’s salary, and only physicians were allowed to have it. The first patient to use it was Dr. Richard Bernstein of low carb fame, who was possibly the first person to ever test his own blood sugar. Not until the late 1970s could patients buy a meter without a prescription.

These days, meters weigh a few ounces and are crammed with bells and whistles. If you’re arthritic, you can get them with strip cartridges so you never have to handle a strip. You can get them that store up to 3000 tests and give you an average of blood sugar tests done in the past seven days. Most use tiny batteries, can be downloaded, and keep track of all sorts of things. New meters are springing up like tulips, so check out the new WaveSense Keynote, the FreeStyle Lite, and the updated LifeScan and Bayer models.

But no matter how advanced meters are, they’re not the cat’s meow. That’s reserved for continuous glucose monitoring systems, or CGMs, which give an average reading every five minutes, continuously, so that you can see exactly where you are and where you’re going. They are becoming increasingly important as it becomes apparent that even a good A1c can be the average of big swings between high and low. After-meal excursions, which sound like a picnic but are anything but, are becoming implicated in complications. They’re the highs that happen after meals, and CGMs are the perfect tool to expose them and to get them under control. A new monitor, the Freestyle Navigator from Abbott, is expected to receive approval soon.

And Medtronic’s CGM, the Guardian REAL-Time System, just launched in March, so check the chart for their new features. The problem with CGMs is the fact that insurance companies won’t pay for them yet, and they’re one more thing that you have to hook up to. But research shows that just using one, even without specifi c instructions, improves A1c’s. The device can capture dangerously low overnight blood glucose levels that often go undetected, reveal high blood sugar levels between meals, show early morning spikes in blood sugar, and help evaluate how diet and exercise affect blood sugars.

At the end of the road, what’s the best meter? It’s the one that you’ll use the most often. So find the features that work for you, and go to it.

See also: Tips for Successful Blood Sugar Monitoring

See also: Diabetes Health Product Reference Charts to see updated Meter and CGM comparisons.