Q&A With Dr. Richard Bernstein
You were very instrumental in making glucose testing available at home. If you could make the guidelines for meters used at home for checking blood glucose, what features would you require the meters and test strips to have?
Answer: Almost every blood sugar meter on the market today is inaccurate. In fact, the bestsellers tend to be least accurate. The one that we recommend for patients, which I won’t mention now, is very accurate in the vicinity of 70 to 100 ml/dl, where I try to keep my patients. Even the one that we use here is not accurate at high blood sugars. When you get up to 160 and above, my meter is not accurate and will have variability in its results.
This lack of accuracy is caused by poor quality control on the strips. It’s easy to make an electronic device that’s consistent, but it’s not easy to make blood sugar test strips that are consistent from batch to batch.
I’ll give you an example. For a number of years, we recommended a particular meterthat was very easy to use and was quite accurate at blood sugars around 70 to 100. If you did five blood sugars in a row, they were the same, plus or minus one. Then, all of a sudden, the numbers that were presented didn’t make sense. If you did five blood sugars in a row, and let’s say the real blood sugar was 85, the numbers would vary from 70 to 110.
It made no sense, and so I called the manufacturer’s salesman and asked him to find out what happened with their strips. It turned it out that they had originally manufactured them in the US themselves, but to save money, later farmed them out to Thailand.
I think that poor quality control of the strips is the biggest problem today with the meters. All other features are trivial in comparison to accuracy and are frequently used to seduce customers into buying inaccurate meters.
Richard K. Bernstein, MD is one of the most knowledgeable, committed, and successful pioneers in the field of diabetes today. He invented blood sugar self-monitoring and basal/bolus insulin dosing when he was an engineer.
Dr. Bernstein is Director Emeritus of the Peripheral Vascular Disease Clinic of the Albert Einstein College of Medicine in Bronx, NY. His private medical practice in Mamaroneck NY specializes in treating diabetes and obesity.
He is a physician, research scientist, thriving type 1 for 67 years, and best-selling author of nine diabetes books including Diabetes Solution, The Diabetes Diet and several e-books. This link diabetes-book.com will give you more information about his publications. To sign up for his free monthly tele-seminars, visit askdrbernstein.net