Testing Blood Glucose Meter Accuracy

by David Mendosa Patient Advocate

The Accu-Chek Aviva blood glucose meter gets the highest rating for accuracy and precision. It was first in an evaluation of a dozen meters conducted by a team of testing experts at Germany’s University of Ulm led by Guido Freckmann, M.D.

In the more than 20 years that I have been writing about diabetes, few studies of meter accuracy have appeared. Dr. Freckmann and his team of researchers have been the most relevant, reliable, and prolific in testing our meters. But some of the meters that they evaluated aren’t available in the United States.

The leading diabetes journal that evaluates our meters just released the full text of this meter accuracy study. The editors tell me that the study will be free online only until March 31.

The most important takeaways of the study

So don’t wait too long if you want to review the whole thing. Meanwhile, I summarize below what I think is the most relevant information.

The journal is Diabetes Technology & Therapeutics, and the study is “Evaluation of 12 Blood Glucose Monitoring Systems for Self-Testing: System Accuracy and Measurement Reproducibility.” The journal published it two years ago, but until now only the abstract has been freely available to us.

Dr. Freckmann and his colleagues rated the meters against both the current and proposed standards. The current standard can be met more easily. It requires that at least 95 percent of the results fall within plus or minus 15 mg/dl at blood glucose levels below 75 mg/dl and within plus or minus 20 mg/dl at levels greater than or equal to 75 mg/dl. The International Organization for Standardization (ISO) set this level back in 2003, and it is the standard not only in Europe but also in the United States because the U.S. Food and Drug Administration uses it.

The tighter standard

ISO’s 2013 standard is tighter, but is still pending approval both in the U.S. and Europe. To be acceptable at least 95 percent of the results have to be within plus or minus 15 mg/dl at blood glucose levels below 100 mg/dl and within plus or minus 15 percent at blood glucose levels greater than or equal to 100 mg/dl.

Ten of the 12 meters that Dr. Freckmann and his team evaluated met the higher standard. Two meters, which they didn’t name, failed the test. The FDA hasn’t approved six others for sale in the United States.

But four of the five top meters are available in the United States. While the Accu-Chek Aviva got the best score in this evaluation, the Contour XT, sold here as the Contour Next EZ, is the next most accurate and precise meter tested that is available here. Numbers four and five are the GE100 and GE200, also available here.

Dr. Bernstein’s recommendation

Of course, I am aware that Richard K. Bernstein, M.D., recommends the Abbott FreeStyle Freedom Lite meter as “the most accurate.” He is the author of Dr. Bernstein’s Diabetes Solution and is the leading exponent of the very low-carb diet for people with diabetes.

In fact, I tested the Abbott FreeStyle Freedom Lite when it first came on the market. My results were so variable that I immediately threw it away. Now that I’ve read the results of the evaluation by Dr. Freckmann’s team, I’m glad that I still test with one of the Accu-Chek Aviva meters that I started using more than 10 years ago.

David Mendosa
Meet Our Writer
David Mendosa

David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.