Do you order a glucometer (glucose meter) from a patient's pharmacy for diabetes management?

Ordering Glucometers for Diabetic Patients

Yes, you should order a glucometer from the patient's pharmacy for diabetes management, as self-monitoring of blood glucose is an essential component of effective diabetes care. 1

Indications for Glucometer Prescription

The need for a glucometer varies by patient type:

• Insulin-treated patients: Essential for all patients on insulin therapy to monitor and prevent hypoglycemia and hyperglycemia 1

  • Multiple daily injections or insulin pump users should check 6-10 times daily
  • Check before meals, snacks, bedtime, exercise, driving, and when hypoglycemia is suspected

• Non-insulin treated patients: May benefit when:

  • Altering diet, physical activity, or medications (especially those causing hypoglycemia) 1
  • Part of a structured diabetes self-management education program 1
  • Assessing hypoglycemia or glucose levels during illness 1

Ordering Process

1. Write a prescription for:

   • Glucometer device
   • Test strips (quantity based on testing frequency)
   • Lancets
   • Control solution (often overlooked but important for accuracy verification) 2

2. Specify "FDA-approved meter" on the prescription 1

3. Consider insurance coverage when selecting specific brands, as this often determines final patient choice 3

Important Considerations

• Accuracy: Only prescribe FDA-approved meters with proven accuracy 1

  • FDA standards require home-use meters to have 95% of readings within 15% of actual blood glucose values 4

• Test strip availability: Ensure test strips are readily available and covered by insurance 3

• Patient factors: Consider visual acuity, manual dexterity, and technological literacy when selecting a meter 1

• Counterfeit strips: Advise patients against purchasing preowned or secondhand test strips 1, 4

• Potential interferences: Be aware of medications and factors that can affect meter accuracy:

  • High-dose vitamin C
  • Hypoxemia
  • Certain medications 1

Patient Education

When prescribing a glucometer, ensure patients receive:

1. Instruction on proper technique for blood sampling and meter use 1
2. Guidelines on when to check glucose based on their treatment regimen 1
3. Training on how to interpret and use results to adjust therapy 1
4. Information on using control solution to verify meter accuracy 2
5. Regular evaluation of technique and result interpretation at follow-up visits 1

Common Pitfalls to Avoid

• Not considering insurance coverage: This is often the ultimate deciding factor for patients 3
• Failing to prescribe control solution: Only 39% of pharmacies routinely stock it, and many providers never recommend it 2
• Not providing adequate education: Simply having a meter without knowing how to use the data is ineffective 1
• Assuming all meters are equally accurate: There is substantial variation in accuracy among widely used systems 1

By following these guidelines, you can ensure your diabetic patients have appropriate tools for glucose monitoring that will contribute to improved outcomes in terms of morbidity, mortality, and quality of life.