Preferred blood glucose meters - for adults with type 2 diabetes - Wandsworth CCG
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Preferred blood glucose meters
for adults with type 2 diabetes
Introduction
This guidance rationalises the choice of blood glucose meters for patients and healthcare professionals. This review of
meters has been carried out locally in collaboration with, Merton & Wandsworth Community diabetes specialist
nurses, St George’s & Queen Mary Hospital diabetes specialist nurses, Practice Nurses, a GP, and Medicines
Management Pharmacists.
The chosen options have been assessed for technical specifications (including ISO 15197:2015 compliance), clinical
features, ease of use, cost effectiveness and quality of support provided by the meter companies.
Contents
1. Healthcare professional decision aid for choosing a blood glucose meter
2. Preferred Meters
3. Implementation
4. Blood Glucose Meter Systems – Technical Overview
5. Apps – Technical Overview
If you have any queries or comments on this guideline, please contact the Medicines Management Team: Produced: May 2019
Rajiv.dhir@swlondon.nhs.uk or Ragini.Dasani-Patel@swlondon.nhs.uk Review: May 2021
Page 1 of 7
1. Healthcare professional decision aid for choosing a blood glucose meter
DOES THE PATIENT NEED TO SELF-MONITOR THEIR BLOOD GLUCOSE (SMBG)?
Please refer to local guidelines on self-monitoring of blood glucose in patients with diabetes which provides information
on which patients should be testing & how frequently.
How is the patient managing their diabetes?
No
Insulin alone or in
combination with
Diet & Exercise Oral therapy only
oral therapy
HbA1c to be SMBG not routinely SMBG recommended if SMBG
measured to assess recommended on oral anti diabetic recommended
long term glycaemic Provide patient with therapy known to cause
control every 2 to 6 for all patients
rationale for this & hypoglycaemia e.g.
months depending on reassure if they have
glycaemic stability SULPHONYLUREAS and
previously been testing
GLINIDES*
Box 1: Exclusion Criteria
- Patients managed by secondary care diabetes teams
- Patients who are planning pregnancy / currently pregnant.
Does the patient meet any of the EXCLUSION
(Consider WaveSense JAZZ Wireless) CRITERIA in Box 1?
- Patients with renal impairment CKD4
- Child or adolescent under 18 years old
- Patients with haemoglobinopathies.
- Patients who have ketone prone type 2 diabetes – Consider
No
4SURE Smart duo under specialist advice only
- Registered visually impaired patients: consider voice meter
Offer patient
- Patients who use a meter to adjust bolus insulin dose
Yes
Seek advice from the patients 4SURE Smart® or
Specialist Team / DSN
1
NICE NG28 (Type 2 diabetes in adults) advises that patients
WaveSense Jazz®
should not routinely be offered self-monitoring of blood glucose (see meter options on next page)
unless: *Glinides (meglitinides) include nateglinide and
They are on insulin or oral medication that may repaglinide.
increase risk of hypoglycaemia while driving or Do not issue ketone strips solely for use by patients
operating machinery prescribed an SGLT-2i. If a patient on an SGLT-2i
presents unwell, their blood ketone levels should be
There is evidence of hypoglycaemic episodes checked even if blood glucose levels are in the
The person is pregnant or planning a pregnancy normal range.
2
If you have any queries or comments on this guideline, please contact the Medicines Management Team: Produced: May 2019
Rajiv.dhir@swlondon.nhs.uk or Ragini.Dasani-Patel@swlondon.nhs.uk Review: May 2021
Page 2 of 7
2. Preferred Meters – All meters below are recommended and with no first or second line recommendation
4SURE Smart 4SURE Smart Duo WaveSense JAZZTM WaveSense JAZZTM
WIRELESS
Accurate, simple to use with large high-resolution
Accurate, simple to use with large high-resolution back-
backlit display. Works in conjunction with award-
lit/LED display. Works in conjunction with free of charge
winning Diabetes:M bolus calculator App. Ketone
Zero-Click and AgaMatrix Diabetes Manager App
testing available only on 4SURE Smart Duo
Prescribe: 4SURE Test strips (50), Prescribe: WaveSense JAZZTM Test Strips (50) or
4SURE Lancets (Extra Fine 33G) WaveSense JAZZTM DUO Test Strips (2 x 25), AgaMatrix
Ultra-Thin Lancets (33G)
If you have any queries or comments on this guideline, please contact the Medicines Management Team: Produced: May 2019
Rajiv.dhir@swlondon.nhs.uk or Ragini.Dasani-Patel@swlondon.nhs.uk Review: May 2021
Page 3 of 7
3. Implementation
Adults newly diagnosed with Type 2 diabetes
Patients who meet the recommendations for SMBG testing as per the local guidance on self-monitoring of
blood glucose in patients with diabetes, should be provided with a choice from the preferred list of meters.
Existing patients
It is appreciated that some patients will already be using meters that are not on the preferred list of products.
These patients should continue using their meter until such time that they express their wish to change their
meter or are happy to change to a meter on the preferred list, following a discussion with their healthcare
professional at their next review. The patient should then be supplied with a meter in accordance with this
guidance, unless there are exceptional circumstances. It is essential that the patient is offered training on
how to use their new meter.
Initial supply of meters available to each surgery. Obtain subsequent supplies
by contacting the relevant Company - (see bottom of table on page 6).
Remove non-preferred meter stocks from the practice.
Practice staff to familiarise themselves with the meters
TRAINING of staff & patients can be arranged by contacting the relevant Company
Ensure there is agreed & documented goal(s) for SMBG (including
appropriate blood glucose levels for that patient)
Check patients know:
How to use the meter & lancet device (wash hands prior to testing)
When to test & what to do with the result
How to Quality Control (QC) the meter & emphasise importance of
regularly checking the accuracy of their meter. Control solution can
be obtained from Company help line
How to safely dispose of sharps
Prescribe: Testing Strips & Lancets
Frequency of self-monitoring may increase on a short-term basis e.g. during periods of illness, or whilst fasting for religious reasons (such as
the month of Ramadan). Prescribing of glucose test strips should be adjusted to support any increased short-term clinical need.
If a patient requires a meter due to clinical need, these will be provided free of charge. Patients should be dissuaded from purchasing
their own meter or receiving one free & should be made aware that test strips and lancets may not be prescribed on the NHS for a
meter that has not been obtained from their GP practice or diabetes clinic, in line with the locally preferred list of blood glucose
monitoring meters.
If you have any queries or comments on this guideline, please contact the Medicines Management Team: Produced: May 2019
Rajiv.dhir@swlondon.nhs.uk or Ragini.Dasani-Patel@swlondon.nhs.uk Review: May 2021
Page 4 of 7
4. Blood Glucose Meter Systems – Technical Overview
Name of 4SURE Smart 4SURE Smart WaveSense WaveSense JAZZ™
Meter DUO JAZZ™ WIRELESS
Size Palm size Palm size Palm size Palm size
Test strips 4SURE Test strips (blood glucose)
WaveSense JAZZ™ Test strips (blood glucose)
4SURE B-Ketone (for Ketones)
Enzyme for
Glucose dehydrogenase – FAD Glucose Oxidase - GOx
testing
50 strips (£) WaveSense JAZZ™ Test Strips -£8.74 (vial of 50
4SURE Test Strips -£8.99 (pot of 50 blood
strips)
glucose strips)
WaveSense JAZZ™ DUO Test Strips -£8.74 (2 vials of
4SURE Ketone Test Strips £9.92 (10)
25 strips)
Expiry after 24 months from date of manufacture, 22 months from date of manufacture, 6 month open
opening regardless of when vial is opened. vial stability
Haematocrit
0 - 70% (10 - 70% β-Ketone) 20 - 60% (With linear accuracy throughout range)
range
Memory
1000 tests 1,865 tests
Capacity
Measurement
5 Seconds 5 Seconds
Time
Mmol/l range 1.1 – 33.3 mmol/l 1.1 – 33.3 mmol/l
Lancets (£ per 4SURE Lancets 0.195mm/33G AgaMatrix Ultra-Thin Lancets 33G
100) £2.90 for 100 £5.43 for 200
Sample size 0.5µl 0.5µl
Coding
No Coding for glucose testing No Coding
required
Meal tagging Yes – Pre/Post
Yes – Pre/Post meals Breakfast/Lunch/Dinner/ Yes – Via ADM App
Bed
Meter
7, 14, 30, 60, 90 day 14, 30, 90 day
Averages
Strip self-
Yes No
ejection
Control
detection Auto detects control results. Important for Auto detects control results. Important for DVLA
DVLA regulations. Cannot be deleted regulations. Cannot be deleted
Alarm Ketone Alarm on Yes 7 test reminders + Hypo and Hyper
Yes - 4 test reminders
reminders Smart Duo Hypo/Hyper Alarms Alarms
Ketone Yes, available on 4SURE Smart Duo meter
Yes
warning 4SURE B-Ketone strips £9.92
Measure
Yes, only on 4SURE Smart Duo meter No
ketones
Download Yes – Download via Download available Yes – either via ZeroClick
Results 4SURE diabetes via the Diabetes:M PC software or to ADM Yes – via ADM App
manager app App
Diasend
Yes (Transmitter & Uploader) Yes (Transmitter & Uploader)
Compatible
App available Yes, free premium access to the award-winning Yes, free of charge - AgaMatrix Diabetes Manager
Diabetes:M App – Includes bolus calculator App
Batteries Alkaline AAA – Free replacements available Lithium CR2032 – Free replacements available
If you have any queries or comments on this guideline, please contact the Medicines Management Team: Produced: May 2019
Rajiv.dhir@swlondon.nhs.uk or Ragini.Dasani-Patel@swlondon.nhs.uk Review: May 2021
Page 5 of 7
Instruction
Yes (including online) Yes (including online)
Manuals
www.nipro-diagnostics.co.uk www.agamatrix.co.uk
Educational
Yes (also available online) Yes (also available online)
materials
Contact Details
for ordering
meters
Louise Willshire – 02380 604 304
Emma O’Reilly - 07733453829
Louise.willshire@nipro-group.com
eoreilly@agamatrix.com
Michael Payne – 07769 882 643
Alternatively, fax “Meter Request Form” (supplied by
Michael.payne@nipro-group.com
AgaMatrix) to 01235 838648
Alternatively, fax “Meter Request Form”
(supplied by Nipro) to 02380 604 319
Patient 0800 08 588 08 0800 093 1812
helpline 8.30am-5.30pm Monday to Friday, voicemail 8.00am-6.30pm Monday to Friday, voicemail out of
over the weekend hours
Smartphone Applications
The use of Smartphone Apps in the management of Diabetes is becoming ever more popular with Health Care Professionals
and Patients in the management of Diabetes in parallel with all aspects our lives.
Apps allow data to be shared electronically and in real time across several Web based platforms.
They allow numerous data sets to be stored in one place and easily shared as appropriate with Health Care Professionals.
Apps can track not only Blood Glucose Results but other health related data including carbohydrate Intake, insulin dosage
and weight.
Bluetooth® technology allows easy transfer of data from the Blood Glucose Meter to the App and then as appropriate to
the Web platform or via email reports to their Health Care Professional.
The more a patient tracks, the more they can visualise trends to aid pattern management.
References
1. NICE guidance NG28 Type 2 diabetes in adults: management, December 2015 http://www.nice.org.uk/guidance/ng28/chapter/1-
Recommendations#self-monitoring-of-blood-glucose
2. MHRA Drug Safety Update, SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin): risk of diabetic ketoacidosis, 26 June 2015
https://www.gov.uk/drug-safety-update/sglt2-inhibitors-canagliflozin-dapagliflozin-empagliflozin-risk-of-diabetic-ketoacidosis
If you have any queries or comments on this guideline, please contact the Medicines Management Team: Produced: May 2019
Rajiv.dhir@swlondon.nhs.uk or Ragini.Dasani-Patel@swlondon.nhs.uk Review: May 2021
Page 6 of 7
5. Applications – Technical Overview
Name of App and how to download Compatible meters Features
* Award winning App - Over 50,000 active users in
4SURE Smart
Europe
Free premium version available for 4SURE Smart DUO * Bolus Calculator - Carbohydrate counting and
4SURE patients – contact Nipro for
insulin dose calculator.
access code. Call 0800 08 588 08
* Vast food database with easy portion and quantity
Availible for iOS and Android selection. You can easily add your own food to the
database.
* Clean Logbook - A logbook for glucose, insulin,
Free download from App store or
nutrition, medications, injection sites, notes,
Google play
categories and others.
* Detailed timeline graph of blood sugar tests
including also boluses, basal insulin, activity chart
and other useful data.
* Free Clinician Account - Remotely manage your
patients through the web interface. Useful for virtual
clinics, gestational teams and vunerable patients
* Additional profiles - For parental monitoring
If you have any queries or comments on this guideline, please contact the Medicines Management Team: Produced: May 2019
Rajiv.dhir@swlondon.nhs.uk or Ragini.Dasani-Patel@swlondon.nhs.uk Review: May 2021
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