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Calibrating glucose meters

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A 62-year-old man with type 2 diabetes agreed to change his insulin program to a pump—yes, insulin pumps can be used effectively in type 2 diabetes, but that's a topic for another time.

He decided to start everything anew and bought the latest and greatest glucose meter. Horrors!! There was a 60 to 70 mg/dL difference in capillary blood glucose between his old and his new meters. He called me in a mild panic. Which one should he trust?

Calibrating glucose meters is a tricky business with no easy way to do it. Perhaps the best way is to have the patient go to the lab and have a venous blood sample drawn for a blood glucose measurement and at the same time take a finger prick sample to get the CBG on the meter he or she will be using. An alternative would be to go to the local emergency department and have them obtain a CBG on thier machine and at the same time on the patient's machine. This, of course, assumes that the ED calibrates their CBG meters regularly.