Newer portable glucose meters - Analytical improvement compared with previous generation devices?

Background: Newer glucose meters are easier to use, but direct comparisons with older instruments are lacking. We wished to compare analytical perform ances of four new and four previous generation meters. Methods: On average, 248 glucose measurements were performed With two Of ea ch brand of meter on capillary blood samples from diabetic patients attendi ng our outpatient clinic. Two to three different lots of strips were used. All measurements were performed by one experienced technician, using blood from the same sample for the meters and the comparison method (Beckman Anal yzer 2). Results were evaluated by analysis of clinical relevance using the percentage of values within a maximum deviation of 5% from the reference v alue, by the method of residuals, by error grid analysis, and by the CVs fo r measurements in series. Results: Altogether, 1987 blood glucose values were obtained with meters co mpared with the reference values. By error grid analysis, the newer devices gave more accurate results without significant differences within the grou p (zone A, 98-98.5%). Except for the One Touch II (zone A, 98.5%), the othe r older devices were less exact (zone A, 87-92.5%), which was also true for all other evaluation procedures. Conclusions: New generation blood glucose meters are not only smaller and m ore aesthetically appealing but are more accurate compared with previous ge neration devices except the One Touch II. The performance of the newer mete rs improved but did not meet the goals of the latest American Diabetes Asso ciation recommendations in the hands of an experienced operator. (C) 1999 A merican Association for Clinical Chemistry.