Blood sugar meters touted as easy for diabetics to use may actually take more than 50 steps to get a reading and are complex enough to befuddle most college people, says a new study.

But critics of the ergonomics survey say the Georgia Institute of Technology researchers used old data to support their premises, the newest machines are indeed simple to use, and they are "making mountains out of molehills."

What both sides do agree on is that monitoring blood glucose is the most important thing a diabetic can do. Armed with this information, the patient can manage the disease by adjusting his medicine, diet and exercise, all of which can lessen the risk of developing life-threatening complications.

The Georgia researchers found that to perform an average test of his blood sugar, a diabetic must perform between 30 and 40 steps in the proper order to get accurate results. If the machine needs calibration, or the patient is using a new vial of test strips the number of steps can be as high as 52, says the study.

"We did an analysis of this device which is supposed to be easy to use and discovered it to be very complex," says one of the study's authors, Wendy Rogers, an associate professor at the Georgia Institute of Technology in Atlanta.

Making these hand-held, battery-operated machines user friendly is critical because they are crucial to managing diabetes. There are more than 15 million diabetics in the United States, and it is the seventh-leading cause of death in this country. If a diabetic doesn't pay close attention to his blood sugar levels, he might end up blind, with kidney or nerve damage, heart disease, stroke or even have limbs amputated.

The problem comes when the diabetic makes an error taking his blood sugar level -- there is little to no feedback from the machines, and each step has to be done to completion and in order so that they can go on to the next step. The more steps there are, the greater the chance a mistake will be made. And the more mistakes, the greater the likelihood a diabetic's health will suffer.

Rogers and her colleagues studied the devices to try to discover where errors were being made and what could be done to correct them. They also surveyed 26 diabetics about how they used the machines. Results of the study appear in the current issue of Ergonomics in Design.

To use the device, diabetics need to prick their finger with a small needle called a lancet and place a drop of blood on a test strip that is put into the blood glucose meter. The machine then measures the patient's blood sugar. Whenever a new package of test strips is purchased, the patient must also enter the code for those strips into the machine.

The biggest problem with the devices, she says, is a lack of feedback. She says if the test is done wrong, the machine studied did not let the patient know that there was an error in the test.

Another problem is that some buttons on the machines have more than one use. And, the number of steps it takes to complete the test is a problem. Fifty-two steps leaves a lot of room for error, says the study. And it's not just the one meter. The Georgia researchers tested another commonly used meter and found testing took 61 steps.

The instructions for these devices may also be too complex, say the authors. And, even an instructional video included with the device used vocabulary that may be too difficult for some people to understand.

The Georgia researchers surveyed 26 people, and over 70 percent said they had trouble with the meters when they were first learning how to use them, reports the study. This is even though the subjects averaged 15 or more years of education.

But others disagree with the findings of this study.

"Monitoring your blood sugar at home is really not that hard to do, and it's getting simpler and simpler all the time," says Dr. Steven Edelman, an associate professor of medicine at the University of California San Diego, and himself a diabetic. Edelman is also author of Taking Control of Your Diabetes.

Paula Yutzy, a certified diabetes educator from Mercy Medical Center in Baltimore, agrees that the devices are simple to use, and says the study's authors are often "making mountains out of molehills" when they point out some of the potential trouble spots with the meters. She also points out that many of the studies referenced in the study are older and would have been completed using meters produced in the early to mid 1980s. And those machines are very different from the machines in use today. Yutzy says the manufacturers are constantly improving the meters and making them easier to use.

What To Do

Rogers and her colleagues say manufacturers should make test strips larger and easier to handle, and that they should be standardized. They also recommend making the area that receives the blood larger, though Yutzy says this would then require the diabetic to put more blood on the strip. Yutzy says she would like to see the strips less sensitive to changes in temperature and humidity, which she says manufacturers are working on.

The study also recommends reducing the number of steps required to perform the test and to have the machines provide feedback if a step is done incorrectly.

Edelman and Yutzy both agree that a more important problem is that people aren't taught what to do with their blood sugar level numbers. They aren't taught how to adjust their medication or their diet, and they say knowing your glucose number without having the information is useless. Both suggest talking with your physician, and having the physician or nurse show you how to use the machine and explain how to adjust your lifestyle when necessary. Better yet, says Yutzy, get a referral to a diabetes educator.

If you have problems with a particular machine, Edelman says the companies' toll-free numbers are great places to start because the makers can walk you through the process step by step.

(From HealthScout)