Thursday, November 5, 2009

DO NOT throw away old blood sugar test-strips

I've got an Aviva Accu-chek [R] blood sugar test meter. Last year, and this year, my employer based private health insurance covered test strips 100% with no deductible. Cool. In 2010, the cost of the test strips and lancets will be applied until my newly imposed $2000 deductible is reached - so I looked into how expensive these test strips are - more than a $1 each! Yikes! ('08 and '09 had no "deductible" for my family & I)

Yikes, considering that a few months ago, I tried to use an "old" refill. "Old", in that they were 2008 strips, instead of 2009 - Aviva (and many other meter makers) have this annoying little IC chip you have to stick into the side of the meter for "calibration". Built into that chip is an evil "expiration date" that yields the strips obsolete after a date that some marketing genius has pre-determined. Grrrrrrrrr! Yeah, if I did not have central HVAC, and didn't live in a state where the average RH is below 15%, then "shelf life" MIGHT be a problem - but everyone stores and keeps all sorts of things in the desert, and sealed container test strips, are No Different!

So I removed the battery out of the back of my meter, waited a minute for capacitors to discharge, reinserted it, and reset the date to January 2009. When 01Jan2010 arrives on the global calendar, I will not be throwing away perfectly good test strips again, since my meter will believe it is only March 2009. =)

8 comments:

  1. Thank you for this information. My insurance also stopped paying for testing supplies, and I have been trying to make mine last. No doubt soon I will have reached the 'use by' dates and will use this. Thanks again!

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  2. This is BAD BAD Advice IMO..just had a real shock when my blood sugar test results weren't accurate with how I've been feeling. I checked on 3 different fingers...3 sticks..3 different strips & got one result of 89..the other around 250, & the next at 189.. I was shocked since I had been sensing that something was out of balance for a long time. Checked my strips & the Expiration was April of 2009 !!! (now it's 3/21/2010)
    Nearly a year out! switched to new ones, & checked again twice on 2 different fingers w/2 different strips..this time readings of 162 & 175...so, though a little high, not bad since it wasn't that long after a meal & was consistent with how I felt... My research has showed that out of date strips tend to give higher than average readings often...But as you can see from my experience, the readings can vary wildly !!! BE CAREFUL !This could be DANGEROUS if you think for instance you are too high..take more insulin, & are actually low in the 1st place..Could even KILL you !! Not worth it! MUCH safer to use in date strips! I won't make this mistake again !!! Hope this helps someone. ..Peace & Harmony !

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  3. again, I live in the Desert, and my strips don't get above 78F in a 20% Relative Humidity Environment. It's the same environment where the airlines store unused aircraft for years. Oxidation, corrosion, degradation by moisture is not a factor here. Un-opened, sealed containers of strips with GOLD contacts (remember, gold does not Oxidize) have proven to me to work very well. In what part of the country do you live tlindsey?

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  4. Hello JustJoeP,

    Thank you for posting my comments. To answer your question, I live in Tennessee, indeed in the south where it is very humid much of the time. Believe me, I would trade places with you any time (humiditywise) and live in the desert, where humidity is not a factor. As I often state about our weather here in Tennessee, that it's like living in a swamp! ... Otherwise Tennessee is a great and beautiful state. So I'm sure this will somewhat validate your argument, as far as humidity affecting the degradation of the strips and other things.... Let me also say, my purpose here, is not to be the one who is right, or to show either of us as right or wrong, but rather to provide a useful discussion, which will hopefully help other diabetics who may discover your forum while just doing a Google or other search while online (as I did) and trying to answer their own diabetic health questions.
    So, with that in mind, let me outline a few things I have found while researching the subject.

    Number one. Diabetic test strips can indeed be good well after the expiration date.

    Number two. Diabetic test strips can also go bad before the expiration date.

    Number three. Factors such as humidity, how long the bottle has been open,(test strips should always be used within 90 days after opening the bottle under any conditions)
    and other factors can affect the rate at which strips become no longer effective.

    However, with all that being said, what we are talking about here, is the breakdown of the chemical coating on each strip. The strips are coated with a chemical which reacts with your drop of blood on each sample. Light, or an electrical current, is then passed through the strip and is then able to determine how much glucose is in each sample. That is the basic way that a blood glucose meter and strips work to give you an accurate reading.
    ... So we are not talking about degradation of metal, i.e. gold tips or whatever... we are talking about a chemical breakdown that will invariably take place over a certain amount of time. The time it takes could of course vary due to certain environmental factors... but I am talking about unopened bottles, that had never been exposed to the atmosphere, how long an opened bottle will last is truly a whole other discussion, but the generally accepted time range of an opened bottle with in date strips, is 90 days.
    >>Note: Continued in next post !!!

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  5. Part 2:

    So, when you are talking about chemical processes at work, I really think it's a very different thing, then when you are talking about how metal breaks down, or other material such as in planes and machinery due to environmental factors such as heat humidity etc.
    ... So whereas it is easy to just assume that the strip manufacturers put the date on the bottles or encoded into a code key etc. just to make you have to buy strips before you really need them, I believe the fact is, that the manufacturing companies are aware that the strips have a certain chemical lifespan, and though they may be well aware that the strips may last long past their expiration date, they as a company, cannot guarantee that. And of course if they didn't set guidelines, you know someone would be suing them holding them legally responsible etc. etc... but again the simple fact is, there are chemical coatings on each strip that do degrade over time and there is just no way to guarantee whether or not they will be accurate after the expiration date that is on the vial of strips.
    ... So all I can say, is if you're going to take the chance of using out of date strips, you should also take steps to verify that you're getting accurate results. Such as, making sure your A1C results are in the acceptable range for you.... Another good way to be sure that your meter and strips are testing accurately, which I have done myself, is to just carry your meter and strips with you to your doctor's appointment and check it against their results right while you're there in the office.... Note: there will always be some variance between meters, and indeed even when you check yourself with your own meter as I described in an earlier post (doing two sticks from two different fingers with two different blood samples and two different strips) there will always be a variance of readings. The information I've gathered says that a 5 to 15 point difference is in the acceptable range here. If it's much more off than that, especially if you're seeing readings 50, to 100 or more points different, when you doublecheck your readings this way, then you can be pretty sure that either your strips, and/or your meter are probably bad.

    Note: Continued in PART3 !!!

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  6. Part 3:

    ... So the bottom line, is this:
    Your blood sugar results from testing are your roadmap. They are your guide to the miles you need to travel to get where you want to be. If I have a roadmap from Tennessee to Texas showing me the number of miles I need to travel to get from here to Dallas for example, if the map is off by 50, 100, or 150 miles, I'm going to get pretty lost aren't I?... I will either be very short of my destination, or very much past it.... Just as you check your blood sugar results to see your levels and know how to adjust your insulin or other diabetic medications accordingly. You absolutely need the most accurate results possible in order to make the needed corrections to keep your blood sugars in the acceptable range for good health. So the problem with using out of date strips is just simply that you just can't know past the expiration date for sure whether they're good or not. The only reason I'm spending this much time on this is just that if someone who is less informed than either one of us stumbles across these posts and thinks "oh hey it's okay to use out of date strips after all" they could really be making a big mistake with some dire health consequences... and as I said before even life-threatening results.... Just not worth it!!!
    Diabetes is an every day struggle. Accurate test results are absolutely vital to being able to manage it effectively.... Let's face it, diabetes is a tough row to hoe, it's a daily challenge, and knowing how to adjust your medication is just critical and therefore accurate blood glucose readings are maybe the single most important tool at your disposal to keeping this disease in check. So in my opinion, it is just not worth the chance to use outdated strips.... Keep in mind, if this works for you and saves you money and if you're doublechecking your results in some other ways such as those I outlined, then I guess it is of course your choice to use your outdated strips. But again in my opinion it is just playing Russian roulette.... I.e., you just never know when those strips may turn chemically ineffective after that expiration date is up.
    Anyway, a good discussion here on a very important topic I think. So thank you very much for the opportunity to post here. Again my only hope is that this may provide some help and source of valuable information to others who share our struggle with Diabetes.
    ... Again good luck to all of you and hope this will help someone. (See info and links below)


    Here's a quote from a gentleman I found on a blog discussing this exact subject who states he was:

    "a senior medical lab tech for 20+ years in the Army and at Tacoma General Hospital."

    ...He states:

    "There are chemicals in the strips. Usually glucose oxidase or hexokinase. These are enzymes that will reduce glucose and with some other chemicals in the strip, either produce a color that is in proportion to the amount of glucose present or a small amount of electric current proportional to the amount of glucose. Since these chemicals are enzymes, they are highly specific to glucose, but they can be fooled. Vitamin C (ascorbic acid) will give false results as well as some other common things. Some other medical conditions may also interfer. I can't remember which ones."

    ... And here are a couple of links I found while researching this on the Internet, which explain exactly how blood glucose monitor strips work and the chemicals and processes involved if you want to know more:

    http://www.livestrong.com/article/65971-diabetes-test-strips-work/

    http://www.ehow.com/how-does_4898797_glucose-test-strips-work.html

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  7. Yes tlindsey, if you see massive swings in the readings, then don't use the old strips. Time, temperature, and contamination (humidity, dust, light/UV) will work to degrade the enzymes on the strips. Using strips that are 5 or 10 years old would be foolish. Using strips that are 6 or 12 or 18 months "out of date", that have been kept in a controlled environment, will not add significantly to measurement error. Minimize the time, temperature, and contamination, and you've minimized your measurement error.

    A1C is the reliable indicator. ELIMINATING most carbs from my diet and increasing moderate exercise, I drove my A1C from 6.6 (borderline diabetic) to 5.5 (perfectly normal) in a year, and this is WITH an overwhelming family history of type II diabetes (both parents, both brothers, all my over-weight relatives).

    If your A1C is above 6.7, and you're using multiple bottles of opened strips that are over 2 or 3 years old, then I agree with you, don't reset your meter's date.

    Be well

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