ACCU-CHEK Instant

Blood glucose monitoring devices are used for:

• Diabetes Mellitus (Type 1 and Type 2):
• For self-monitoring of blood glucose (SMBG) levels at home, in clinical settings, or while traveling.
• Helps assess effectiveness of antidiabetic therapy (insulin, oral agents).
• Gestational Diabetes:
• Monitoring maternal blood glucose to maintain optimal glycemic control during pregnancy.
• Hypoglycemia Risk Management:
• Early detection of low glucose levels to prevent severe hypoglycemic events, especially in insulin-treated patients.
• Pre-diabetes Monitoring:
• In at-risk individuals to assess fluctuations and guide lifestyle interventions.
• Hospital and ICU Settings:
• For tight glycemic control in critical care patients receiving parenteral nutrition or insulin therapy.
• Off-label/Clinical Use:
• Monitoring glucose trends in metabolic disorders and pancreatic dysfunction.

Not applicable as this is a device. However, proper usage instructions include:

• Preparation:
• Wash hands thoroughly.
• Prepare the lancing device and insert a new lancet.
• Insert the test strip into the meter.
• Blood Collection:
• Use lancet on side of fingertip or alternate site (as approved).
• Place drop of blood on the test strip.
• Reading & Recording:
• Wait for the meter to provide the glucose value (usually within 5–10 seconds).
• Record or sync reading via app, logbook, or digital platform.
• Frequency of Monitoring:
• Type 1 Diabetes: 4–10 times/day (before/after meals, exercise, bedtime).
• Type 2 Diabetes (on insulin): 1–4 times/day.
• Type 2 Diabetes (not on insulin): Varies (daily to few times/week).
• Gestational Diabetes: Typically 4 times/day.
• Per healthcare provider’s recommendation.
• Calibration: Some models may require manual calibration using control solution.

Blood glucose monitoring devices work by detecting the glucose concentration in a small blood sample using enzymatic reactions. Most modern glucometers utilize glucose oxidase or glucose dehydrogenase enzymes that react with glucose in the blood sample, producing an electrical current or colorimetric change. The device converts this signal into a numerical blood glucose reading (mg/dL or mmol/L), providing real-time glucose data. This mechanism allows individuals and healthcare providers to manage and adjust therapy based on current glucose trends.

Not applicable for medical devices.

• Pregnancy: Safe for use during pregnancy, especially in gestational diabetes management. Frequent monitoring is essential to ensure maternal and fetal well-being.
• Lactation: No known risks. Continued monitoring helps maintain maternal glycemic control, supporting healthy lactation.

• Medical Device
• Subcategory: Blood Glucose Monitoring System (SMBG)
• Variants:
• Capillary blood-based (fingertip prick)
• Alternate site testing devices
• Continuous Glucose Monitoring (CGM) devices
• Flash Glucose Monitoring systems

• Do not use in:
• Patients unable or unwilling to perform self-monitoring correctly.
• Severe peripheral vascular disease (may affect capillary blood flow).
• Use on dehydrated, hypotensive, or shock patients without clinical validation.
• Use of incompatible test strips or lancets.

• Accuracy Concerns:
• Ensure proper technique, compatible strips, and unexpired materials.
• Infection Control:
• Never share lancing devices or meters.
• Environmental Factors:
• High altitude, extreme temperatures, or humidity may affect readings.
• Interfering Substances:
• High levels of ascorbic acid (vitamin C), uric acid, or acetaminophen may skew results.
• Device Maintenance:
• Regular calibration, battery replacement, and cleaning required.
• False Readings:
• In anemia, hypotension, hypoxia, or high triglyceride states.

As a non-pharmacologic tool, blood glucose monitoring has no systemic side effects. However, potential issues include:

• Local Skin Effects:
• Pain, bruising, or calluses at frequent prick sites.
• Infection Risk:
• Rare, but possible with improper hygiene.
• Device-Related Issues:
• False highs/lows from improper use.
• Skin irritation (in CGM users due to adhesive patches).

• Not applicable directly, but drug interference with device readings includes:
• Vitamin C (ascorbic acid): May falsely elevate results.
• Acetaminophen (paracetamol): May falsely lower or elevate depending on the meter.
• Dopamine or Mannitol: Interference possible with some devices.

• ADA 2024 Guidelines:
• Recommend wider adoption of Continuous Glucose Monitoring (CGM) in Type 1 diabetes and insulin-treated Type 2 diabetes.
• Increased emphasis on “time in range” metrics alongside traditional SMBG.
• WHO Recommendations:
• Promote SMBG access in low-income settings and provide training.
• FDA Notices:
• Stricter standards on device accuracy and real-time data syncing via mobile applications.
• Interoperability Advancements:
• Enhanced app integration, cloud-based tracking, and AI-driven glucose pattern recognition.

• Device:
• Store at 4°C to 30°C (do not freeze).
• Protect from moisture and direct sunlight.
• Keep away from dust, high humidity, and magnetic fields.
• Test Strips:
• Store in original container at 4°C to 30°C.
• Use within 3–6 months of opening (check manufacturer’s label).
• Close lid tightly to avoid contamination or humidity damage.
• Lancets:
• Store in a clean, dry environment.
• Dispose of used lancets in approved sharps containers.