Do You Use Control Solution to Test Your Glucometer?

While recently cleaning out one of my son’s old diabetes kits—a soft, camouflage-printed lunchbox we used when he was first diagnosed three years ago—I came across a bottle of glucose control solution. It was expired, of course. When we were still in the hospital just after my son’s diagnosis, our diabetes educator had taught us how to use the solution to ensure the accuracy of a new batch of strips. We used it once or twice, and honestly, that’s the last time we used the stuff.

Looking back, I think we were so overwhelmed by everything we had to do to keep our son healthy that the control solution seemed like a step we could skip. In those early days we were just trying to get through breakfast, lunch, dinner and all the places in between as we took our son’s blood sugar, scribbled that number into a hefty binder provided by the children’s hospital, counted the carbs, did the carb ratio math—and, if necessary, the formula for a correction—prepared the syringe, then injected the insulin. It all seemed monumental.

With time, we got used to the routine, developed our own way of doing things, switched to an insulin pump and got hooked up to a continuous glucose monitor.

So after finding that little bullet of a bottle, I started thinking about it. I see our pediatric endocrinology team as a pack of superstars, who constantly save the day and know what’s best. So I called one of the educators there. “We don’t use the control solution,” I confided to her. “Should we?”

She explained that, while there are no good studies to indicate its effectiveness, her team “teaches it” as a way to see if test strips are working. It’s a safety measure; after all, she said, “you’re injecting a potent drug.”

Then I asked her if she—a type 1 diabetic herself—used it. She laughed. Sometimes, she said, as a way to troubleshoot, particularly if her numbers seemed off. I asked her if she thought most people used it. She said, “A lot are, most not, more people should.” (The Joslin Diabetes Center’s webpage, under “How to Avoid an Inaccurate Blood Glucose Reading,” says, “Before using the meter for the first time and then again every few weeks, check your meter using the control solution … Control solution is only good for three months once opened.”)

A forum on ChildrenWithDiabetes.com addressed this same issue. The thread was picked up by about a dozen of parents with kids with type 1 diabetes, and many admitted they didn’t use the control solution. Though there were a few who did. One wrote, “I use the control solutions fairly often … [they] are the only invariable in the whole meter mess.” Others said it they used it rarely, and in the words of one parent, “Only if we think something funky is going on.” Another parent added, “We were told by the nurses at the hospital to do that. But I think they were just reading what the manufactures [sic] directions say.” Along the same lines, someone wrote, “And of course the manufacturer would recommend this only to avoid lawsuits and also the more you use the more you need and that is all good for them.”

Out of curiosity, I contacted a d-mom I know, whose child was diagnosed a year ago. “No, we don’t use it,” she answered, “do you?”

And then I reached out to another d-mom friend, whose child was diagnosed more than a decade ago. “No,” she said, “we stopped doing that, like, nine years ago!”

She brought up another reason to skip it: wasting strips. Those are a diabetic’s gold, particularly when you’re running low and especially when you’re paying out of pocket. And then there’s the cost of the glucose control solution, which the experts say needs to be replaced—once opened—every three months.

Finally, I shot a message to a friend who has had type 1 diabetes for more than six decades. (Of course, glucometers weren’t available until about 25 years ago, he reminded me.) He’s a guy who does things by the book, who’s fastidious about his care. I expected him to say yes.

He did. But after a year of using the control to test his strips—in his case, the first strip in every third or fourth vial—he stopped. “I never noticed a difference,” he said.

So, all of you out there … do you use control solution?

Annie Stoltie

Annie Stoltie is a mom to two children—one of whom was diagnosed with type 1 diabetes at age 4—editor of Adirondack Life magazine and a contributing writer to publications that include Slate.com, the New York Times, Newsweek, Modern Farmer and Good Housekeeping Magazines. She’s the author of the guidebook The Adirondacks (W.W. Norton, 2012) and is currently the Writer-in-Residence at the State University of New York at Potsdam. She lives in Jay, New York.

Annie Stoltie

Annie Stoltie is editor of Adirondack Life magazine. She and her family live in Jay, New York.