Cheating With Glucose Test Strips

Strumph (1) noted the possibility of "cheating" with the ExacTech blood glucose system. By leaving a used strip in the meter and pressing the "on" button a second time, after the initial reading has been obtained, a lower reading could be obtained the second time. Strumph's observations call attention to the important principle that, when a patient wants to mislead parents or health-care professionals, there is often a mechanism by which this can be done. The same type of cheating could just as easily be done with colorimetric strips, by either starting the timer before applying blood to the strip and wiping off the blood before the timing cycle is complete or wiping too hard and removing some of the color pad. If children are not observed while testing is being done, they may simply be fabricating values and entering them in the logbook rather than going through the trouble of sticking their finger. Ideally, of course, we should reward good behavior and not good blood glucose levels to minimize the motivation for this type of cheating. There is no device on the market that a clever patient cannot find a way of subverting to his/her own uses.