Diabetes Testing

Easy and Accurate Diabetes Monitoring at Home Is Available

The A1CNow device is the easiest and most accurate way for those of us who have diabetes to check our key blood glucose level at home. But it still has spotty availability.

Chex Diagnostics, formerly known at Polymer Technology Systems, started shipping it six months ago after the company had purchased the A1CNow business from Bayer Diabetes Care last year. But many pharmacies don’t have it yet.

The good news, however, is that we can get it for less than ever before.

The pharmacist at the local Kroger supermarket told me today that he had never heard of a way to check our A1C at home. A pharmacist at the most upscale pharmacy near me remembered that they had sold the A1C test when Bayer made it but didn’t have any record of the Chex Diagnostics or Polymer Systems Technology device. I couldn’t find it on the Rite Aid, Target, or Costco websites.

But Chex Diagnostics provides the A1CNow device to two retailers who sell it as house brands. Chex Diagnostics owns the proprietary names under which Walgreens sells as the “Walgreens At-Home A1C Test Kit” and which Wal-Mart sells as the “ReliOn Fast A1C Test.”

You can get the two tests in the Walgreens At Home A1C Kit for $32.99, according to the company website. At least I think that’s the price, because much of the “overview” information is wrong. Besides describing what is obviously a blood glucose meter, it refers to a “lover limit of the A1C target.” Don’t you love it!

The situation at Wal-Mart stores is much better, although its website hasn’t caught up. It’s not yet on the Wal-Mart website, which shows the Bayer version at $29.88 but as no longer available.

But Wal-Mart stores started getting their ReliOn Fast A1C Test kits from Chex Diagnostics about two weeks ago, Chex’s Director of Marketing Laura Wilkerson told me. I found it at my nearby Wal-Mart, and my correspondent Dave Persinger found it a a Wal-Mart in California. Special thanks to Dave for being the first person to bring this source to my attention.

Dave and I each paid only $22.88 for a kit of two tests. And at least here in Colorado I didn’t have to pay any sales tax on top of that.

I think this is a great deal for all of us who want to manage our diabetes most effectively. A1c tests first became available about 1978, ​but we didn’t​ how important ​they were​ ​until the Diabetes Control and Complications Trial (DCCT) finished in 1993​. Until then​ no one knew the direct relationship between blood sugar and diabetic complications.​

The ​DCCT​ ​was a major clinical study​ ​of 1,414 volunteers​ ​conducted from 1983 to 1993 and funded by the ​U.S. government. The study showed that keeping blood ​sugar levels as close to normal as possible ​can ​slow​ and perhaps stop​ the onset and progression of the eye, kidney, and nerve damage caused by diabetes.​ The device that Chex Diagnostics makes and sells as the A1CNow and under the proprietary names that Wal-Mart and Walgreens use is the only home testing device that the National Hemoglobin Standardization Program, or NGSP, certifies as being compatible to those reported in the DCCT.

Nowadays, most everyone recommends that those of us who have diabetes get our A1C levels checked every six months. But I make sure to check mine on the first day of every month, and I always use one of these home testing devices for the great convenience they offer.

Two often? My primary care physician hinted during my most recent visit that he thought I was a bit obsessive. However, my level jumped from 5.3 to 5.6 in a 31-day period earlier this year. I may have been suffering from an infection, and the early warning prompted me to take immediate action.

The A1C test measures our average blood sugar level during the previous three months or so. That’s generally all that most resources will say about it, so most people would not expect such a big change as I experienced in a one-month period. But this is an oversimplified understanding of the A1C.

Half of the A1C level depends on the previous month, according to the definitive reference for clinical chemistry, Tietz Textbook of Clinical Chemistry and Molecular Diagnostics, 5th Edition, page 1442. Days 30 to 60 determine one-fourth and days 60 to 120 determine the other fourth. I made sure to order this book through inter-library loan rather than buying my own copy, because the best price I could find for it was $243.19.

You may or may not want to check your A1C level as often as I do. But in any case I don’t think that you can do any better than to use an A1CNow device with whatever name it has on it.

This article is based on an earlier version of my article published by HealthCentral.

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54 Comments

  • Reply Ralph June 15, 2016 at 8:08 am

    Thanks, David!

  • Reply Ralph June 13, 2016 at 1:16 pm

    Has anyone found a video that guides a new user through using the ReliOn FastA1C test kit?

  • Reply zecamara December 1, 2015 at 9:13 am

    A1CNOW needs refrigeration (regular fridge, not freezer) to last longer, but it is important to let it come to room temperature before testing. I normally take one out the day before I will use it, and don’t keep the meter in the fridge, just the test supplies.
    I also test on the first of the month, nice to see trends.

    • Reply David Mendosa December 1, 2015 at 9:27 am

      Good points. I keep mine in the fridge too, but remember reading in the guidance once that I need to take it out for an hour beforehand so that’s what I do. The trend is important.

  • Reply Myke FB October 22, 2015 at 5:08 pm

    Hi David – I stumbled across your blog and want to thank you for taking the time to answer everyone’s questions. I use the ReliOn Fast A1C and it has helped me to get better control of my Type 2 diabetes. I just tested this morning and it was 6.1, which is much better than my past results. I am too embarrassed to say how high is was, but it was over 9. !!!! My doctor added Invokana to my regimen several months ago and it has indeed made a difference. I also take Metformin and Glimepiride. It will be interesting to see what my lab A1C results will be when I go back to see him in a couple of weeks.

    • Reply David Mendosa October 22, 2015 at 8:36 pm

      Thanks for writing, Myke. Please continue sharing your good news.

  • Reply Jim S. July 8, 2015 at 12:15 pm

    David,
    Have you heard of the Accu Chek Performa Nano? This looks to be an Israeli-made unit. The descriptions on eBay and Amazon are vague at best. Maybe a subject for another blog, but I’m intrigued to see more on the market. Interestingly, this isn’t in Accu Chek’s product line on their website. Also unsure of which test strips they use. Any additional details would be fascinating.

    • Reply David Mendosa July 8, 2015 at 1:00 pm

      I have heard a little about this meter, Jim. It’s actually been available in Europe and Australia and perhaps other places for several years. It uses Accu-Chek Performa test strips, which are not generally available in the U.S. because the FDA hasn’t approved the meter here (and I don’t think that Roche even tried). I am surprised to see it on Amazon, where it says it was made in the U.S. but shipped from Israel.

  • Reply Zakia June 27, 2015 at 10:19 pm

    Hi Jim,
    I’m not sure where you live, but you should consider going to Joslin if you are in the vac injury of Mass General. I’m T1, have been diabetic for 20 years and have been followed by a FANTASTIC endo for the last 12 years. Try Joslin, they specialize in diabetes, I’ve always received excellent care.
    Good luck!

  • Reply jim Corbett June 21, 2015 at 12:58 pm

    After missing tests at Endocrinologists office, and my intern’s office and at MA Gen’l in prep for transplant,I decided to look on web since all the Drs cannot remember to take it. Good news.
    Dave, if you just had an MD, you could have charged about $25,000 for all the above consults.. My Endo,says hello to me, checks my ankles, does an A1C in 5 min. says “bye”, and now I am in Stage 4 kidney failure!! Not a word about kidney disease! A MA Gen’l Chief of Transplant said “TAKE CONTROL OF YOUR HEALTH NEEDS, because no DR will !”

    • Reply David Mendosa June 21, 2015 at 2:39 pm

      I would suggest that you get another endo, Jim, but just about all of them are like that. How sad. I do like what the transplant chief told you.

  • Reply Carol May 20, 2015 at 11:53 am

    Hi, Just took my first Relion Fast a1c test and was very pleased with the result. It was 5.7. My last lab a1c result was 6.4 in Feb. 2015. At that time, my primary doc added Glimepiride 1 mg daily to my diabetes drug arsenal so I was hoping the a1c would go down.
    My question is: do you have any idea how reliable my 5.7 result is? I’m real happy with that number but won’t be having another lab a1c until June 30. Thanks in advance.

    • Reply David Mendosa May 20, 2015 at 12:27 pm

      I have used this device (under several different brand names) for years and it is one of the few A1C tests that is standardized and therefore as reliable as they come. You are doing great!

  • Reply James April 27, 2015 at 9:30 am

    I wonder if anyone had ever thought to bring their test gear to the lab so their blood glucose and A1C test can use the same blood sample for comparison of the lab results with your test results. I was informed that this may be an available option decades ago. There may even be enough leakage when the needle is withdrawn for both tests, especially if the sample size is small. Since I have not taken advantage of this opportunity recently, you may wish to ask before going to the lab. I am sure the technician will cooperate unless there is a company prohibition.

  • Reply Jim S April 2, 2015 at 6:08 am

    Hi Gary,

    I’m not David, but this is what I gathered from reading here and looking on Amazon. PTS (Polymer Technology Systems) is described in this article as the former name of Chek Diagnostics, the company that took this product over from Bayer. I think that in 2015, everyone should steer clear of anything branded Bayer or PTS. Even if the expiration date is good, there is really no telling how the stock has been handled.

    I think anything with Chek, Walgreens or ReliOn on the packaging would be reliable.

    David, after reading your response, I dove in and bought a $22.88 ReliOn Fast A1C kit from Wal-Mart last night. The test was easy. The result of 6.2% was a bit higher than my last lab of 5.3, but my daily glucose readings have been a bit higher, so a higher A1C is rational.

    I plan to check my A1C monthly at home and compare its trend with lab work as decided by my doctor.

    • Reply David Mendosa April 2, 2015 at 8:26 am

      Dear Jim,

      Thanks for your message. I agree entirely with it.

      Best regards,
      David

  • Reply Gary April 1, 2015 at 10:02 pm

    David, the one I bought on Amazon wasn’t the Bayer, it’s from PTS Diagnostics.

    Gary

  • Reply Jim S March 31, 2015 at 10:18 am

    Fascinating read! I plan to give the ReliOn a shot. Can you order refills, or are the meters so cheap they are disposable?

    • Reply David Mendosa March 31, 2015 at 10:22 am

      Dear Jim,

      Good question. The meters are disposable.

      Best regards,
      David

  • Reply Gary March 19, 2015 at 8:54 pm

    Hi David,
    Thanks for all the information you’ve provided about the A1C Now Test. I was just reading your comments section and came across the discussion about refrigeration. I just ordered a test that arrived today from Amazon. On the box it says to store between 64–77F No mention about refrigeration. Just wondering if I should put it in the refrigerator or not?

    • Reply David Mendosa March 20, 2015 at 11:04 am

      Dear Gary,

      Good question, and perhaps I misled you. The A1CNow test is sold both in 10-packs and 2-packs. The 10-pack does need to be refrigerated because you won’t be using all the tests for quite a while, perhaps a year. The 2-pack doesn’t.

      By the way, I just searched Amazon for what they and third-party vendors are offering for the A1CNow and was shocked to see that tests made by Bayer are still offered. Bayer hasn’t made the A1CNow for more than a year and I would think that those devices are too old to be accurate. Chex Diagnostics has made them more recently, as I have written. If I were in your shoes and had purchased a Bayer-made A1CNow kit, I would return it.

      Best regards,
      David

  • Reply Judy February 4, 2015 at 12:44 pm

    Ernest,

    I was a lab tech years ago and the information you have was true, then. Now, the finger stick test can be as accurate as a venous sample. As David was alluding to, you and the doctor need to know how the sample was tested to know the accuracy of the test that was used on the venous sample. Changing out the test equipment or using different reagents can change the test results.

    Hang in there it can be a wild roller coaster ride of conflicting information until you find out what your body needs to get and stay healthy. One size does not fit all!

    • Reply David Mendosa February 4, 2015 at 12:57 pm

      Dear Judy,

      Thank you so much for your helpful information and sound advice!

      Best regards,
      David

  • Reply Ernest February 4, 2015 at 12:21 pm

    That was my understanding based on reading lots since being diagnosed with Type 2 a few weeks ago. If you have not heard of it then I may have misunderstood. Will look into and try to verify.

    Thanks

  • Reply Ernest February 4, 2015 at 4:44 am

    David

    Thank you.

    I am not sure if there is some confusion here. I assume that most test kits (A1C kits and regular blood glucose monitors) are pretty close to 100% accurate.

    However, the reason why fingerstick tests are only within 20% accuracy is because the blood is taken from capillaries in the finger tip and not from veins.

    Traditionally, A1C testing is based on venous sampling, which is why I thought they are more accurate. If however, the new A1C monitors also use blood drawn from the finger tip, it follows that they should also only be accurate within 20%

    I am new to all this but is my understanding. Am I on the right track?

    Many thanks

    • Reply David Mendosa February 4, 2015 at 9:36 am

      Dear Ernest,

      Both of your points are new to me. What are your sources?

      Best regards,
      David

  • Reply Marcus Valdes February 3, 2015 at 2:46 pm

    My ReliOn result was 7.1, measured 7.7 at the Dr. office the next day. Also my second test didn’t work properly. I called ReliOn and they sent me a giftcard to help pay for a second batch of tests. Great customer service!

    • Reply David Mendosa February 3, 2015 at 2:50 pm

      Dear Marcus,

      Actually, I would be inclined to accept the ReliOn result rather than in your doctor’s office, because the ReliOn test is standardized and not all tests done at doctor’s offices are.

      Best regards,
      David

  • Reply Ernest February 3, 2015 at 7:41 am

    Thanks David. If it is not a venous sample then I think (not sure though!) that it will then be only within 20% accuracy (i.e. 10% either way) so still useful but not as good as the venous sample taken by your doctor.

    is that correct?

    Thanks

    • Reply David Mendosa February 3, 2015 at 11:24 am

      Dear Ernest,

      Actually the 20 percent figure doesn’t apply at all to A1C tests — much less to fingersticks! People through that number around a lot, based on earlier limitations of blood glucose meters. Now, the standards even for them are higher.

      Best regards,
      David

    • Reply David Mendosa February 3, 2015 at 11:53 am

      Dear Ernest,

      A few minutes ago I missed responding to your comment that the A1CNow test is not as accurate as what your doctor would use. But the case is probably different. Please see my articles on this very subject at:

      http://www.mendosa.com/blog/?p=1782
      and
      http://www.mendosa.com/standardizing.htm

      Best regards,
      David

  • Reply Ernest February 3, 2015 at 4:52 am

    David

    Hi! How do you do an A1C test at home? Don’t you need a venous sample? Is that dangerous?

    Thanks

    • Reply David Mendosa February 3, 2015 at 5:33 am

      Dear Ernest,

      Thanks for asking. Actually, the blood sample is exactly the same as for a regular blood glucose meter! No problem at all.

      With metta,
      David

  • Reply Graham February 3, 2015 at 4:15 am

    Hi David,

    Do you know if these kits are available in the UK, or if they can be purchased from the USA by folks over in the UK?

    • Reply David Mendosa February 3, 2015 at 4:21 am

      Dear Graham,

      I am sorry that I don’t know the answer. The best thing for you to do is to contact the company directly by email. Then, please let us know here. Thank you.

      With metta,
      David

  • Reply Patrick Michael January 25, 2015 at 7:28 pm

    David, I used to use the A1C now. Tried hard to religiously follow the instructions. My results were not consistent, so I tested myself twice, same morning a couple of times. My results were significantly different both times. I don’t remember exactly, but something like a 6.0 and a 5.6. What now (I know, go with the lower one

    • Reply David Mendosa January 26, 2015 at 9:28 am

      Dear Patrick,

      Thanks for sharing your experience. Of course, I wonder why you have had such a problem. I have used the A1C Now for years testing every month. And even then with 30 or 31 days between tests, my numbers usually are only 0.1 percent different and never more than 0.2 percent different. Could you be using expired devices?

      With metta,
      David

  • Reply Ernest January 13, 2015 at 7:25 am

    David

    July (26 October) asks why check A1C levels monthly if you randomly check daily glucose levels?

    I assume the answer is that the daily tests are only a snapshot at any given moment in time, but also, because the daily tests are not accurate.

    I was really surprised to read somewhere that the daily tests are only accurate to within 20%. Is that true? And can we assume the A1C test is accurate?

    Many thanks

    • Reply David Mendosa January 13, 2015 at 10:20 am

      Dear Ernest,

      Good questions. Daily tests are generally not very accurate, but the 20% error figure that is often cited is an oversimplification (these tests don’t have to be as accurate at higher levels because then accuracy isn’t as important as at lower levels. The A1C tests that the National Hemoglobin Standardization people certifiy as being compatible with the DCCT, which includes the A1C Now test, are much more accurate. Of course, no test of any sort is 100% accurate!

      Best regards,
      David

  • Reply Marcus Valdes December 2, 2014 at 7:15 am

    Picked mine up last night and it worked great. I’m having one done at the Dr on Wednesday, so will be interesting to compare the two results. I was 7.1, so plenty of work to do.

    • Reply David Mendosa December 2, 2014 at 1:57 pm

      Dear Marcos,

      You are on the right path. And let us know please how the test at the doctor’s office compares. Don’t assume that the doctor’s test is the better one, though. Please see if you can learn what test that the doctor is using and whether it is a standardized one.

      Best regards,
      David

  • Reply Greg Close November 13, 2014 at 10:08 am

    No fan, but but there are many supplies that have been unavailable through the Bahamas, Turks Caicos, and here since we left the states in late March, so WalMart here we come.

  • Reply Greg Close November 13, 2014 at 6:37 am

    We are in Luperon in the Dominican Republic now, but we will leave soon for Boqueron on the west coast of Puerto Rico.

    Never really thought I’d so look forward to a WalMart!

    • Reply David Mendosa November 13, 2014 at 9:40 am

      Dear Greg,

      I’m no fan of Wal-Mart either. But since I know from talking with the manufacturer that the ReliOn and A1CNow devices are exactly the same, except for the words used to describe them, I am buying the device at Wal-Mart from now on.

      With metta,
      David

  • Reply Greg Close November 11, 2014 at 6:41 am

    Thanks, David. I have been looking for one of these at a reasonable price. I have not found a way to get tested down here, and I am ordering one of these as soon as we get to Puerto Rico. Thanks for the great info on this site!

    • Reply David Mendosa November 11, 2014 at 9:07 am

      Dear Greg,

      Yes, Puerto Rico is probably the only place in the Caribbean where you can find the ReliOn A1C device. However, several Central American countries have Wal-Mart stores. Where you are sailing now?

      With metta,
      David

  • Reply Peggy November 9, 2014 at 10:45 am

    Thank you! I just put them in the fridge and will give them a go. And yes, my test results from the “no good” AC1Now kit last month and the Relion (this month) was only 0.1 difference.
    I really appreciate your prompt and helpful response.

    • Reply David Mendosa November 9, 2014 at 11:26 am

      Dear Peggy,

      Great! Thanks for letting me know.

      David

  • Reply Peggy November 8, 2014 at 11:00 am

    I bought 10 A1C Now test kits via the Chek Diagnostics website. A month ago I happened to notice a very small thermometer icon on the outside of the package. Concerned that I had been storing the kits wrong, I called the company who confirmed they needed refrigeration and the remaining 6 of my test kits were no longer valid and should be thrown out. The proper storage instructions were well embedded in the small print of the package insert. I was just a bit perturbed that the need for refrigeration was not stated more clearly on the outside of the package.
    So per your suggestion again, I bought the Relion kits at Walmart. I was quite surprised to find that there is no longer a refrigeration requirement though it appears to be the same product as A1CNow. Do you know anything about this change? Might my original A1CNow tests still be valid?
    Many thanks. Love your blog. It is so helpful to a newbie : )

    • Reply David Mendosa November 8, 2014 at 2:27 pm

      Dear Peggy,

      I am sorry that you may have wasted money because the refrigeration warning was not prominently stated. The ReliOn A1C meter is exactly the same as the original, as the people at Chex Diagnostics told me. The difference is that when the cartridges aren’t used for many months they need to be refrigerated. If I were you, I would refrigerate them now and use them one per month. I really don’t know if you would have a problem and whether the problem would be that the test measured too high or too low. But as soon as you see one test that doesn’t make sense to you, throw out the rest. By the way, I test monthly and I have never seen a change of more than 0.2 month to month, since my diet is pretty consistent.

      David

  • Reply marla November 5, 2014 at 5:57 am

    THANK YOU!!!
    “Can’t manage what you don’t know.”…exactly.

  • Reply Judy October 26, 2014 at 9:36 pm

    If you are checking your Glucose levels daily at random times, would you not be able to spot a trend of the numbers being a little high? I guess, I am not seeing the value in checking my own A1C unless my insurance would not cover having this done as part of routine office call.

    • Reply David Mendosa October 27, 2014 at 10:21 am

      Dear Judy,

      Thanks for asking! If you check your blood sugar level randomly, you probably could spot whether your numbers were trending up or down. But you would still not know if your A1C level was a healthy one. And do you actually check your level randomly? I don’t know anyone who does that. The best guidance that I know about is to check your fasting level if you have a high A1C, somewhat above 7.0, and to check it two hours after the first bite of a meal with substantial carbohydrates. Some other guidance is to check it at other times, particularly when you go to bed. Most people’s medical insurance covers A1C testing in a lab that your doctor will send you to every six months, seldom directly in the office. Testing at home is both more convenient and can be more frequent. And frequent testing always means better diabetes management, because we can’t manage what we don’t know.

      With metta,
      David

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