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The Precision Xtra® from Abbott Diabetes Care is the only meter that tests for both blood glucose and blood ketones. The latest verision of the Precision Xtra is quite small and weighs just over 1.5 ounces, making it easy to carry around. The latest glucose test strip requires only 0.6 microliters of blood and produces results in just 5 seconds. The latest ketone strip requires 1.5 microliters of blood and produces results in 10 seconds. These improvements make the Precision Xtra highly recommended.

Even if you choose another blood glucose meter, the Precision Xtra remains an indispensable tool for managing type 1 diabetes because of its blood ketone testing capability. Every family who has a child with diabetes should have a Precision Xtra for blood ketone testing.

The Precision Xtra uses foil wrapped test strips. Ketone test strips are sold separately (about $30 for eight ketone strips). Testing for blood glucose is very simple: unwrap the touchable strip, insert into meter, meter turns on, apply sample, read result in 5 seconds. The 5 second result time matches the best times available, and 0.6 microliters -- while not the absolute smallest volume -- is small enough for alternate site testing.

Testing for blood ketones is exactly the same, except we noted that the ketone strips require more blood than the glucose strips (1.5 microliters versus 0.6 microliters for blood glucose). Ketone results come in 10 seconds with the latest strip (available June 2006).

The Precision Xtra is approved for alternate site glucose testing. The latest glucose strip requires only 0.6 microliters, which is small enough for any alternate site.

Testing for blood ketones represents a significant advance over testing for urine ketones. Not only does it free you from messy urine ketone test strips, but more importantly, it provides an accurate and current reading of blood ketones. Urine testing reports on previous ketone levels. This difference is akin to testing urine for glucose compared with testing blood for glucose. One of our tester's simply said, "It's better than peeing on a strip." Regardless of what meter you use for blood glucose testing, having a Precision Xtra for blood ketone testing is essential for best practices.

Two recent studies (February 2006) demonstrate clear medical benefit from blood ketone testing. The first study (Diabetic Medicine 23 (3), 278-284) showed a significant reduction in hospitalizations during sick days (38 vs. 75 per 100 patient days) for people who used blood ketone testing compared with urine ketones testing. Staying out of the hospital is a very powerful argument for using blood ketone testing. The second study (Diabetes Technol Ther. 2006 Feb;8(1):67-75) showed that, for patients using insulin pumps, blood ketone testing could identify interruptions in insulin flow faster and more accurately than even blood glucose monitoring and could thus help pumpers prevent DKA better than if they didn't use blood ketone testing.

The Precision Xtra has many features that make it a good choice for glucose testing:

  1. Latest blood strips require 0.6 microliters and produce results in 5 seconds
  2. You can touch the test strip without contaminating it
  3. End or top fill glucose test strips
  4. If the blood sample doesn't look like it's enough, you can apply more blood to the same test strip within 5 seconds
  5. The meter will report "EXPIRED" if you load an expired test strip

These features make it well suited for use by kids, who often forget to adhere to "rigorous testing procedures." And, because the test strips can be handled without contaminating the test, the usual concern about the difficulty little kids have opening foil wrapped strips does not apply. They can practically wrestle the strip open and it will still work.

Precision Xtra Rating

  • Ease of use: 10
  • Features: 10 (blood ketone testing; alternate site; 450 memories; 7, 14, and 28 day averages; data port; two AAA batteries)
  • Speed of results: 10 (5 seconds glucose, 10 seconds ketones)
  • Suitability for use by children under ten years old: 10
  • Suitability for use by children over ten years old: 10
  • Cost: 1 (about US$89 per 100; $1,940/year at 6 tests/day; ketone strips priced at about $30 for eight)
  • Overall Rating: 54

About Blood Ketone Testing

Just as blood glucose testing proved to be superior to urine glucose testing, so too is blood ketone testing proving to be better than urine ketone testing. Ketones appear first in the blood, then in the urine after being cleansed by the kidneys. Thus the body has been producing ketones for a while before you can detect them in the urine.

Ketones in the blood can be detected well before ketones in the urine be detected, offering you the opportunity to treat sooner than you would if you waited for urine testing. (Have you ever tried to make a three year old pee on command?) Also, being able to test with a finger stick eliminates the need to find a bathroom to test if you're away from home. (How many of you carry urine ketone strips when you're out shopping or at an amusement park? And if you do, do you like the thought of peeing on a strip in a filthy public bathroom?)

The latest blood ketone test strip, available in the summer of 2006, requires only 1.5 microliters of blood (70% reduction from the previous strip), produces results in 10 seconds compared with 30 seconds for the previous strip, and has both top fill (as before) or end fill capability. The new product packaging has ten ketone strips instead of eight. Also, the new strip can be used with any Precision Xtra, including older models.

Regardless of the meter you use for blood glucose monitoring, everyone who uses insulin should have a Precision Xtra for blood ketone testing.

Blood Ketone Measurements

If you're used to using urine test strips to check for ketones, the following chart can help you interpret the results of the Precision Xtra's blood ketone test results:

Blood Ketone Reading Indications
Above 1.5 mmol/l
Readings above 1.5 mmol/l indicate that you may be at risk for developing diabetic ketoacidosis (DKA). Contact your healthcare provider immediately for advice.
0.6 to 1.5 mmol/l
Readings between 0.6 and 1.5 mmol/l may indicate the development of a problem that may require medical assistance. Follow your healthcare provider's instructions.
Below 0.6 mmol/l
Readings below 0.6 mmol/l are in the normal range.
Source: Precision Xtra documentation

The following studies discuss blood ketone testing:

For more information about blood ketone testing and sick day management, see

Blood Ketone Strip Ordering Information

If you are having problems getting the blood ketone strips, the NDC code is 57599-0745-01 and the UPC code is 0-93815-70745-5. Give that information to your local pharmacist to help with the order. Abbott Diabetes Care also has a list of stores that carry their diabetes care products. ADC also reports that Precision Xtra blood ketone strips are widely available at Wal-Mart pharmacies across the United States.


Meter Image
The new Precision Xtra meter shown between the FreeStyle Flash (left) and original Precision Xtra (right). The new Xtra meter is not only smaller, but is half the weight (just over 1.5 ounces). Click for a larger image.

Meter Image
The Precision Xtra with the very latest blood glucose test strip. Click for a larger image.

Meter Image
Product packaging for the older ketone strip (pre June 2006).
UPC code 0-93815-98815-1
NDC code 57599-8815-8
  Meter Image
Product packaging for the new ketone strip (June 2006).
UPC code 0-93815-70745-5
NDC code 57599-0745-1
Logo   Abbott Diabetes Care
1360 South Loop Road
Alameda, CA 94502
(510) 749-5400

Last updated September 22, 2007

The reviews of products are the opinion of children with DIABETES. Each product is reviewed with a single purpose: to determine if the product is suitable for use by children with type 1 diabetes, their parents, and, to a lesser degree, adults with type 1 diabetes. There are many products aimed at adults with type 2 diabetes that are not appropriate or suitable for children or adults with type 1 diabetes.

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