Diabetes care

Glucose Meter Error Codes: What ER4, E-4 and Other Errors Mean

Diabetes

ER4, E-4 and similar codes don’t mean the same thing on every glucose meter: each manufacturer numbers its own errors. On many meters, a code in this range points to a problem with the blood sample or strip, such as too little blood, blood applied too late, or a used or damaged strip. Retest with a new strip and a full drop of blood, then check your meter’s manual or helpline for the exact meaning.

By Dr. Ema HudsonUpdated: October 20264 min read

Illustration: Glucose meter error codes – Canfora Medicine Guide

The short answer

  • No universal code list: “E-4” on one brand and “ER4” on another can mean different things. The manual’s “error messages” page is the authority.
  • Most common causes: not enough blood, blood added after the strip timed out, a used or damp strip, the strip removed during the test, or the meter too hot or cold.
  • First fix: new strip from a closed vial, wash and dry hands, form a full round drop, apply promptly, keep the meter still until the result shows.

What meter errors usually point to

Manufacturers group errors into a few families. The numbers differ, but the fixes are similar.

Family What the meter detected What to do
Sample errors Too little blood, blood applied too late, sample applied twice, or blood on the wrong part of the strip New strip; bigger drop; touch the drop to the strip’s edge or tip as the manual shows; don’t add more blood to the same strip
Strip errors Strip used, wet, damaged, expired, inserted wrongly or the wrong type for this meter New strip from a vial that has been kept closed; check expiry and the “discard after opening” date
Strip removed early Strip moved or pulled out during the countdown Retest and keep the meter still
Temperature Meter or strips outside operating range (often about 10–40 °C) Leave both at room temperature for 20–30 minutes, then retest
Meter/electronic faults Internal fault, low battery, damaged port Change the battery; if the error persists, call the helpline (number on the back of the meter)
HI / LO Glucose above or below the meter’s range (often >33.3 or <1.1 mmol/L; >600 or <20 mg/dL) Retest immediately; act on it if confirmed (see below)

HI or LO is not a fault code. If a retest confirms “LO”, treat for hypoglycaemia at once (15 g fast-acting glucose, recheck in 15 minutes). If it confirms “HI”, check ketones if you can and contact your diabetes team or emergency services, especially with vomiting, abdominal pain, fast breathing or drowsiness.

A step-by-step retest

  1. Wash hands in warm water and dry them completely (sugar on fingers, hand cream and wet skin all cause errors or false readings).
  2. Take a new strip, close the vial straight away, and insert the strip fully the right way round.
  3. Wait for the “apply blood” symbol.
  4. Lance the side of a fingertip; let a full, round drop form without squeezing hard.
  5. Touch the drop to the strip’s sampling edge and let it draw the blood in until the meter beeps.
  6. Keep the meter flat and still until the result appears.

If the same error appears with two or three fresh strips, run a control-solution test. If that also fails, the meter or strip batch is likely faulty: contact the manufacturer, who usually replace meters free of charge.

When readings don’t match how you feel

Even without an error message, a reading can be wrong. Under the ISO 15197:2013 standard, a meter may read up to 15% above or below the lab value (above 5.6 mmol/L or 100 mg/dL) and still pass. Readings can also be affected by low red-cell counts (anaemia) or high counts, dehydration, very high vitamin C doses with some strips, and testing on alternate sites while glucose is changing. If a result doesn’t fit your symptoms, wash your hands and retest from a fingertip. More on testing accurately is in the diabetes care guide.

Frequently asked questions

What does E-4 mean on an On Call meter?

On Call models differ, so check the error table in your model’s manual or the ACON/On Call support site. In general, codes in this range are sample or strip problems; retest with a new strip and a larger drop.

What does E04 mean on my glucose meter?

On several brands, E04-type codes indicate a sample or strip problem (for example too little blood or a used strip). Because meanings vary, confirm with your meter’s manual.

Can I reuse a strip after an error?

No. Strips are single-use; once blood or moisture has touched one, use a new strip.

Do cold strips cause errors?

Yes. Strips and meters left in a cold car or near an air conditioner often give temperature errors. Let them warm to room temperature first.

Date, time and memory resets are covered in how to reset a glucose meter.

More on this topic: testing accurately and the main diabetes medicines are covered in Diabetes Care: Glucose Meters, Diabetes Medicines and GLP-1 Pens.

Medical disclaimer: this article is general information, not a diagnosis or a personal recommendation. Check with your doctor or pharmacist before starting, stopping or combining medicines. Read the full disclaimer.

Back to the diabetes care guide