The strips where you drop blood contains chemicals that react with glucose. Once blood hits it, it gets activated and starts to react with the glucose in your blood. These chemical reactions generate energy and also forms a new product.
Depending on the device, it either quantifies the energy generated which is proportional to the glucose in your blood, or it quantifies the products produced which is also proportional to the glucose in your blood. It makes small calculations based on this information to obtain the blood glucose level.
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