The invention concerns a medical hand-held device, in particular blood glucose meter comprising a housing (12) with a cassette compartment (14) for receiving an exchangeable test tape cassette (16), a drive assembly comprising an electric motor (32) and a gear arrangement (40) adapted for rotating a tape spool (20) of the test tape cassette (16), wherein the gear arrangement (40) has a worm drive (52) in which a worm (56) meshes with a worm wheel (58) and a multistage speed-reducing unit (54) comprising several spur gears (60-66) arranged between the worm wheel (58) and an output gear (72) that can be directly coupled to the tape spool (20).