Today's handy hint
How to save your fingertips
While fingertip testing is one of the greatest advances in diabetes self-management, one of the next-greatest seems to be the ability to not test your fingertips once in a while.
Doctors have been putting a great deal of effort into determining when it's okay-and when it's not to test other areas of the body, including the palm, forearm, upper arm, thigh or calf.1 Here's what you may be wondering, and what they've learned about it...
Is testing on other areas of the body as accurate as fingertip testing?
It depends on the test. For fasting or testing more than 90 minutes after eating, testing on other parts of the body is likely to be as accurate as your fingertip. However, if you've recently eaten or exercised, only your fingertip and palm should be trusted. The readings at your forearm or other sites tend to lag, and can be off by as much as 10 or 20 percent.2 If your blood glucose is well controlled, your doctor may agree that testing other sites is fine, but just for routine tests.
When shouldn't I test a different site?
It's especially important to rely on fingertip or palm results whenever you think your blood glucose may be dropping-which is why those post-meal and post-exercise tests need to be done on a fingertip or your palm.2 You want to be able to identify low blood glucose as soon as possible, so you can treat it. A forearm or thigh test may not give you the heads-up you need.
Does testing on other areas actually hurt less?
When asked to rate the pain associated with various testing sites, more participants rated the palm, forearm or thigh as "low pain," compared to testing on the fingertip. More than half said they'd be likely to use the palm or forearm for future tests.2 Of course, choosing a site comes down to your personal comfort. With your doctor's approval, you might want to try a few places to see what works best for you.
Why does testing other parts of the body hurt less?
It's simple. Your lips, tongue, and fingertips are the most sensitive parts of your body, because they have the greatest concentrations of nerve endings, or receptors. Each fingertip is packed with about 3,000 receptors, each of which is specifically designed to feel pressure, heat, cold or pain. By contrast, your entire torso has only about as many receptors as one hand.3 These dense fingertip receptors allow people to make delicate distinctions-like reading Braille-but they also make it hard to miss a receptor when you test.
Any place else I might want to try?
Well, researchers at the University of Pittsburgh Medical Center found that testing the tip of earlobe can also provide reliable results, but they acknowledged the awkwardness of trying to lance it yourself.4 You'd pretty much have to enlist the help of a friend to collect the blood sample. For now, you'll probably want to stick with the sites listed above.
Can I use my regular meter?
Only certain meters are approved for testing other areas of the body. If you're using an Accu-Chek Perfoma, you can use your meter on an alternate site, as long as you've discussed it with your doctor. And the Accu-Chek Multiclix lancing device works on other sites, if you attach the clear cap first.
1Get the facts about alternate site testing and talk with your doctor before deciding if it's right for you.
2American Diabetes Association. "Clinical Impact of Prandial State, Exercise and Site Preparation on the Equivalence of Alternative-Site Blood Glucose Testing." Diabetes Care 26:981-985, 2003. Available at: http://care.diabetesjournals.org/cgi/content/full/26/4/981?maxtoshow=&HITS=10&hits=10 &RESULTFORMAT=&fulltext=forearm+testing&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype= HWCIT. Accessed May 14, 2008.
3Johns Hopkins University. "The Handy Guide to Touch." Available at: http://www.jhu.edu/~jhumag/495web/touch.html. Accessed May 14, 2008.
4American Diabetes Association. "Alternative Site Testing at the Earlobe Tip." Diabetes Care 27:616-617, 2004. Available at: http://care.diabetesjournals.org/cgi/content/full/27/2/616-a?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&full text=earlobe&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT. Accessed May 14, 2008