April 27, 2014

Alternate Site Testing

I have blogged about alternate site blood glucose testing and that would be this blog. I admit I don't like to blog about this, as there are too many people that then use these sites and not their fingers when they are having hypoglycemia. I therefore suggest that the following warning should be followed if you are on insulin or oral medications that can cause hypoglycemia. WARNING - Always check from your fingers when blood sugar may be changing:
  • Following a meal, when blood sugar is rising quickly
  • After exercise
  • Whenever you think your blood sugar might be low or falling

Alternate site testing should only be used when blood sugar is stable:
  • Immediately before a meal
  • When fasting
  • Near bedtime

Important alternate site testing notes:
If you're considering alternate site glucose testing, please remember:
  • Never ignore the symptoms of low or high blood sugar.
  • If the results of a blood glucose test don't match the way you feel, confirm with a finger tip test. If the finger tip result still doesn't seem to reflect the way you feel, get in touch with your healthcare professional.
  • Please talk to your healthcare professional before using sites other than your finger tip side areas for testing blood sugar.

Always remember when you read finger tips that many people for some reason forget that there are more nerves in the finger tips and sole of the fingers. That is the reason it is necessary to say the side of the finger tips.

I very seldom use an alternate site because I use insulin and prefer the now factor in my test results. Most of the alternate sites are shown in the image below. Even though they title the image as alternate site testing areas, I am not sure why they list finger tips too. The second image down also shows the finger tips. You have the right to experiment, but many people have the problem of excess pain on the finger tips.
Image above courtesy of Abbott Diabetes Care



Like most sources say – talk to your doctor before using alternate-site testing and please, please ignore the television ads that say you don't need to test on your fingers anymore. All they are doing is taking advantage of people that don't stay in touch with their doctors and basically do little talking during an appointment. My endocrinologist did ask me about some of the TV ads about alternate-site testing and I explained that was a fabrication as far as I could tell and I would not test there because I am on insulin. The doctor thanked me for that and said he had two patients that had fallen for the TV ads and wanted prescriptions for the test strips. Both were on insulin he stated and one was a type 2 and the other a type 1.

You should never use results from an alternative sampling site to calibrate a continuous glucose monitor (CGM), or in insulin dosing calculations.

If you are a person with type 2 diabetes that is well managed and you wish to try alternate-site testing, talk with your doctor and read this article from Diabetes-in-Control.  Remember that you can have pain using the alternate sites.

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