Painless self-monitoring of blood glucose at finger sites.

INTRODUCTION

Skin punctures at alternative sites can reduce the pain associated with self-monitoring of blood glucose (SMBG). However, delays in detection of blood glucose at alternative sites during rapid systemic blood glucose change have been reported. Accordingly, we developed a novel method of finger pricking and tested it to see if it would both reduce or eliminate pain and accurately reflect systemic glucose levels, even during rapid changes.

METHODS

Each of 35 healthy volunteers (10 females and 25 males; mean age 36.6 years, range 18-82 years) received 5 serial punctures from a lancet device on randomly selected fingers. The puncture target was the dorsal side of the finger between the nail and the distal finger joint. We used a lancet device designed for accurate punctures of 0.2, 0.3, 0.4, 0.5 and 0.6 mm depths. Immediately afterward, as a control, a conventional fingertip puncture was done on the front of a 6th finger. After each puncture, subjects were asked whether or not they felt pain.

RESULTS

Following punctures at depths of 0.2 mm and 0.3 mm, respectively, 31 of 35 subjects (89%) and 33 of 35 subjects (94%) felt no pain. Following conventional punctures, all 35 subjects (100%) felt pain. Blood sample volumes> or =2microL were obtained in all cases except for two punctures at 0.2 mm depth. Blood glucose levels did not differ with differing puncture sites, (conventional fingertip sites vs. alternative sites used in this study).

CONCLUSIONS

Our findings demonstrate that 0.2 and 0.3 mm punctures at our alternative finger site - the dorsal side of the finger between the nail and the distal finger joint - can provide blood samples sufficient for SMBG, substantially redu-ces the proportion of subjects who experience pain, and accurately reflects systemic glucose levels.