Less-Ouch Blood Sugar Tests
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Tips for "less-ouch" finger pricks
If you fret over the momentary "ouch" that can come with lancing a drop of blood, you're not alone. It's natural to fear the finger prick.
But new lancing tools have made getting that important blood sample easier on the fingers. We show you top tips for easing the pain of finger pricking.
Use a Lancing Device
Lancing devices, which hold lancets, help you get an adequate blood sample with a tiny skin puncture and minimal irritation. Typically, a lancet is placed in the device and set for use by pulling back on a spring-loaded control or by pushing a plunger. The lancet is hidden, and you push a button to get the blood drop.
To use a lancing device:
1. Load a new lancet and set the device by pulling back on the spring-loaded control or by pushing the plunger.
2. Place the lancet end of the loaded device on the finger.
3. Push the button that fires the lancet. The device is less likely to wiggle than a handheld lancet, so the tiny prick is swift.
Most meters come with lancing devices. If you need a replacement device, consider:
Health-plan coverage: To save money on supplies, check if your provider covers only specific brands and quantities of lancing devices and lancets.
Size: Many are conveniently small, such as the Stat Medical Devices Qwik-Let Ultimate, which is just over 3 inches long. Look for one that will easily fit in your diabetes supply case.
Depth adjustments: Many lancing devices offer different settings to adjust how deeply the lancet penetrates the skin.
Ease of handling: Try ergonomic devices such as Bayer HealthCare's Microlet Adjustable Lancing Device or Owen Mumford's Autolet Impression.
Safety: Check how easy it is to remove used lancets from the device. Some eject the lancet with the push of a button. Some lancing devices have cartridges with preloaded lancet drums so you don't have to handle individual lancets. Ask your doctor if you can try a lancing device in the office before purchasing.
"I recommend that my patients try the lancing devices we have in our office to decide which device feels right for them," says Jeff Miller, M.D., an endocrinologist in South Carolina. Ask your doctor if you can do the same before you purchase one.
Choose the Right Lancet
Lancets, the small needles that fit into lancing devices, come in several thicknesses or gauges. A higher gauge number means a thinner lancet tip, which is usually less painful. For example: A 30g lancet would likely be less painful than 28g, but getting enough blood for your test might be more difficult with the thinnest lancets. The thinnest lancets are 33g.
Test the Side of Your Finger
Testing on the side rather than the pad of the fingertip is generally more comfortable. There are fewer nerve endings on the sides, and you'll protect the sensitive tips of your fingers. "When I complained to the counselor at my diabetes center that my fingers were getting sore, she said to use the sides of my fingers," says Casey Vanshie, PWD type 2.
Some lancing devices and blood glucose monitors allow you to sample blood from alternate sites, such as the forearm or abdomen. But testing from the fingertips is still the most accurate, especially when blood glucose levels are rapidly changing. "If people are experiencing low blood sugar, they should use a finger-stick test because it gives the best measure," says Jeannee Diaz, R.D., L.D., CDE, CPT, of Humphreys Diabetes Center in Boise, Idaho.
Get a Good Sample on the First Try
Prepping your fingertip to get a good sample means you'll avoid painful squeezing and the need for another prick.
Check out these tried-and-true tips from Shirley Ann Confer, PWD type 2, for getting a good sample from your fingertip:
- Make sure your fingertip is warm, not cold.
- Before cleaning your fingertip with soap and warm water, vigorously shake your hands to get blood to the tips.
- Rub your finger in a "milking" motion when cleaning your fingertip.
- Choose a setting on the lancing device that you find comfortable.
- Place the finger on a sturdy surface. "I flinch away from the lancet otherwise," Shirley Ann says.
Use a New Lancet Each Time You Test
Minimize pain by using a new lancet each time you test, which is what manufacturers and many practitioners recommend.
Despite this guidance, diabetes educators say many people choose to reuse lancets, either because it saves money or is more convenient.
Tiphani Martinez, R.D., L.D., CDE, of the Minnesota Center for Obesity, Metabolism, and Endocrinology in Eagan, Minnesota, offers these lancet tips:
- Discard lancets as soon as they start to get dull. A dull lancet will hurt more.
- If you reuse lancets, it's even more important to wash your hands with soap and water before testing.
- If the lancet touches anything other than your finger, throw away the lancet.
To dispose of used lancets, Martinez advises people with diabetes to collect them in a heavy-duty plastic or metal container with a tight-fitting lid, such as an empty laundry detergent bottle. Then check with your trash collector to find out if the container can be thrown in the trash or if it must be taken to a special collection site.
Use a Lighter Setting
A deep lance will take longer to heal (the black dots are tiny scabs). Try using a lighter setting, but prepare your finger by rubbing or shaking it first so you get a good drop of blood. Make sure your fingers are warm.
To avoid overstressing your fingers, check your lancing device -- are you using a deep setting? To denote the depth at which the needle will pierce the skin, some devices use numbers and others use marks. If numbers are used, 1 is most commonly the shallowest depth and the highest number is the deepest. If marks (lines, circles, or dashes) are used, the biggest or longest mark denotes the deepest skin pierce.
You want a setting that provides a large enough blood sample without having to squeeze your finger. Squeezing may alter the composition of the sample and make your result less accurate.
Keep Track of Finger Pricks
Rotate the sites of your finger pricks so you don't overstress one area of your finger. To make sure you adequately rotate lancing sites, outline your hand on a piece of paper. Place a dot on the outline to mark your most recent lancing site. The next time you lance, choose a different spot.
Some Diabetic Living readers have told us they like to hit two or three spots on the outside of a finger, then two or three on the inside before moving to the next finger.
Casey Vanshie, PWD type 2, eliminates sore fingers by rotating where she pricks each finger. Check out her suggestions:
- Start by using a spot on the inside of one of your fingers.
- The next time, use the same finger and same side but a different spot.
- Then move on to the next finger, using the inside of that one in two different spots.
- Once you have used all fingers, do the same thing using the outside of each finger.
"Your fingers will be less calloused," Casey says.
Test an Alternate Site
Give your fingertips a break and try an alternate testing site, such as your upper arm, forearm, thigh, or base of your thumb (the soft part of your palm).
Alternate testing sites can be less painful to prick because they have fewer nerve endings. Your lancing device should have a clear cap to use with alternate sites.
What you should know before testing from an alternate site:
- Not all glucose meters can use blood from alternate sites, so only test from sites that are identified in your meter's instructions.
- Avoid using alternate sites when glucose levels are quickly changing, such as after a meal or workout, after taking insulin, or when you're sick or stressed.
The U.S. Food and Drug Administration suggests drawing blood from a fingertip rather than an alternate site if you think your blood glucose is low, you don't regularly have symptoms when your blood glucose is low, or how you feel doesn't match the results from the alternate site.
Basic steps for testing an alternate site:
- Replace the lancing device cap with the clear cap. (Don't use a clear cap when testing at the fingertip.)
- Choose a fleshy area from your meter's approved testing sites.
- Increase the blood flow by rubbing the testing area before lancing.
- Press the lancing device clear cap against the site and fire the lancet.
Let your health care provider know if you regularly test on alternate sites.
Apply Oil to Sore Fingertips
Frequent lancing can lead to sore fingertips. Consider applying tea tree oil to your fingertips twice a day to ease the pain, suggests Virginia Zamudio Lange, R.N., M.S.N., CDE.
Why it works:
The terpenoids in oil from the Australian tea tree (Melaleuca alternifolia) have antiseptic properties that can help your skin heal.
Where to find it:
The oil is sold over the counter at most pharmacies, and you can find some brands online.
Tip for use:
The smell of the tea tree oil can be pungent. For less mess, use a cotton swab to apply it to your fingertip. Avoid touching your eyes or face after application.
Lower Your Blood Sugar
Now that you are able to do the finger prick less painfully, it's time to make sure your glucose readings are in your healthy range. Here are some quick tips to help you lower your blood sugar.
Tips to Lower Blood Glucose
You can achieve lower blood glucose numbers! And doing so can help you live a happier, healthier life with diabetes. Feel better and reduce your risk of diabetes complications when you lower your blood sugar levels to your target range. We can help you get there.