Less-Ouch Blood Sugar Tests
Tips for "less-ouch" finger pricks
If you fret over the momentary "ouch" that can come when you prick your finger or an alternate site with a lancet to get a drop of blood, you're not alone. No one enjoys inflicting pain on themselves, even if it’s just a little bit.
New lancets and lancing devices help make getting that important tiny drop of blood a bit easier and less painful. Here are some tips to try.
Using Your Lancing Device
The lancing device, which holds a lancet, helps 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 a tiny drop of blood.
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.
Many meters come with a compatible lancing device the company provides. If you need a replacement device, contact the manufacturer about their replacement policy. Other lancing device considerations include:
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. 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 or devices with easy-to-use features for people with arthritis.
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 health care provider if you can try a lancing device in the office before purchasing a meter and lancing system.
Choose the Right Lancet
Lancets, the small needles that fit into lancing devices, come in several gauges (the thicknesses of the needle). A higher gauge number means a thinner lancet tip, which is usually less painful. For example: A 30g lancet is thinner than a 28g needle. The thinnest lancets are 33g. The thickness of the gauge you use depends on what you need for your skin. The best advice is to try lancets with the thinnest needle first. If you have a hard time getting adequate blood, then try a lancet with a thicker gauge. Talk to your diabetes educator or health care provider if you need help figuring out which gauge is best for you.
Test the Sides of Your Fingers
Pricking 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 about my fingertips being sore to the educator at my diabetes center, she suggested I 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 sugar levels are rapidly changing. "If people are experiencing low blood sugar, they should use a finger-stick test because it gives the most accurate measure," says Jeannee Diaz, RD, LD, 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 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.
• Place the finger on a sturdy surface. "I flinch away from the lancet otherwise," Confer says.
In general, choose a setting on the lancing device that you find comfortable so you’re not adjusting settings for each individual test.
Use a New Lancet Each Time You Test
After multiple tests, needles become dull; manufacturers and many practitioners recommend using a new lancet each time you test.
Despite this guidance, diabetes educators say many people choose to reuse lancets, changing them maybe once a day, for example, either because it saves money or is more convenient.
Tiphani Martinez, RD, LD, 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.
Dispose of Needles Safely
To dispose of used lancets, Martinez tells people to collect them in a sharps container. You can purchase sharps containers or save money by using a heavy-duty plastic or metal container with a tight-fitting lid, such as an empty laundry detergent bottle. To get rid of a full bottle of used diabetes supplies (lancets or insulin needles, if you use them), 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. Do not put them in the recycling. For more information on safe needle disposal, visit safeneedledisposal.org.
Use a Lighter Setting
You want a setting that provides a large enough blood sample with minimal pain. You should not have to squeeze the site to get an ample sample of blood. Start with lighter depth, and increase it if you’re not getting sufficient blood for a test. Prepare your finger by rubbing or shaking it first, and make sure your fingers are warm.
To limit unnecessary pain and ongoing soreness as lancing sites heal, check the depth setting on 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. A deep lance will take longer to heal (the black dots are tiny scabs).
Keep Track of Finger Pricks
Rotate the sites of your finger pricks to limit the amount of pain and soreness your fingertips incur. 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 use 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 become less calloused," Vanshie 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 sugar is low, you don't regularly have symptoms when your blood sugar 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, RN, 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 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.
In general, moisturizing your hands and fingertips with lotion or hand cream can also help keep skin in healthy condition.