”Mao sugar ah, I am not too measured, every day to tie the finger 4-5 times, and painful and costly.” As an endocrinologist, I often hear such complaints from diabetic patients.
”Self-monitoring of blood glucose is one of the principles of the “five horsemen” of diabetes treatment, and measuring capillary blood glucose (gross glucose for short) is a quick and easy way to achieve self-monitoring. However, too frequent or incorrect measurement is not only painful to the fingers, but also a waste of expensive test paper, and sometimes misleading. So, what exactly is the point of measuring “gross sugar” and what do we need to pay attention to?
Question 1: Which finger should we really test? Is there any difference between them?
There is no difference between the blood glucose measured by the left and right hand or five fingers. You should try to choose the fingers that have less activity, low probability of infection, light pain and affect daily life, such as ring finger, middle finger and little finger. The most flexible, sensitive and most used thumb and index finger should be avoided as much as possible.
Question 2: For patients who need to monitor blood glucose for a long time, how can we avoid finger soreness? How should the fingers be arranged?
The nerve endings that feel pain are distributed in the epidermis. As long as the speed and depth of crossing the epidermis is fast enough, the pain can be effectively reduced. Therefore, it is recommended to choose a blood glucose meter that requires a small amount of blood and a needle that can be adjusted for depth and “force”. It is recommended that the needle be used “disposable”, as multiple use will blunt the needle and increase pain, and is prone to infection. In addition, tightening the skin at the site of the needle so that the needle moves more quickly in and out of the skin can further reduce pain.
Selecting the sides of the fingertip for blood collection has a richer blood supply and few sensory nerve endings, making it easier to bleed and less painful. In addition, taking turns to collect blood from the finger in a certain order and time period can reduce the probability and number of repeated needle sticks.
Question 3: What do I need to pay attention to when cleaning and disinfecting my finger for blood glucose testing?
If the finger is broken, infected, scarred or has a rash, do not choose this finger for the time being.
Alcohol disinfection is the most common method. However, long-term use can cause dehydration, dryness and roughness of the finger skin and the formation of calluses, causing inconvenience in future blood collection. Finger blood collection, wash with warm soapy water can effectively prevent infection and remove impurities on the finger containing sugar that affect the accuracy of the results. In addition, warm water promotes blood circulation and better blood filling of the fingers. Regardless of the method of cleaning, it is important to wait for the skin to dry before collecting blood to avoid affecting the accuracy of the results.
Keeping the fingers moisturized after blood collection with a hand cream or an ointment for diabetic hand and foot protection can reduce the development of calluses. In case of redness, swelling and pain in the finger, be alert to the occurrence of infection. Antibiotic ointment can be applied and bandaged. If there is no relief after simple treatment, please seek medical attention promptly.
Question 4: If there is not enough blood in the finger after the blood glucose needle is stuck, can I squeeze my finger? What is the correct way to do it?
Repeatedly, forcibly squeezing the finger will cause a large amount of tissue fluid to be mixed into the blood, which will contaminate or dilute the blood specimen and affect the accuracy of the results. The recommended practice is to drop the arm to fill the fingertip with blood before the blood is collected, and after the needle is inserted, gently push upward on both sides of the finger from the root to make a “small drop” of blood emerge from the wound site.
In addition, the finger can also be filled with blood by the following methods.
(1) Before measuring blood glucose, massage the finger area where the needle is to be inserted from the root to the tip 5-6 times to make it warm and engorged, and lower the arm so that it is below the level of the heart to better engorge the blood.
(2) Shake your arm like a thermometer to fill your fingertips with blood.
(3) Tie a rubber band around the middle knuckle of the finger to be tested to allow the fingertip to fill with blood. Loosen the rubber band after tying to allow the blood to flow.
In addition, I would recommend that patients can gently swab the first drop of blood after collection with a cotton swab, as the first drop of blood often contains more tissue fluid, which may also affect the results.
Question 5: Is there anything else I can do for patients who have been monitoring their blood glucose for a long time and whose fingers are already sticking out?
In addition to the practice of rotating the finger we mentioned in the previous section, there are now some blood glucose meters that can take blood glucose readings from other parts of the body, such as the arm and thigh. However, blood glucose monitoring in these areas is not suitable for everyone. On the one hand, some people find it more difficult to tie bleeding in the arm or thigh. On the other hand, sugar lovers should know that when blood glucose fluctuates a lot, the blood glucose results measured by the arm, and thigh are often inaccurate. For example, if you want to measure blood sugar after meal, when you feel hypoglycemia, after short-acting insulin application, or after a lot of exercise, it is better to use your finger to collect blood. In this regard, each blood glucose meter is different, so you need to check the manual of your own blood glucose meter for specific details.
Of course, the most important thing is not to forget to record or input the blood glucose into the insulin pump after taking a good blood glucose test, so that your doctor can better understand your blood glucose control. If you have extremely high or low blood glucose, be sure to report it to your doctor and have some knowledge of self-rescue. As for measuring finger glucose, everyone has their own different experiences. What works for one patient does not necessarily work for others. I hope this article can help sugar lovers to solve some confusion and find out the suitable method of blood glucose measurement for themselves.