Alternative Site Testing

• Introduction
• Why Is Alternative Site Testing Less Painful?
• Where Can I Test Using A FreeStyle Meter?
• When Is Testing On The Finger Preferred?
• How Do I Perform An Alternative Site Test?

Introduction

Self-monitoring of blood glucose is an important part of the treatment plan for people with diabetes. It helps you develop your individual blood glucose profile, so you and your health care team can plan your particular diabetes management regimen. It provides you with the ability to make day-to-day treatment choices with meals and physical activity as well as with oral agents and insulin, and it helps you recognize and understand the effect of lifestyle and diabetes medication on your diabetes control.¹

More frequent self-monitoring has been associated with better glucose control, regardless of the diabetes type or therapy.² However, barriers to frequent testing include the pain associated with the required finger stick along with the accumulated trauma to the fingers. With FreeStyle® meters you can enjoy the benefits of Virtually Pain-Free Testing and the flexibility of the most test sites available through alternative site testing.³ The term alternative site testing (AST) means using parts of the body other than the fingertips to obtain blood for blood glucose testing.

Why Is Alternative Site Testing Less Painful?

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Your fingertips are full of nerve endings (receptors), which make the fingertips feel pain more readily. Other body sites such as the forearm have fewer nerve endings per square inch than the fingertips, thus resulting in less pain. This can make alternative site testing with FreeStyle® meters Virtually Pain-Free. A 2004 US diabetes patient market study showed that of patients who tested using alternative sites, seven in ten believe alternative site testing to be less painful.4 This graphic shows the concentration of nerve endings (receptors) in the fingertips vs the forearm. Alternative site testing with FreeStyle® meters offers the most test sites available and gives those who have occupations or hobbies that require extensive use of their fingers another option to fingertip testing.3

Where Can I Test Using A FreeStyle Meter?

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When using a FreeStyle® meter, a blood sample test can be performed on the fingertips, forearms, upper arms, thighs, calves, and hands.3 However, it is always best to consult your health care professional for acceptable sites for your testing needs.

When Is Testing On The Finger Preferred?

It is important to note that when your glucose is changing rapidly, there may be a difference in the glucose readings between your finger and other test sites, like the forearm, upper arm, thigh, calf, and other areas of the hand. Differences in blood glucose measurements between the other test sites and your finger many be observed after eating, insulin medication, or exercise. Because blood flow to the finger is three to five times faster than other alternative sites, blood samples from the finger may show changes in your glucose sooner than the forearm, upper arm, thigh, calf, and other parts of the hand. The possible difference in glucose readings between the finger and other alternative sites could delay your detection of hypoglycemia. Vigorous rubbing of the alternative test sites before lancing will help to minimize the difference between finger and other alternative site test results.³

Testing On The Finger Is Recommended:

• If you think your blood glucose is low (hypoglycemia). Blood glucose that is too low must be treated right away. If you have symptoms such as weakness, sweating, nervousness, headache, or confusion, follow your doctor's recommendation for treating hypoglycemia.
• If you have a history of hypoglycemia unawareness (no symptoms when your blood glucose is low).

How Would I Know If I Have Hypoglycemia Unawareness?

• Have you often obtained blood glucose readings below 4 mmol/L without any of the usual symptoms of hypoglycemia (sweating, tremors, rapid heartbeat, nervousness, extreme hunger)?
• Have you had episodes of impaired thinking?
• Have others observed you in situations where you appeared pale, tired, confused or acting as if you were in "slow motion"?
• Have you acted irritable or forgetful, even though you physically felt fine?
• Have you had difficulty managing a hypoglycemic episode, which required the assistance of others?
• Have you ever had a seizure or loss of consciousness without any warning signs?
• Do you try to maintain very tightly controlled blood sugars (often readings running below 7 mmol/L)?
• Have you had frequent episodes of hypoglycemia?
• Have you had diabetes over 20 years?
• Have you had a recent episode of severe hypoglycemia?

If you answer yes to any of these questions, please discuss this situation with your physician.

How Do I Perform An Alternative Site Test?

The following graphic shows the general steps involved in forearm testing.

• First, you vigorously rub the area until it's warm to increase blood flow to the surface.
• Second, you lance the arm.
• Third, you touch the test strip to the blood drop. It's that easy.

For more information on how to perform a blood glucose test, please refer to your user's guide.

References:

1. Benjamin, EM. Self-Monitoring of Blood Glucose: The Basics. Clinical Diabetes, 20, #1, 45-47, 2002
2. Karter, AJ et.al., Self-Monitoring of Blood Glucose Levels and Glycemic Control: The Northern California Kaiser Permanente Diabetes Registry. The American Journal of Medicine, 111, #1, 1-9, 2002
3. If you are using an Abbott Diabetes Care meter, when testing for hypoglycemia or if you have hypoglycemia unawareness, we recommend testing on the finger only.
4. 2004 NOP World Roper Consumer Study.