Test Your Knowledge #537: A 24-year-old woman who has had Type 1 diabetes mellitus for 15 years...
A 24-year-old woman who has had Type 1 diabetes mellitus for 15 years was switched to an intensive insulin regimen that used an insulin pump 4 months ago. She has self-monitored her blood glucose 8 to 10 times daily since initiating continuous subcutaneous insulin infusion therapy. Her hemoglobin A1c value has decreased from a pre-pump level of 7.8% to 6.1%. She has at least four to six episodes of mild hypoglycemia weekly.
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She recently switched to a meter that allows her to self-monitor blood glucose using her forearm (alternate-site testing) because she plays the guitar professionally and has had considerable fingertip discomfort since increasing the frequency of self-monitoring.
Which of the following should the patient do to safely use her forearm for self-monitoring blood glucose?
A. Rub the forearm site prior to testing.
B. Repeat a forearm blood glucose assessment within 10 minutes if the first value is less than 60 mg/dL (3.33 mmol/L).
C. Use the fingertip or palm for monitoring if hypoglycemia is suspected.
D. Use the upper arm for monitoring if symptoms of hypoglycemia are present.
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