At one session I asked her what was going on when she had the 37mg/dl blood sugar. She replied that she had forgotten to test before she left the house after lunch, and was driving down the road when she remembered. She tested and was 37 mg/dl. I asked her, “Were you having low symptoms?” and she said, “No.” I then cautioned her about the low and testing while driving. That was when she said, “I test on my arm and it is easy to drive and test.” Alternate site testing was not working for her. The next two weeks I had her test only on her fingers, the blood sugars became more consistent and she did not report any more low readings.
Every person with diabetes using insulin or a sulfonylurea drug which can cause hypoglycemia should be reminded to test every time they get behind the wheel to drive; to never test on alternate sites before driving; and to test only on the fingers.
I now ask all clients with wide variations in blood sugars what sites they use to test and caution them to not use alternate site testing if their blood sugars are unstable. We need to take the time to explain which sites are best with blood sugar testing to clients newly diagnosed as well as to those who have had diabetes for a long time. Testing should be consistent and the site should be consistent.
Lee Ann Griffin, RN, CDE
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