IMPORTANT
TECHNIQUES FOR MEASURING BLOOD SUGARS
Many instruction books give
inadequate instructions for preparing the finger or getting
the blood to the strip. The following are my techniques. They
aren’t based on something I learned in medical school
or read in a medical journal. They’re the ones I use
on myself every day. I’ve been measuring my own blood
glucose levels for more than thirty years and have performed
more than 90,000 measurements.
If you’ve handled glucose
tablets or any food since last washing your hands, wash them
again. Invisible material on your fingers can cause erroneously
high readings. Certainly wash your hands if they are soiled.
If you are sitting in a car or some other place where you
cannot wash your hands, lick the appropriate finger and dry
it on a handkerchief or clothing Don’t wipe your fingers
with alcohol this will dry out the skin and can eventually
foster the formation of calluses. Neither I nor any of my
patients have developed finger infections by not using alcohol.
Unless your fingers are already quite warm, it may be necessary
to rinse them under warm water. Blood will flow much more
readily from a warm hand.
Lay out all the supplies you will need at your work area.
These usually include a finger-stick device loaded with
a lancet, your blood glucose meter, a blood glucose test strip,
and a tissue for blotting your finger. If you have no tissue,
just suck off the blood. Insert a disposable test strip into
your blood sugar meter. (Some test strips are supplied in
individual foil packets. The accompanying instruction booklet
may tell you not to handle the strips directly but always
to hold them in the foil This assumes that your hands are
always dirty which is absurd, since they must be clean for
an accurate result.)
Most spring-activated finger-stick devices are depth adjustable
or come with two covers for the end that touches your finger
Usually the light-colored cover is for thin or soft skin,
while the darker cover is for thick or callused skin To get
a shallower puncture, use the thicker cover. To get a deeper
puncture, use the thinner cover. An even deeper puncture may
be obtained by strongly pressing your finger against the lancet
cover. A very shallow puncture may be obtained by barely touching
the fingertip to the cover. The pressure of the finger on
the cover determines how deep the puncture will go. It should
be deep enough to provide an adequate amount of blood, but
not be so deep as to cause bruising or pain. Contrary to common
teaching, the best sites for pricking fingers are actually
on the back of the hand. Prick your fingers near the nails,
or between the first and second joints (not over the knuckles),
as shown by the shaded areas in Figure1. Pricking these
sites should be less likely to cause pain and more likely
to produce a drop of blood than will pricking your fingers
on the palmar surface face of the hand. You will also be free
from the calluses that occur after repeated punctures on the
palm. If you find it repugnant to prick the dorsum (back)
of your fingers, use the sites on the palmar surface illustrated
in Figure 2. As you will not be sharing your finger-stick
device, you need not discard the disposable plastic lancets
with the metal point after every finger stick It is a good
idea to discard them once a month, as they do eventually become
dull.
Fig 1. Sites to prick on
the dorsal Fig 2. Sites to prick on the palmar
surface of your fingers surface of your fingers
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My patients and I are much
indebted to Mr. Ron Raab of the International Diabetes Institute
of Caulfield, Australia, for this not-so-obvious dorsum technique.
Mr. Raab’s attempts to publish this important finding
were repeatedly scorned by medical journals and finally came
to my attention via personal correspondence. I use Mr. Raab’s
technique myself and find it far superior to the palmar technique,
which I also use. By the way, this technique was in common
use by physicians seventy years ago. Like so many things in
medicine, it had to be rediscovered.
--------------------------------------------------------------------------------
5. Prick any finger. Over
a period of time, you should use all the fingers of both hands.
There is no reason to prefer one finger to the others. Squeeze
the finger (use a rhythmic action rather than steady pressure)
with the opposite hand until the drop of blood is about 1/16th
inch (2 mm) in diameter. If flow is inadequate (see below),
perform a deeper finger stick.
Touch the drop of blood to the proper point on the test strip.
Most meters will start an automatic countdown as soon as the
strip has absorbed enough blood The countdown, in seconds,
appears on the display screen and concludes with the appearance
of your blood glucose value. If your meter has a timer button,
press it immediately after applying blood, without delay,
do not stop to examine the strip in order to determine whether
or not you have applied enough blood (This comes later). Since
the accuracy of the test usually depends upon the timing,
the delay between applying the blood and pressing the button
should be no greater than 1 second.
Once the timer has started, you may examine the strip to make
sure it is adequately covered or filled with blood. If it
is not, discard the strip and start again.
If you get a little blood on your clothing, rub on a few drops
of hydrogen peroxide with a handkerchief. Wait for the foaming
to stop. Then blot and repeat the process. Continue until
blood has disappeared. This works best while the blood is
still wet.
If you are measuring someone else’s blood sugars, use
a fresh lancet each time, and wipe off the end of the finger-stick
device with fresh bleach after each use. It is possible to
transmit serious infectious diseases from one person to another
via finger sticks.
The entire process, from pricking the finger to a final reading,
takes as little as 25 seconds, and rarely more than 2 minutes.
Richard K. Bernstein, M.D.,
F.A.C.E., F.A.C.N., C.W.S.
Artwork by Terry Eppridge
The above was abstracted from
Dr. Bernstein’s book “Diabetes Solution”.
To view other advice from
Dr. Bernstein go to
http://www.diabetesincontrol.com/bernsteinarchive.htm
For Information on Dr. Bernstein’s
book “Diabetes Solution” go to
www.rx4betterhealth.com or visit Dr. Bernstein’s
site at http://www.diabetes-normalsugars.com
for excerpts.
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