![]() ![]() ![]() ![]() Actually, the BG measurements used for evaluation are normally taken for insulin dose adjustments and therefore focus on fasting and preprandial values, i.e., times usually not characterized by rapid BG changes. They do not specify whether BG values must be taken during periods of slow or rapid BG changes. These results are related to the general design of standard study protocols for the technical and clinical evaluation of SMBG devices ( 7). Several systems for BG testing at alternate sites have been recently approved according to the provided evidence that BG values from these sites do not differ from values measured in blood samples collected at the fingertip. At the first hypoglycemic fingertip BG value (≤3.5 mmol/l), 80% of forearm BG values were ≥5.0 mmol/l ( Table 1). An individual maximal difference in BG between forearm and finger of 5.4 mmol/l (1.6) (range 3.4–6.6) was observed 15–75 min after administration of insulin. ![]() The rate of decrease in BG measured at the fingertip was 0.17 ± 0.06 mmol The decrease in BG at the fingertip was also consistently larger than that at the forearm. An individual maximal difference in BG between forearm and finger of 4.7 mmol/l (1.3) (range 2.6–7.6) was observed 30–90 min after the ingestion of glucose. The rate of increase in BG measured at the fingertip was 0.13 ± 0.03 mmol The increase in BG at the fingertip was consistently larger than that at the forearm. There were no obvious device-specific differences.ĬONCLUSIONS-To avoid risky delays of hyperglycemia and hypoglycemia detection, BG monitoring at the arm should be limited to situations in which ongoing rapid changes in BG can be excluded.Īt baseline, no relevant differences between BG values at the finger and forearm were observed. Endnote vs zotero vs mendeley skin#Rubbing of forearm skin decreased the observed differences but with a large intraindividual and interindividual variability. At the forearm, BG was delayed by a median of 35 min ( P < 0.01) in relation to the fingertip. During rapid decrease in glucose, lower BG values were recorded at the fingertip (maximal difference to forearm 5.0 ± 1.0 mmol/l, P < 0.001). However, during rapid increase in glucose, BG values at the fingertip were consistently higher than at the forearm (maximal difference 4.6 ± 1.2 mmol/l, P < 0.001). RESULTS-In the fasting state, the BG values at the fingertip and at the forearm were similar (7.8 ± 2.4 vs. A rapid increase in BG was induced by oral administration of glucose, and subsequently, a rapid decrease in glucose was induced by intravenous administration of insulin. In a subgroup of patients ( n = 8), local rubbing of the forearm skin was performed before blood sampling. RESEARCH DESIGN AND METHODS-Capillary BG samples were collected every 15 min for 3–5 h from the fingertip and the forearm of 17 insulin-treated diabetic patients and analyzed with different glucose monitors (FreeStyle, One Touch Ultra, and Soft-Sense). OBJECTIVE-We have examined whether rapid changes in blood glucose (BG) result in clinically relevant differences between capillary BG values measured at the forearm and the fingertip and whether local rubbing of the skin before blood sampling can diminish such differences. ![]()
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