Comparison of Glucose Levels in Capillary Blood Samples Obtained from a Variety of Body Sites

Abstract

The AtLast Blood Glucose System was developed to eliminate painful finger punctures by testing samples from less sensitive body sites. Studies were designed to evaluate subjects under various glycemic states and to compare glucose concentrations in samples obtained from the forearm and palm to those found in the finger. The palm is more similar to the finger in blood flow rates, while the forearm is less perfused. AtLast measurements of forearm samples from subjects at a minimum of 2 h postprandial produced good regression statistics when compared to reference finger results with a correlation coefficient of 0.978. Agreement was quite weakened in subjects undergoing extreme glucose loads, resulting in a slope of 0.85, an intercept of 30.82, and a correlation coefficient of 0.938. Time course data indicate that forearm glucose levels often appear lower than finger concentrations when glucose is rapidly rising and somewhat higher when glucose is quickly falling. On the other hand, glucose levels of palm samples produced a close correlation to finger concentrations under all glycemic states. In participants undergoing rapid glucose change, the linear correlation resulted in a slope of 1.01, an intercept of 2.46, and a high correlation coefficient of 0.983, with steady tracking of palm and finger concentrations throughout the study. The palm of the hand was also identified as a comfortable testing site that equals the forearm in affording painless testing. Glucose monitoring of blood samples from the forearm is suitable when expecting steady state glycemic conditions. At times of rapid glucose change, the palm of the hand offers a painless sampling site that compares well with the finger.

Special Considerations for Older Adults With Diabetes Residing in Skilled Nursing Facilities

“…Alternative site testing is only accurate when blood glucose is in a steady state, such as fasting and preprandially, although the palm can be used for postprandial measurements. 23,24 However, alternative site testing is not generally recommended when hypoglycemia is suspected. 25 Although CBGM can be used to determine blood glucose values that are out of a resident's target range and to identify patterns in blood glucose fluctuations to evaluate the medication regimen, there are no data to guide the frequency of CBGM in long-term care settings.…”

Comparison of spectroscopically measured finger and forearm tissue ethanol concentration to blood and breath ethanol measurements

“…This phenomenon has been observed in past alcohol efforts as well as in the mea- surement of other analytes such as glucose at different skin locations. [7][8][9][10][11] An alternative view of the observed concentration differences is depicted in Figs. 11(a) and 11(b) which shows the rms error by hour from consumption relative to breath Fig.…”

“…This "alternate site" phenomenon has been investigated by many researchers [7][8][9][10][11] and refers to sites other than the finger tip (the current standard of care) where capillary blood or interstitial fluid can be obtained for the glucose assay. Several clinical studies have shown that finger and forearm glucose concentrations can exhibit significant concentration differences over time.…”

Hemoglicoteste: influência dos locais de punção sobre os níveis de glicose e intensidade de dor

“…Esta é geralmente impregnada de glicose-oxidase, ou seja, a enzima específica da glicose e com reativo de cor, a qual possibilita que o resultado apareça no visor. O teste deve ser realizado antes ou duas horas após as refeições, ou após a injeção de insulina, para aqueles que a utilizam 10 . Um dos aspectos que dificultam a realização do exame é a dor, visto que o local mais utilizado para realizá-lo é nas falanges distais dos dedos da mão, tornando-se um dos fatores limitantes para o automonitoramento.…”