Ask The Doctor

Ask The Doctor

ASK
THE DOCTOR
by Wesley
W. Wilson, MD

NOTE: If you have any questions

for "Ask the Doctor," please send them to the VOICE editorial office.

The only questions Dr. Wilson will be able to answer are the ones used in this

column.

Wesley Wilson, MD is an

Internal Medicine practitioner at the Western Montana Clinic in Missoula, Montana.

Dr. Wilson was diagnosed with type I diabetes in 1956, during his second year

of medical school.

Q: I am working hard to

control my diabetes and check blood sugars before each meal and at bedtime.

I also occasionally check between meals or when I suspect my blood sugar is

"not right." My fingers are sore from all the blood tests. Can I use

any other spot?

A: Your attention to detail

is great. Careful control does require frequent blood sugar testing, and for

most persons with diabetes, that tends to be the most troublesome part of managing

their illness. You brought up a point that is important to me personally, since

I like to know where my blood sugar is, but don't like to stick my fingers,

nor do I like having holes in my protective skin over my fingers, particularly

when I see patients in my office who have hepatitis or other infectious problems.

There are more nerve endings

in the fingertips than almost any other part of the body, so blood sugar sampling

from fingertips, even with the new super-sharp lancets, sometimes causes discomfort.

Because I wish to have

my fingertip skin left intact but test frequently, I did a study several years

ago in which I checked a blood sugar from my finger, another from the area just

above my kneecap, and another venous blood sample taken by the laboratory and

run on their precise equipment to check blood sugars. All the tests were done

within five minutes. Then I compared the three test group results after I had

done the three tests on 40 separate occasions.

The blood sugar samples

from the finger were dropped onto the test strip. The blood sample from above

the knee required squeezing the skin to get a large drop of blood on the surface

of the skin, and then the test device had to be turned upside down and placed

on top of the drop of blood.

The three separate tests

all matched very closely. The blood sugar from the knee was as accurate as the

blood sugar from the fingertips, and they all agreed very closely with venous

blood samples done in the laboratory.

I have used this method

with a variety of glucose monitors, including Glucometer, Accu-Chek Advantage,

and Medisense; and they all seem to work reasonably well, though some are more

convenient than others. Some glucose meters require the blood to be applied

to a strip already inserted, making it very difficult to get a drop of blood

on the test area.

The point is, it is important

to check sugars frequently, and the blood can be obtained from spots other than

the finger. The important requirements for testing from above the kneecap are:

(1) your need to get a large enough sample of blood, (2) you need a meter whose

test strips are such that the blood can be non-traditionally applied, and (3)

squeezing the punctured skin to force the drop of blood out does not affect

test accuracy.