Page 24 - The SA Journal Diabetes & Vascular Disease Volume 9 No 4 (November 2012)

166 VOLUME 9 NUMBER 4 • NOVEMBER 2012
MONITORING SA JOURNAL OF DIABETES & VASCULAR DISEASE
LANCING DEVICES
Lancers are not available on prescription, and usually come with glu-
cose meters. Again, a guide such as MIMS for Nurses can help identify
which lancers are compatible with which lancets. Lancets are available
on prescription, and cost between £6 and £7 for 200. In a clinical setting,
single-use lancers must be used rather than the lancer that comes with a
particular meter. There have been cases of hepatitis B transmission from
blood carried via the head of the lancer from patient to patient.
MULTIPLE SITE TESTING
With the necessity for frequent monitoring of blood glucose, some peo-
ple will complain of sore fingers and be reluctant to continue testing.
More and more meters are now claiming to be suitable for multiple site
testing, whereby a capillary blood sample can be obtained from sites
other than the fingertips. These alternative sites include: thumb, palm,
forearm, upper arm, abdomen, thigh and calf.
It is important to discuss different testing sites with patients before
they try them as they are not suitable for everybody, or for every oc-
casion. Results can be inaccurate during periods where blood glucose
levels are changing rapidly, for example after a meal, after injecting in-
sulin, and during, or after, exercise. Testing at other sites is contraindi-
Tips for safe and accurate blood glucose monitoring
• Always wash hands and dry thoroughly before every test
• Ensure test strips are in date
• Ensure meter is correctly calibrated for the test strips if required
• Use a new lancet every time
• Do not squeeze or ‘milk’ the finger to obtain blood sample
• Always record the result, with the time and the date
• If the result is out of the expected range, note why this may be – missed
meal, missed medication, unexpected exercise etc
• Ensure you perform regular quality control on your meter.
cated when measuring glucose for a suspected hypoglycaemic episode
and where a person has reduced awareness of hypos.
TEST STRIPS
More money is spent on testing strips than is spent on diabetes medi-
cation. This has led to some PCTs banning or rationing test strips. With
monitoring being an integral part of insulin management, the health-
care professional must ensure each individual has access to test strips,
with appropriate education to avoid waste. Test strips are available on
prescription, costing £14 – £16 for 50. Each type of meter requires
its own strips, so patients should be discouraged from changing me-
ters frequently and care should be taken to avoid prescribing incorrect
strips.
Some meters need re-calibrating for each new batch of strips. Pa-
tients who struggle with this will find non-calibrating meters simpler to
use. Some patients may find single test strips difficult and benefit from
meters that use drums. Test strips have an expiry date, after which
most meters will not recognise them. However, even if the meter allows
a strip to be used, the result is unreliable, so patients should be dis-
Alternative testing sites for blood glucose