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Use of an Automated Device for Alternative Site Blood Glucose Monitoring

  1. S. Edwin Fineberg, MD1,
  2. Richard M. Bergenstal, MD2,
  3. Robert M. Bernstein, MD3,
  4. Lori M. Laffel, MD4 and
  5. Sherwyn L. Schwartz, MD5
  1. 1Indiana University School of Medicine, Indianapolis, Indiana
  2. 2International Diabetes Center, Minneapolis, Minnesota
  3. 3Regional Endocrinology Associates, Santa Fe, New Mexico
  4. 4Joslin Diabetes Center, Boston, Massachusetts
  5. 5Diabetes & Glandular Disease Clinic, San Antonio, Texas

    Abstract

    OBJECTIVE—To evaluate the accuracy, comfort, and ease of use of a new automated device for blood glucose monitoring using the arm as an alternative sampling site.

    RESEARCH DESIGN AND METHODS—These studies use an automated hand-held device that applies a small vacuum, lances the skin, transfers blood onto an electrochemical test strip, and measures glucose. Patients who had type 1 or type 2 diabetes and had received no prior training using this device were recruited from five diabetes clinics. Testing was performed by the patients using this device and by trained healthcare professionals. Blood glucose was measured by 354 patients: from the arm using the device, from the finger using a laboratory reference instrument, and from the finger using the device via the secondary test port. Each patient completed a questionnaire rating the level of pain and ease of use of the device.

    RESULTS—Blood glucose results in samples obtained from the arm with the automated device agreed well with finger-stick plasma glucose results using a reference instrument (regression slope 0.98, intercept 0.01 mmol/l [0.1 mg/dl], r = 0.96). Error grid analysis showed that 100% of the measurements fell within zones A and B. In the survey, 60% of the patients reported that arm testing with the automated device was “painless;” another 31% of the patients stated that it was “much less painful,” and 6% of patients considered using the device “less painful” than finger-stick testing. In a survey containing 15 questions for rating the ease of use with a scale of 1 to 6, the overall mean rating was 5.5.

    CONCLUSIONS—The automated device is easy to use and provides accurate glucose results; 97% of the patients found it less painful than finger-stick testing.

    Footnotes

    • Address correspondence and reprint requests to S. Edwin Fineberg, Indiana University Medical Center, Wishard Hospital West Building, M200, and 1001 W 10th Street, Indianapolis, IN 46202. E-mail: efineber{at}iupui.edu.

      Received for publication 15 September 2000 and accepted in revised form 22 March 2001.

      The institutions at which S.E.F., R.M.B., R.M.B., and S.L.S. are employed have received funds from Abbott Laboratories, MediSense Products, to conduct studies on glucose-monitoring systems. S.E.F. has received honoraria for speaking engagements from Abbott Laboratories, MediSense Products. L.M.L. has received unrestricted grant support from Abbott Laboratories, MediSense Products, to conduct the study on the automated device for alternative site blood glucose monitoring, has served on an advisory board for Abbott Laboratories, MediSense Products, for their blood ketone meter, and has received honoraria from Abbott Laboratories, MediSense Products, for lecturing.

      A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

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