Abstract
### Case 1 C.K. is a 21-year-old man who has had type 1 diabetes since the age of 8. A sophomore in college, he has been a patient of a comprehensive diabetes care and education program in the Midwest since his diagnosis. Upon arrival at his latest diabetes refresher course, he handed the nurse educator his business card, which read “Guitarist.” The educator asked C.K. if he had been performing self-monitoring of blood glucose (SMBG) at home, and he responded by showing his bruised, tender fingertips. C.K. is passionate about playing the guitar but had been hindered in this pursuit because frequent SMBG had left his fingertips very sensitive. An insulin pump user, C.K. tests his blood glucose levels at least four times a day, 7 days a week. His careful monitoring of diet, exercise, and insulin has helped him keep his glycemia under control despite his hectic college schedule. The educator demonstrated the new Freestyle (Therasense) alternate site meter. C.K. was so excited about alternate site testing that he asked his mother to buy him a new meter that evening. At his next clinic visit, C.K.’s HbA1c concentration was 7.3% and reported that alternate site testing was improving his guitar playing. ### Case 2 B.T. is a 52-year-old man who was recently diagnosed with type 2 diabetes and prescribed two oral agents. He works as a market analyst and spends much of his days at a computer keyboard. Upon diagnosis, he was obese, hypertensive, and hyperlipidemic. B.T. was extremely anxious about his diagnosis …
Highlights
IntroductionSummary According to the available literature and our own informal surveys, alternate site blood glucose testing is appealing to many patients with diabetes
Several blood glucose meters have Food and Drug Administration approval for testing with blood taken from alternate sites
Many patients would welcome a change from the fingerstick testing that has become a standard of self-monitoring of blood glucose (SMBG)
Summary
Summary According to the available literature and our own informal surveys, alternate site blood glucose testing is appealing to many patients with diabetes. Alternate site testing may improve patients’ compliance with their diabetes management regimen by reducing the pain of testing, decreasing apprehension for newly diagnosed patients, decreasing resistance to testing from children with diabetes, and offering patients a choice of several test sites. The risks of alternative site testing may include inaccurately high forearm readings and inadequate collection of an appropriate-sized blood sample. With additional studies and continued development of blood glucose meters in the future, alternate site testing will likely be used by more patients and with more confidence
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