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When testing your blood sugar, do you use the first drop of blood or the second?
We teach patients to wash their hands with soap and water, dry them, and then test their blood glucose using the first drop. We advise that if the person isn't able to wash his or her hands with soap and water, then the second drop may be used. However, I've heard some patients tell me that they were instructed to use the second drop of blood, even after washing hands with soap and water.
Monitoring your blood sugar is essential to managing diabetes and helps you to make decisions related to diet, exercise and medication. So, what is the "right way" to test your blood glucose?
A February 2011 article in the American Diabetes Association's journal, "Diabetes Care," details a study that investigated whether capillary glucose concentrations, as measured in the first and second drops of blood, differed by 10 percent or more compared with a control capillary glucose concentration in the following situations:
The conclusion of this study, which included 123 participants, is: "The first drop of blood can be used for self-monitored glucose testing, but only after washing hands. If washing hands is not possible and they are not visibly soiled or exposed to a sugar-containing product, it is acceptable to use the second drop of blood after wiping away the first drop." The study also found that external pressure (or squeezing) of the finger can lead to unreliable readings, as well.
You can find the article at: http://care.diabetesjournals.org/content/early/2011/02/01/dc10-1694
All in all an interesting study. What are your thoughts?
Nancy Klobassa Davidson, R.N.
Peggy Moreland, R.N.
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Unfortunately a lot of solid and liquid soaps (especially the "soft on hands" varieties) contain sugar. I used to get wildly fluctuating readings (from 5.2 to 8.8) in multiple consecutive tests and found this to be the culprit. Typical of the medical industry to overlook something so basic and obvious.
When I first started testing I was shown to use a alcolol wipe on my finger. Will that make a difference in the testing. I always make sure I blow it dry before pricking.
Insulin pens: Yes, they do require priming. Dialing up 1 or 2 units and then pushing on the plunger until a drop of insulin appears helps get rid of air bubbles and gives a more accurate dose. Point the needle upwards and tap the pen to force bubble to the top before priming. To prevent air from entering the pen, do not leave the needle on the pen between injections. I will try to do an article on DPP inhibitors in the future. Thanks for sharing.
Interesting article -- thanks! Have never heard of this b-4. Also, heard for the 1st time this week that I should be "wasting" the 1st 2 units of Novolog b-4 I inject my dosse? Have never heard of this. Is this correct? If so, what is the rationale? Also, please do a column on Victoza and the other new diabetes drugs. Thank you.
Yes new to this, I tested yesterday .5 hr after eating it was 219, hr after that 356, hr after that 256,hr later 241, this morning tested it was 257. When should i test and how often? I am reporting the results to my VA doctor monday but would like advice I believe that I have become a diabetic, and would like to hear from ppl with it if you dont mind.
I have just started looking at 1st, 2nd drop readings. The other day after excercise I did 3 successive readings starting with the 1st drop. The numbers were 39, 62, 73 within seconds of each other. I chalked it up to the possibility of the liver's work to kick in some glucose?
What is excessive squeezing? I use one lancet a day (3-4 tests), and I normally prick and give one slight squeeze on most fingers. Since I am right handed, I use a deeper setting on that hand to get through the thicker, tougher skin.
I never heard anything about "First or Second Drop". Very interesting. I usually use alcholol pads prior to using the needle. I am going to try it as mentioned to check the difference.
Getting a drop of blood without excessive squeezing is important because the squeezing can cause tissue interstitial fluids to be expressed diluting the droplet of blood. I use a new lancet every time I test and most times I get a drop of blood sufficient for testing without squeezing....except when my fingers are cold.
I don't get the squeeze comment. If I don't squeeze, I don't get a drop of blood. Does that mean my reading for the past 5 years are all incorrect?
Well, without any dairy and meat you would be a vegetarian. Lots of healthy people are vegetarians but that doesn't mean it's a cure for diabetes.
And who are "they" that are trying to keep this a secret and what would they have to gain by doing such a thing. There's no conspiracy going on here. The Mayo Clinic website even has the suggestion that eating more fruit, vegetables, and grains will benefit those with diabetes.
I hate to be in a location where I can't wash my hands with soap and warm water. I test so much and it makes it easier and just feel clean. I use the first drop but am home most of the time.
Truthfully, I will wash my hands if I've been working with food or lotion, etc., but I go with the first drop. If I don't like the answer ;) I'll wash with soap and make sure all soap residue is rinsed off. I'm usually in a hurry.
What is the answer to Jason who claims Type 11 can be cured by not eating dairy or meat? I have never heard such a thing and there are lots of stuff like that going around. If that were true wouldn't the doctors know about it and how healthy can a diet be by leaving out those foods?
Wesley: Good question. Actually, soap and water are all you need to prevent infection. Alcohol can cause skin dryness and skin breakdown, especially for those who need to test often. Also, if you don't let the alcohol completely dry, the blood glucose test can sting. Alcohol may react to the chemical in the test strip and cause a false blood glucose reading which is why we "waste" the first blood glucose drop when we do a fingerstick blood glucose test in the lab.
Why not swipe with alcohol on gauze as in lab. phleb.?
Cure type II Diabetes by simply eliminating DAIRY and MEAT for 6 - 8 weeks! They don't want you to know! God Bless!
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