Does the 1st or the 2nd drop of the self -analysis of blood glucose in the control of DM1?
A Dutch study finds significant differences
The objective of this curious study, conducted Holland on diabetic patients over 18 treated with insulin of Isala Clinics in Zwolle, between September 2009 and February 2010, was to see if the concentrations of capillary glucose, measures between the first drop and inThe second drop of blood, differed ≥ 10% in different circles: not washing their hands, after exposing the hands to fruit, after washing the hands exposed to fruits, and during the application of different amounts of the external pressure of the finger.
It was considered relevant in this study Variations in capillary glucose equal or greater than 10% or a difference of 0.82 mmol/l.Although variations of 4.2 mmol/l were considered clinically relevant.
123 DM1 patients were studied.2-4% of variation was found in which the measure with the second drop was equal to or greater than 10% than the first.
-If they did not wash their hands, there were at least 10% difference compared to control in relation to the measure of the first and second drop, being at 11% (P less than 0.001) and 4% (lower Pat 0.001) of the participants respectively.
- If they were exposed to play fruit before, 10% or more glucose concentrations were found in the first drop in 88% of patients (P less than 0.001) compared to control.In 11% of cases the concentration of the second drop was 10% higher than control (P less than 0.001).
- If their hands were washed after manipulating fruit, it was found that 4% (P 0.001) and 5% (p = 0.189) of those studied showed differences greater than 10% in glucose concentrations compared to control.
-As for the different pressures on the finger shows that the concentration of glucose increases when the pressure grows.With 40 mm Hg pressures, 10% differences are observed with comparison with the controls in the first drop and in the second in 5% (p = 0.055) and 10% (p = 0.009) of the participants respectively.With 240 mmHg it occurs in 12% (p = 0.018) and 13% (p = 0.217) of the participants.
Conclusion: It is recommended to wash your hands with soap and water, dry them, and the use of the first drop of blood for the automation of blood glucose.If hand washing is not possible, and are not visibly dirty or exposed to a product that contain sugar, the use of the second drop of blood is acceptable after cleaning the first drop.External pressure can lead to unreliable readings.
Hortensius J, Slingerland RJ, Kleefstra N, Logtenberg SJ, Groenier Kh, Houweling St, et al.self-Monitoring of Blood Glucose: The Use of the First Or the Second Drop of Blood.Diabetes Care Publish Ahead of Print, Published Online February 2, 2011 (Link)
