title: Patient perceptions of different lancing sites for self-monitoring of blood glucose: a comparison of fingertip site with palm site using the OneTouch Ultra Blood Glucose Monitoring System.
abstract: BACKGROUND
  Alternate-site testing (AST) for self-monitoring of blood glucose leads to improved glycemic control for treatment of diabetes mellitus. The aim of this randomized, open-label, two-period, crossover study was to compare the comfort of two different lancing sites, fingertip and palm sites, for AST in diabetes patients.
  
  
  METHODS
  Patients injected insulin four times a day. Self-monitoring of blood glucose was carried out more than thrice daily with fingertip measurements for at least three months using apparatuses except the OneTouch Ultra Blood Glucose Monitoring System (OneTouch) before examination. The comfort of two lancing sites using OneTouch were compared. In two randomized groups that used one fingertip lancing site for one week followed by the alternate lancing site for another week, patients completed 11-item questionnaires assessing usability of the site before and after each week. Each item was scored on a visual analogue scale from -100 (most negative) to +100 (most positive).
  
  
  RESULTS
  Most patients desired to continue AST, which was insignificantly different between the two lancing sites (fingertip and palm AST) in 43 diabetes patients aged 57.3 +/- 13.8 years, body mass index of 23.1 +/- 2.5 kg/m(2), diabetes duration of 19.6 +/- 9.7 years, and hemoglobin A1c of 7.4 +/- 1.1%. However, patients were less (p < .01) satisfied with using the palm lancing site as compared to the fingertip lancing site because of difficulties in inserting the needle, drawing blood samples, and applying enough blood into the test strip.
  
  
  CONCLUSIONS
  These results suggest that patients desire to use the palm for AST, but more technological advances in AST of a palm site is required to reduce patient discomfort.
authors.affiliation: Center of Diabetes and Endocrine and Metabolism Disease, Nagaoka Red Cross Hospital, Nagaoka, Niigata, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Ito
authors.forename: Kyuzi
authors.initials: K
authors.lastname: Kamoi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Minagawa
authors.forename: Keita
authors.initials: K
authors.lastname: Kimura
authors.forename: Akane
authors.initials: A
authors.lastname: Kobayashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015190:Blood Glucose Self-Monitoring / Q000009:adverse effects / Q000295:instrumentation / Q000523:psychology*; D002921:Cicatrix; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D004311:Double-Blind Method; D005239:Fear / Q000523:psychology; D005260:Female; D005385:Fingers; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D010361:Patients; D011795:Surveys and Questionnaires