title: The accuracy and acceptability of performing capillary blood glucose measurements at the earlobe.
abstract: OBJECTIVE
  To examine the accuracy and acceptability of capillary blood glucose monitoring using the earlobe.
  
  
  BACKGROUND
  In current practice, blood samples for capillary blood glucose monitoring are obtained from the fingertip. Because obtaining blood samples from the fingertip is sometimes contraindicated, it is necessary to identify an alternative site for the procedure.
  
  
  METHODS
  A single-patient design with repeated measurements.
  
  
  METHODS
  Patients from an outpatient clinic and four medical wards were recruited to the study, in 2014, if they met one of the following criteria: (i) were in a relatively stable glycaemic state; (ii) were currently receiving intravenous infusion; (iii) had been diagnosed with chronic renal impairment or (iv) were aged 65 years or above and bedbound. Blood samples were obtained from the fingertip and the earlobe consecutively for blood glucose monitoring. Participants were asked to rate the respective pain level caused by the procedures. Intra-class correlation coefficient was calculated to demonstrate the level of absolute agreement between the two blood glucose readings. The Wilcoxon signed rank test was used to compare the pain levels.
  
  
  RESULTS
  A total of 120 patients participated in the study between February - December 2014. The intra-class correlation coefficient between the readings at the two sampling sites was significantly high, except in a hypoglycaemic state. Participants generally reported a significantly lower level of pain when the earlobe rather than fingertip was pricked.
  
  
  CONCLUSIONS
  The earlobe is to be recommended as a safe alternative site for capillary blood glucose monitoring unless the patient is in a suspected hypoglycaemic state.
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, China.
authors.forename: Helen Y L
authors.initials: HY
authors.lastname: Chan
authors.affiliation: Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
authors.forename: Tracy S L
authors.initials: TS
authors.lastname: Lau
authors.affiliation: Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
authors.forename: S Y
authors.initials: SY
authors.lastname: Ho
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, China.
authors.forename: Doris Y P
authors.initials: DY
authors.lastname: Leung
authors.affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, China.
authors.forename: Diana T F
authors.initials: DT
authors.lastname: Lee
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D002196:Capillaries; D004423:Ear; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis; D008297:Male; D010146:Pain
chemical_list: D001786:Blood Glucose
keywords: diabetes; evidence-based practice; nursing