after cleaning finger with alcohol for a year, was advised to use soap and water. this has made getting an adequate sample from a finger prick much more difficult AND when using a meager sample(barely enough to register on meter) , actual meter reading is 10%-15% higher on avg.
if i wait half an hour on jump up and down and wring my arm blood starts to flow and meter reading drops by that same 10%-15%.
any thoughts?
The various studies that I have read say that alcohol is NOT the recommended approach.
First best approach is as you say, wash hands with soap and water and dry hands.
Second approach when this is not feasible or reason to believe there is contamination on the hands (such as specifically the studies I read were dealing with people who ate/handled fruit for the purposes of the study) is to use the SECOND drop of blood.
Which meter are you using? Reason for asking is what is the size of the blood drop it requires?
If it is one of the meters which uses a larger drop size, perhaps you could try a meter that requires a smaller drop size? It may not entirely resolve your issue but might help?
As FYI, we previously were using the Animas (Lifescan??) One Touch which required a 1.0 (microliter) size drop of blood. Which seemed reasonable when we were using that. We have since switched over to the Contour Next which uses a smaller drop at 0.6 (microliter) size as well as allowing “second chance” to get more blood on the same strip if the first attempt was not quite enough. Our perspective has of course now changed and the older One Touch now seems to need excessive blood.
using Contour Next. Was advised by mfg when i was ordering control solution the Contour Next is latest and greatest version of the Contour pdt line. I understand that while u may think the latest iteration of a pdt is better or more accurate, in fact discontinuing the Contour or other modles is a marketing decision , not a scientific one.
i have settled on Contour pdt line from field studies of reliability or more strictly derivation from the mean on tests which show Contour to be is top 1 or 2 reliable meters. by reliable i mean consistent readings, not necessary accurate , but consistent values from one test to the next.
i hadn’t investigated blood sample size requirement but will do .
thanks
If the size of the blood drop turns out to be part of the issue, several meters require as little as 0.3 microliters, among them Walmart’s Relion Confirm and Relion Micro, and the Freestyle Freedom Lite, Freestyle Lite, and Freestyle Insulinx. Getting a decent-sized drop can be a problem for me. I use the Freestyle Lite strips and I’m often surprised how little blood is needed.
I’m not sure the moderators will jump on me for this or anything, but I haven’t done alcohol OR soap and water for about 3 decades and never had a problem. (Unless the site was actually dirty in which case I did wash!)
Myself, I almost always use fingertips unless my hands are truly filthy but I have used alternate sites like my arm, or toes, or earlobes.
Hot water can help with flow IF the site was previously cold. Cold water can really restrict flow.
Same. I wash my hands if I think they otherwise need it (especially if I think there could be food/something with sugar content on them), but not before every test if they seem clean.
if yu get consistent results i think it probably okay not to wash. i occaisonly forget and have not seen any variation in results. i had been specifically told alcohol washed away skin cells or something or other and that influenced results,
in fact i got same results for alcohol as soap and water. the soap and water situation shrivels the skin making it difficult to get a good sample but i eventually got decent samples , which again were about 10% lower than first , stingy samples directly after washing.
whoops i kinda answered my own question. if alcohol works same as soap and water AND i had no sample problems with alcohol, then use alcohol idiot(speaking to myself here).
Not sure about that, but alcohol does over time thicken the skin, making lancet use more painful and making it harder to draw blood.
That’s the story according to Diabetes Canada, anyway.
Correct, @beacher. Alcohol thickens the skin. What is generally recommended is to wash your hands with warm water and soap, ensure all the soap is rinsed off (as the soap will cause a lower reading), and dry thoroughly (damp hands will result in a lower reading, too).
I would never recommend not cleaning the location, as things like skin oils affect the reading.
@frog - Interesting. I would like to see the studies (I am an engineer, after all 
). I find the Consumer Reports BG Meter Ratings match my personal results. I like the Freestyle meters.
Alcohol is a really bad idea. I don’t wash my hands unless I suspect that they have some form of glucose on them or are especially filthy. A couple times at Famous Dave’s I neglected to go to the restroom to wash my hands, thinking wiping my hands off on the paper towels they have at the table was sufficient. It wasn’t. I ended up with false High readings. Fortunately i tested at the behest of my wife before bolusing.
If I don’t think my hands are contaminated with food residue or any other dirt, I will often test without any cleaning. If I’m using the BG reading to calibrate my Dexcom sensor, I will usually wash and dry my hands before testing.
I gave up using alcohol because it was hard on my skin. For many years I was pricking my fingertips up to 15 times/day. That left me with calluses on my fingertips and alcohol made it worse. And it added another step to my routine, so I dropped alcohol.
As @Tim12 noted above, hot water can help a lot with getting a sufficient sample size. Perhaps you could run hot water over your hands for 30 seconds or so to help with this.
For me, I also found that some finger prickers consistently worked better for me. I use the Roche Multiclix lancet and have similar good results with the Fastclix product, too. So you might experiment with another lancing system.
Can you please decode Contour “pdt”?
Meter rated: here is the report of tests done in 2017
https://www.diabetestechnology.org/surveillance.shtml
since your an engineer can you read this and interpret for me? does this mean Contour Next is reliable? is CR a bettter study?
thanks
pdt…means “product” by which i meant the Contour “product” line and of which there are different models.
@frog
Be aware that there are two very distinctive product lines from Bayer.
The “Contour” product line is older and uses one type of strip.
The “Contour Next” product line is newer and uses a different type of strip.
Within the “Contour Next” product line, there are multiple meters which you can pick based on preference however all of these SHOULD have the same accuracy as each other as they all use the same strip.
In my opinion, the Contour Next meters/test strips are one of the most accurate and I frequently see these at the top of most reviews which I read. I also think the pricing on both the meters and the test strips for the Contour Next line is extremely reasonable.
noted. i had to order “Contour” solution and it didn’t read within range. So i contacted Contour, and rep told me i had wrong solution of the meter and then stated the “Contour Next” is both the latest model and most accurate. She offered to send me a free meter.
i posted a 2017 study result above, Of course i realize that studies are easily influenced by whoever funds it… I have a feeling there is alot of smoke and mirrors in this industry.
The Diabetes Technology Society, the source of the study you cite, is a non-profit organization I find to be closely aligned with the interests of the patient community. I find it a trustworthy source.
The Contour Next line of meters is excellent, IMO. I’m referring to consistent accuracy–not whether or not they have the “best” screens, the smallest sizes, etc, etc. I’m talking strictly about how reliable the readings are. They rock.
@frog - Thank you!
My engineer comment only refers to my like for data. I can’t say which study is better CR is also noon-profit and for the consumer of what they test.
My preference for Freestyle is personal and based on my and my wife’s experiences (she sees diabetics in clinic.) It is more accurate in my opinion.
I have had type1 Diabetes since 1983. To be honest with you, I gave up washing fingers with soap and water and even using alcohol in 1984. Despite tens of thousands of finger sticks since then, I have been fortunate enough to never had an infection at the site of punctures. I am careful about washing hands after using the bathroom and before preparing food, and after working outdoors.
Cleansing fingers before CBSs is a ritual that has not undergone good scientifically valid studies.
I agree with you that the hand-washing protocol taught by medical staff with regard to infection protection is overdone. Like you, I’ve performed tens of thousands of fingerstick test and not one infection. But there is good reason to wash your hands before performing a blood sugar check. From Interferences and Limitations in Blood Glucose Self-Testing, An Overview of the Current Knowledge, published by National Institute of Health, I found this passage:
Inappropriate handling of SMBG [self monitoring of blood glucose] has been identified as the most common factor affecting BG results; more than 90% of overall inaccuracies result from incorrect use of BG meters.4,18 Due to the minute blood samples utilized by modern BG systems, even minor contamination with glucose containing fluids may substantially increase the measurement. Sugar-containing products, such as fruits, can leave considerable amounts of glucose on the skin, thereby causing falsely high SMBG results.17,19,20 In daily practice, a substantial number of patients do not wash their hands before performing BG measurements.
The most persuasive part of this is the fact that the sample sizes we use are so small that even a small contamination will exert large results.
I don’t wash my hands before blood glucose checking to prevent infection but to provide the most accurate and precise number possible. I don’t wash my hands every time, but when I really want a solid number to calibrate my continuous glucose monitor then I make the extra effort.
By the way, can you please decipher, “CBSs”?