Poking Your Fingers

November is National Diabetes Month, but in our clinic every month is about diabetes because each month one of our new family medicine doctors-in-training goes through a training called “Diabetic For a Week”. The new doctor is given a blood glucose meter, an insulin pen filled with salt water, and a bottle of “pills” and taught how to use them. For the next 7 days they are expected to test their blood sugar 4 times a day before meals and at bedtime, take 2 “pills” (actually Mn’Ms) twice a day with breakfast and dinner, and inject a small dose of sterile salt water every night.

The goal of this experience is to teach them a little bit about what their patients go through after being diagnosed with diabetes. For many of these new doctors it’s an eye-opening experience as they struggle to make time in their busy schedule to test their blood, take the pills and do the injections every day for a whole week. It makes quite an impression, helping them appreciate how overwhelming being a diabetic can be, especially at first.

I poke hundreds of fingers every month in people taking warfarin or Coumadin®, a blood thinner, including many folks who poke their own fingers as diabetics. Some of the fingers I see are pretty beat up. When you test your blood several times a day, all those pokes take a toll. I’ve found that many diabetics don’t realize they can protect their fingers when having to test their blood sugar frequently. Are you or someone you love making one of these common mistakes?

Mistake number 1: Using an alcohol swab. Wiping your finger with alcohol before poking it doesn’t kill any bacteria, although it removes surface dirt. Swabbing your finger with alcohol dries out your skin and makes your fingers tender instead of cleaner. A better choice is to simply wash your hands with nice warm water and soap just before you’re ready to do the test. Washing with soap and warm water is much better than using alcohol wipes because not only does it really does clean your fingers, it brings blood closer to the surface of your skin so you can get a nice sample of blood without having to poke very deep. Using fewer alcohol wipes also saves you money.

Mistake number 2: Poking your finger deeper than you need to. Today’s blood sugar meters need far less blood than older ones, but old habits can be hard to break. If you always wash your hands first in nice warm water, you’ll find it much easier to get blood without having to poke very deep. When using a newer meter, you won’t need as much blood for your sample. If you get a smaller drop, there’s a way to get more of that blood on your test strip: aim the edge of the test strip just below your blood drop and then move the strip up a little bit, to “scoop” the blood into the strip.

Mistake number 3: Only poking your finger for a blood drop. Many diabetics started out using meters that only accepted blood out of their fingers, and don’t realize that most of the newer meters allow you to get the blood from your hand or even your arm. I find that using the side of my hand is pretty easy and a LOT less painful than using my finger. In fact, whenever I teach someone to use a meter for the first time I make sure they learn how to get blood by poking the side of their hand. Using the fleshy part of my hand between my wrist and pinkie finger, I show them how to do it, using the clear plastic adapter that came with their lancet (poker) device. Most of today’s machines come with two plastic adapters to their poking device, one solid and one see-through. Using the clear see-through adapter on your lancet device, press it gently to your skin for 5-10 seconds to trap blood near the surface, poke and hold it there for another 5-10 seconds, until you see blood welling up into a small drop. Remove the lancet device, then pick up your machine with the strip in it and “scoop” your blood into the strip.

Using your hand is a great way to “spare” your fingers when you get blood for routine blood testing, but if you suspect your blood sugar is too low or is changing rapidly, getting the blood from your finger is more accurate because it gives the most up-to-date measurement.