Diabetic Alternative Site Testing (AST): technology for independence?
By Andrew Freeway
Diabetes is developing into an endemic disease. More and more people have trouble with their insulin and blood sugar: they either do not make enough insulin or are not able to process it in a normal way. The more prosperous we get, the greater the chance of becoming a diabetic. The older we grow the bigger the odds of having insulin problems. Especially Diabetes II is getting very popular among our senior citizens and especially among those who have not enough physical exercise or have the wrong diet. Whatever the reasons, Diabetes is becoming an important part of the lives of a lot of people. Checking out your blood sugars will become a regular exercise!
Knowledge is power to manage your own situation
Self-assessment is important for people with diabetes. Knowing the reason why too high or too low blood sugars develop is important. This knowledge can give you the possibility to manage your own situation. There is only one disadvantage in measuring your blood sugar: the measuring method. Sticking a small lancet in the side of your finger a couple of times a day on a regular basis creates very painful fingers. So painful that some people stop controlling their disease with all the obvious consequences. And some people are so afraid of needles or blood that they are not able to perform self-measurement.
Is it not possible to draw blood somewhere else? This was the leading question for the industry the past couple of years. And they came up with an answer, or better with 4 answers: the One Touch Ultra (www.LifeScan.com), the InDuo (www.LifeScan.com and www.nordisk.com), the SoftSense (www.medisense.com) and the FreeStyle (www.disetronic.com). Many more of this kind of measuring methods will follow in the near future. But these alternatives are now available.
Challenges
It took quite a while before the AST method became available. The blood sugar values in one's arm, hand or leg had to compare with those from the finger. Furthermore the skin of an arm or a leg is much thicker, which makes it rather difficult to draw a big enough drop of blood to make the measurement possible. But at the end the manufacturers came up with a system that needed only a tiny spot of blood (1 micro liter or even less) making it possible to use a very tiny needle to obtain some blood.
Choices
AST gives a diabetic the choice to measure at one's arm, leg, hand palm, thigh or calf. AST seems to be an excellent method for those who have to measure several times each day and especially those who need excellent sensation in their fingertips like a violin player or a carpenter. But AST is an alternative and not a complete exchange for stabbing your finger. And AST needs a lot of practice because drawing blood from another spot of your body with a tiny needle is not as easy as it sounds.
The advantages and disadvantages of AST are still under a lot of research. LifeScan conducted research among 220 people divided over 10 European countries. On an empty stomach the values of blood sugar varied only 1% between the finger and the arm. About 80% of the test persons experienced less pain with the AST in the arm and half of the tested people decided to go for the AST in the future. On the moment the same research is done with drawing blood from the hand palm and the thigh.
Research
Since November last year Disetronic has been researching the use of the FreeStyle among 550 diabetic patients divided over 46 centers. More then 80% only were using a variety of meter, pens and needles to stab their fingers. All test persons measured about 4 to 5 times a day. They were questioned about their experience with stabbing their fingers, under arm, hand palm, thigh, calf and upper arm with the FreeStyle. The amount of blood drawn from their finger appeared to be enough for a correct measurement. But drawing a big enough drop from their other body parts was much more difficult. All testers found the other areas less painful then their finger with the exception of the thigh and the calf. And all testers thought it was much easier to draw blood from another spot then from your finger.
Variations among the four products
On the moment there are 4 AST measurers available:
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FreeStyle; fast working (only 15 seconds), small and light weight, flexible stabbing spot, a memory of 250 values, needs only 0,3 micro liter blood to measure and can be hooked up on your pc.
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One Touch Ultra; very fast working (less then 5 seconds), easy to use, flexible stabbing spot, memory of 150 values, needs 1 micro liter blood an can be hooked up on your pc. The needle can be adjusted to 7 different depts..
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InDuo; a combination of blood sugar measuring and adjusting insulin, looks like a cell phone, flexible stabbing spot and the link between the measurement and the amount of insulin is easy made.
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SoftSense; the blood is drawn by creating a vacuum on the skin, fast (20 seconds), a memory up till 450 values, rather big, ready to use and can be hooked up on your pc.
Taking away the barrier of stabbing painful fingertips might stimulate people to perform self-management with their diabetes. A thicker skin on your arm or leg together with a thinner needle which penetrates less deeply creates less pain.
But always consult your doctor or other health care worker before you change your way of measuring your blood sugar values. And check with your health insurance before diving into the AST!
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