Glicemia capilar em ponta do dedo versus lóbulo de orelha: estudo comparativo dos valores resultantes e preferências dos pacientes

Abstract

To evaluate the efficacy and patient preferences of ear lobe capillary glycemia (GC) against conventional fingerstick GC, we studied 40 patients (13M/27F; 41.6 +/- 13.5 years) with type 2 diabetes mellitus (DM2). Glucose monitoring was accomplished using a digital glucometer and Accu-Chek Softclix Pro lancetator. Tests were carried out during 27 days with grade 2 of penetration (median) on the distal phalange of the right hand's third finger and on the inferior part of the right ear lobe, at the same time and fasting. The comparative analyzes of fingerstick and ear lobe GC did not show statistical significance (p = 0.008). 72.5% of patients reported no pain during the ear lobe test against 15% in fingerstick GC. There was a significant correlation between ear lobe test and low level of pain (p< 0.001). 82.5% of patients preferred the ear lobe test for monitoring. The ear lobe GC was as efficient as traditional fingerstick test. This new method was associated with low level of pain, safety, comfort, and good acceptance for most patients.

Accuracy, utility and complications of continuous glucose monitoring system (CGMS) in pediatric patients with type 1 diabetes

“…O automonitoramento da glicose no sangue (SMBG) é uma ferramenta importantíssima no controle do diabetes 1 . A principal inconveniência do automonitoramento por meio de glicemia capilar é que os níveis de glicose são avaliados de maneira intermitente, dando apenas um quadro parcial e, portanto, incompleto das flutuações da glicose 1,2 .…”

“…A principal inconveniência do automonitoramento por meio de glicemia capilar é que os níveis de glicose são avaliados de maneira intermitente, dando apenas um quadro parcial e, portanto, incompleto das flutuações da glicose 1,2 . Devido a muitos fatores, inclusive dor e inconveniência, muitas crianças com diabetes não aceitam as freqüentes picadas na ponta do dedo necessárias nesse tipo de procedimento.…”

“…Os quatro valores diários do automonitoramento da glicemia capilar foram comparados, pelos pais de uma criança com diabetes, ao som de quatro notas de uma sinfonia 3 . A possibilidade de um sistema de monitorização subcutânea contínua da glicose (CGMS) (Medtronic; Northridge, CA, USA) oferece a oportunidade de crianças e adolescentes com diabetes mellitus tipo 1 (DM1) atenderem às demandas da terapia intensiva com o monitoramento intensivo dos níveis de glicose no sangue 1,2 .…”

Acurácia, utilidade e complicações da monitorização subcutânea contínua da glicose (CGMS) em pacientes pediátricos com diabetes tipo 1

“…1 The major inconvenience of SMBG is due to the fact that blood glucose is only intermittently measured by fingerstick capillary blood sampling, from which only a partial and therefore incomplete picture of blood glucose fluctuations can be made. 1,2 Because of many factors, including pain and inconvenience, many children with diabetes do not accept frequent fingersticks for SMBG. One parent of a child with diabetes compared his daughters daily four SMBG values to hearing four notes of a symphony.…”

“…3 The availability of the continuous glucose monitoring system (CGMS) (Medtronic; Northridge, CA, USA) offers the opportunity for pediatric type 1 diabetic patients to match the demands of intensive therapy with the intensive monitoring of blood glucose levels. 1,2 The diabetes control and complications trial (DCCT) established that intensive and multidisciplinary treatment of type 1 diabetes mellitus (DM1) improves metabolic control and reduces the complications of the disease. 4 Estimates showed that a significant damage to quality of life is frequently due to DM1 in children and adolescents, including functional limitations, social and economic stress, even major depression.…”