First or Second Drop of Blood in Capillary Glucose Monitoring: Findings from a Quantitative Study

Palese, Alvisa; Fabbro, Elisa; Casetta, Anica; Mansutti, Irene

doi:10.1016/j.jen.2016.03.027

Cited by 7 publications

(16 citation statements)

References 19 publications

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“…There are studies in the literature that support the results of our study (Boyd et al, 2005;Palese et al, 2013). In a study by Palese et al (2016), blood glucose measurements were made from the first and second drops of blood after washing patients' hands with hot water and neutral soap. The results of the study showed that there was a correlation between the glucose values of the first and second drops of blood, and that the first blood glucose value was statistically significantly lower.…”

Section: Discussionsupporting

confidence: 80%

“…However, it was recommended that attention be paid to very high and very low blood glucose values (Li et al, 2014). In a study by Palese et al (2016) conducted with 195 type I diabetes patients in the emergency service, it was found that the measurement of the first drop of blood gave a fast and correct result and was sufficient in making clinical decisions in the measurement of blood glucose when hands were washed in patients who did not have hypoglycemia (Palese et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

“…Examining studies in the literature on the difference between the first and second drops of blood in the measurement of blood glucose, studies were found showing that there was no difference between them (Hirose, Mita, Fujitani, Kawamori, & Watada, 2011; Hortensius et al, 2010; Kurt et al, 2011; Palese, Fabbro, Casetta, & Mansutti, 2016). However, Palese et al (2016) stated that no consistent guidelines were available about whether to use the first or second drop in capillary blood glucose testing in the home or emergency department settings (Palese et al, 2016). In their daily practice, patients and practitioners still appear to be unsure and have inconsistencies regarding the procedure.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Glucose Values of Blood Samples Taken in Three Different Ways

et al. 2017

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The purpose of the study was to determine differences and correlations between the blood glucose values of venous blood and the first and second drops of capillary blood samples taken in three different ways. Blood samples were (a) venous blood, (b) the first and second drops of capillary blood from the middle finger of the right hand (only washed with soap and water), and (c) the first and second drops of capillary blood from the middle finger of the left hand (washed with soap and water and cleaned with alcohol). It was concluded that the fasting capillary blood glucose values could be used in place of venous blood glucose values, that only washing the hands with neutral soap and water for 30 s could be sufficient for capillary blood glucose measurement, and that the first or second blood drop from a clean hand could be used for capillary blood glucose measurement.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of Glucose Values of Blood Samples Taken in Three Different Ways

et al. 2017

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“…User mistakes like not washing hands or not drying hands before a BG test can also contribute to wrong BG results [40]. BG meter readings could be improved by using the second drop of blood for testing [42]. Moreover, cheating with glucose test strips has been reported [43].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the FreeStyle® Libre Flash Glucose Monitoring System in Children and Adolescents with Type 1 Diabetes

et al. 2018

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Background/Aims: The FreeStyle® Libre Flash Glucose Monitoring System (FGM, Abbott) measures glucose concentrations in the interstitial fluid for up to 14 days. It has been approved for use in children aged > 4 years in January 2016. Experience in children is still limited. We evaluated the accuracy and usability of the FGM in children with type 1 diabetes mellitus (DM). Methods: 67 children with type 1 DM (35 girls), aged 4–18 years, were included. Subjects wore a sensor on the back of their upper arm. For the first 14 days, they regularly measured capillary blood glucose (BG) with their usual BG meter (Accu-Chek® Mobile [ACM], Roche [n = 24]; Contour® Next Link [CNL], Bayer [n = 26]; OneTouch® Verio® IQ [OTV], LifeScan [n = 17]) followed by a sensor glucose (SG) scanning. SG readings were compared to BG measurements by consensus error grid (CEG) analysis; the mean difference (MD), the mean relative difference (MRD), the mean absolute difference (MAD), and the mean absolute relative difference (MARD) were calculated. After 14 days, subjects were asked to fill in a questionnaire on the usability of the FGM. Results: 2,626 SG readings were paired with BG results. FGM readings were highly correlated with BG (r = 0.926, p < 0.001). 80.3% of the data pairs were in zone A (= no effect on clinical action) and 18.4% were in zone B (= altered clinical action with little or no effect on the clinical outcome) of the CEG. Overall MD was +7.5 mg/dL; MD varied with the BG meter: ACM +10.4 mg/dL, CNL +14.2 mg/dL, OTV –3.6 mg/dL (p < 0.001). Overall, MARD was 16.7%. We observed a large interindividual variability in the accuracy parameters. MD and MRD were inversely related to BMI (r = –0.261 [p < 0.05]; r = –0.266 [p < 0.05], respectively). MARD was inversely related to age (r = –0.266 [p < 0.05]). Twenty-nine patients (43.3%) reported sensor problems, mainly early detachment of the sensor. Nonetheless, the usability questionnaire indicated high levels of satisfaction. Conclusions: Our results showed a reasonable agreement between the FGM SG readings and capillary BG measurements in children. There was, however, a large interindividual variability. The wearing of the sensor requires special attention. Further studies in children are imperative in order to document the accuracy and safety of the FGM in the paediatric population.

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“…[9] This may be because the glucose meter measurements may be subjected to artifacts resulting from technical problems with the glucometers. [13]…”

Section: Discussionmentioning

confidence: 99%

Using the first drop of blood for monitoring blood glucose values in critically ill patients: An observational study

Saini

Kaur

Das

et al. 2016

Indian Journal of Critical Care Medicine

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Context:Using the first drop or second drop of blood while measuring blood glucose (BG) values.Objective:The study was planned to compare the BG values from the first and second drops of blood.Research Settings:The study was conducted at the Main Intensive Care Unit, PGIMER, Chandigarh, India.Research Design:This study was a comparative study.Materials and Methods:Ninety patients aged 2–93 years were enrolled in this study. BG values from the first and second drops of blood were taken and compared.Statistical Analysis Used:Agreement between two drops was assessed using Bland–Altman analysis. A bias of <10 mg/dl was considered clinically acceptable. Linear regression of the mean difference (bias) with the BG readings was performed.Results:One thousand four hundred and seven pairs of BG readings were taken from the enrolled patients. BG values had a bias of 3.9 ± 14.9 mg/dl. Nearly 96.7% of BG readings were within the limits of agreement. The absolute difference between first and second drops of blood was calculated; nearly 75.4% of the readings had fallen between 0 and 10 mg/dl, i.e. clinically acceptable range.Conclusion:There is no compete concordance of values of blood glucose between the first and the second drops of blood; any of the drops can be used for measuring BG values as the difference is not statistically significant. However, if hands are visibly clean and to decrease the blood loss in the critically ill patients where the BG values are measured frequently, using the first drop of blood is advised.

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First or Second Drop of Blood in Capillary Glucose Monitoring: Findings from a Quantitative Study

Cited by 7 publications

References 19 publications

Comparison of Glucose Values of Blood Samples Taken in Three Different Ways

Comparison of Glucose Values of Blood Samples Taken in Three Different Ways

Evaluation of the FreeStyle® Libre Flash Glucose Monitoring System in Children and Adolescents with Type 1 Diabetes

Using the first drop of blood for monitoring blood glucose values in critically ill patients: An observational study

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