My daughter’s been saying that all her fingers hurt from the constant sticks, and I’m sure they do. She’s already using the lightest setting on the spring-loaded thingamabob, and the endo discourages CGMs (not forever, but at least while this is all so new). So, given that she’s stuck sticking herself, are there things she can do to make it any better at all?
Couple things come to mind. Are you using the finest gauge lancet you can find? There isn’t consistency among lancet device depths, so you may need to try a couple different ones out to see which ones don’t go as deep as your current one.
I have a rotation scheme using 8 fingers. Each finger has a top-side and a bottom-side as I look at them so each general area only gets pricked every other day - I [practically] never poke in the finger center.
If there was a drawing board, I try sketching my pattern, but … My next test is 2:30 AM tomorrow and that being an odd numbered day, I will get blood from the upper side of my left index finger; at 8 AM, I will get blood from the upper side of my left middle finger, etc. Today being an even numbered day, my 2:30 AM test was from the lower side of my left index finger and my last test today was fron the lower side of my right baby finger.
YEAH, sounds confusing but it gets easier - just hold your two hands in front of you, palms facing you and look at ALL those tender places waiting to give blood. OKAY, I’m making light of a tender issue, but maybe I’ve gotten through 58 years by trying to see the bright side.
Get your daughter to lance the sides of her fingers, just below the nail on each side of her finger, as there are fewer nerve endings there, which causes less pain.
Another option is for you to speak with your daughter’s doctor/endocrinologist and ask about a meter that is capable of using alternate sites. (Some blood glucose meters allow taking of the blood sample from areas such as the forearms and palms of hands. This, however, is not quite as accurate as blood taken from the fingers.)
I use both the first and second joints on all ten of my fingers. That can give more area to explore, and the finger tips will be used less frequently.
Mick is right about the alternate sites. my last few meters have had that option but I’ve used it very frequently because of “delayed” response time.
The alternate sites should not be used if a person is more active than usual, or if there is history of rapid changes in BG levels. I’m brittle and have had many otherwise unexplained changes of a few hundred points in BG level over short periods of time.
I just wanted to second Mick’s encouragement to use the sides of her fingers, as well as to make sure you rotate sites. I’m new to this also, and my first instinct was to go right for the center pad of my finger. Switching to using the edges/sides of my fingers made a big difference for me.
Also, as powvens said, it really does help to try a few different lancets. I bought some that I was sure would be perfect because they were super tiny (supposedly) and they hurt worse than anything else I had tried! I just kept trying a few different ones, and now I have ones that (at least for me) work great.
I’ve had type 1 since 1971. I have found the BD Ultra Fine Lancets the sharpest, finest,most comfortable lancets available . You can buy cheaper lancets but you get what you pay for. If you get your supplies from a mail service like Express Scrips, CVS,Walgreens, or Rite-Aid home delivery, you will have to have your Endo. send in a “Prior Authorization” or Prior Auth.
My daughter, son and I use OneTouch Delica with their lancets. They hurt way less than any others we have tried. additionally, since my son is only 4, he knows that his five fingers represent different days of the week and sat/sun are free days (sometimes we use his toes on the weekend). so monday pinky finger through to friday thumb’s up.
Also, both of my kids have been on a CGM since right after diagnosed. GET ONE. So much peace of mind with the CGM - we sleep better, get through our day easier knowing where his numbers are, go on dates without constant worry, send my daughter to friend’s houses without creating additional anxiety for those parents, etc. We have the Dexcom - which now sends the data right to your iPhone for constant monitoring.
If the insurance company denies it initially, get the CGM rep to assist you with appeals - eventually the insurance company will roll over.
I agree with cimataspal. CGMs are a great tool for peace-of-mind. And getting the CGM rep to work with you will help a lot if you’re not comfortable yet with being your own advocate.
Regarding which lancets to use, or where to test…others above have already given lots of good input. I would definitely test other lancet devices until you find one that works. My son uses the Accu-chek FastClix as it allows adjusting the depth and has multiple lancets so less time changing needles. I remember in the hospital whatever they were using was awful for him.
My son’s Endo wasn’t against a CGM, but wanted us to wait until at least 6mos after diagnosis to make sure we were coping and handling everything well. My son is 7, turning 8 in September and he was diagnosed at age 5. We started off doing injections with a needle. Then we moved to a pen-style injection system. Eventually we moved to a pump (Omnipod)…which was an amazing and wonderful change for us. Then, a few months after that we got a Dexcom CGM (before they had the “Share” feature).
The CGM is awesome once you have good practices, as you can then see trends and help stabilize the numbers even more. But it needs regular calibrations through fingersticks anyways, and should not replace mealtime checks. We have had a nice reduction in the daily number of finger sticks though. And his A1C has continued to come down as well. Plus now if he’s feeling “off” we can check his CGM to get an idea of what’s going on. Just recently we had our CGM replaced with the new version that has “Share”. The CGM has on-board Bluetooth and can connect to an Andriod or iPhone phone has internet access, it uploads the data to “the cloud”. So my wife and I can now remotely check what is going. This has been amazing. I now don’t need to go check his CGM in the middle of the night, I can glance at my phone to see what his number is. I had recently upgraded my iPhone, and I’m glad I didn’t sell my old one. So I reset my old one (wiped off the data/apps) and paired it with the CGM receiver. Then I turned off the cellular data, and I make sure the wi-fi is on and I lock it with a passcode. So anytime he’s near a wi-fi signal, I can see his CGM if the phone has used the router in the past). Eventually, I may add the old phone to our data plan, but I’m waiting to see just how much data the app uses in the background. I think the data usage is very light so I doubt it will be an issue.
A CGM is great in the presence of good habits/management. Checking BG only tells you the number at that moment. Seeing a graph of BG numbers taken every 5mins by a device lets you combine knowing the number now and where it’s headed.
I hope by now your daughter is having a more comfortable/less painful time poking her fingers with her lancets. I did want to also suggest that she massage the finger she is going to use right before poking because it causes the blood to circulate making it easier for it to flow and less painful. I found that helped my son a lot when he was first diagnosed (15 yrs. ago). Also; I wanted to caution against moving too fast into pushing for the latest or more convenient system (Talking about the CGM) if your doctor does not think your child is ready for it. I say this because each family/child is different and so is each doctor and although the CGM works well for some for others it may not and if your doctor is on the more conservative side and wants to wait for your family to get a little more acclimated to diabetes management it is usually for a reason and in your child’s best interest. My son’s 1st Dr. whom he had for the 1st 13 years (we only switched last year when he turned 15 because his Dr. moved the office too far away, and we also wanted him to start seeing an adult Endo); was one who did not like to put children on the pump right away (which most did not back in the early 2000s) and when I would meet other parent’s who had children newly diagnosed and on the pump some would say it made things harder and they wish they would have waited. Don’t get me wrong there were also some who were able to adapt easily but; we understood why our Dr. wanted us to wait. The age of the child makes a difference as well because the CGM is a lot more to handle for the parent as well. I would suggest concentrating on getting past one hurdle at a time which is adjusting to managing poking the finger and blood sugar levels first before adding a whole new range of responsibilities. The less stress you and your family have managing T1 the better. I hope this helps, take care.
Site rotation is important for finger blood testing as well as bolus, pump & CGM placement. With two central fingers on each hand I used inside, outside, near tip, mid side of farthest digit and near the farthest finger joint were all used while I tested my blood 6 to 10 times daily. 24 sites was do-able.
For insulin boluses my rotation pattern involves Thumb, Middle, Little, Index & Ring moving around what I call a HASL; hip arm, stomach and leg. Anymore the stomach (40 sites) is reserved for a CGM and TID long acting insulin boluses. This still leaves me with 30 sites for my boluses in my hips, arms and legs. Use both sides, it is a simple shot, not anything real difficult.