Are there any adverse long-term effects from doing lots of finger sticks? I do around 6-10 per day, but I rotate around a ton of sites on each of my fingertips. I’ve tried using palm, thigh, and forearm, but none of those sites given enough blood and require mutliple sticks just to get any. I’ve heard sometimes calluses can develop, which can make drawing blood harder? Anything else? And when do these effects start occurring? Thanks!
You can develop calluses, yes. Rotating sites helps a lot. I tested multiple times a day for 30 years, and that’s the only effect I’ve had from it. (They do clear up if you avoid the callus for a while.)
6-10 is a lot, though. Is a CGM an option?
Also, be careful with using blood from other sites. It’s less accurate, and some meters aren’t designed to properly handle blood from alternate sites. Check your meter’s instructions.
Also, if you’re having trouble getting blood from the site, you may want to try a different lancet, lancet device, or depth setting on the lancet device.
Thanks for the info! I’m 10 months into my diagnosis. I used a CGM for six months, learned a lot about general trends, but gave it up because on a moment-to-moment basis it was too inaccurate, I was constantly having to calibrate, and if not, doing incorrect treatments since the numbers were wrong. It was just way too frustrating to have to deal with. If they get more accurate at some point, I’ll go back.
I have been finger sticking since I was diagnosed in 2017. So far, as long as I rotate sites, I don’t have any problems. (I am starting my cgm soon) I only check 4-6 times a day though. Depending on which meter you have, I believe you can do some alternate sites, but the only semi-okay alternate I have heard of is the palm of your hand. If you do that, I believe that you have to find a spot that is a little fatty!! That may be wrong, I only use finger tips, so check your meters manual.
Inside of the forearm was touted as a good alternate site because it’s less painful than fingertip. But it’s less reliable and the list of times you’re not supposed to use it is ridiculously long.
If I may ask, what CGM did you use? My Medtronic Guardian 3 was fairly accurate, but it required calibration 3 times a day, at least. My Dexcom G6 requires no calibration (though I still do it daily) and it’s usually pretty much spot on (despite the advertised 20% error factor), especially after the first day.
I was warned by the Dexcom people and others that calibrating too often (more than twice a day) can actually confuse the algorithm and make the readings less accurate.
But any CGM will be reading interstitial fluid rather than blood, so the data will always lag a bit from changes in your blood sugar and it will always be a little less accurate than a finger stick.
But I started in 1990 with finger stick meters that required a huge drop of fingertip blood, could not use any alternate sites, and had a 20% error factor. I still only tested twice a day, and my control was pretty good.
Might be worth talking to your endo about options and how much you should be testing. 6-10 times a day every day seems excessive to me. 4-5 on a bad day is a lot by my standards, but I’m not your doctor and I don’t know how your control is.
Otherwise… Back when we did need a very large drop to fill the test strip (and you aren’t supposed to squeeze too much or use a second drop because that will have interstitial fluid mixed in and be less accurate), they told us that if we were having trouble you could wash your hands in hot water to help bring extra blood to the surface of the skin. Not enough that the skin starts to wrinkle, and you have to make sure to dry thoroughly, but it can help.
Switching meters might also help. Freestyle has “butterfly” strips that require almost no blood at all (0.3 microliters). Contour Next (which my endo prefers because it’s a little more accurate) requires 0.6 microliters. One Touch requires 1.0 microliters. My first meter required several times that sample size. There’s a comparison PDF here.
But changing to a higher gauge (thinner) lancet and pressing a little harder or adjusting the setting on the lancet device (so you’re making a smaller but deeper hole) might help.
@BKN480 I have been stabbing my fingers since finger stick meters were invented. yup, since they were first available, ever. I have had maybe 1 local infection in well over 20 years. No other adverse reactions.
my total number of sticks is staggering. The JDRF “Footprint” calculates my bs testing as over 90,000 but it’s wrong because it assumes that there were bs meters when I was diagnosed (there wasn’t) anyway, rotate your sites, change your lance AT LEAST once per year (I change them when they hurt) or if you see rust on them and you’ll be fine. I am kidding. not about never changing the lance but about the rust.
if you want to see the JDRF diabetes footprint calculator, go to https://www.jdrf.org/community/take-action/imthetype/ scroll WAAAAAY down to the bottom and click “Create my T1D Footprint” and put in the dates.
I cede my childhood self-claimed title of Sir Lancet-lot to you, good sir.
I used the Dexcom G6, the leader in the industry. I’m wondering why 6-10 is excessive when the G6, assuming a 16-hour day, gives you 192 readings (and supposedly it’s this constant ability to know one’s numbers that lends itself to greater control and better blood sugar levels)?
My goal is to keep fairly tight control within a range of 80-120, though spiking after meals for a short period of time doesn’t bother me. Given this range, and how close 80 is to going too low, the error rate on the CGMs and their lag time (including during activity/exercise) is precisely why I found it no longer useful, especially once I understood my general trends better (which for that, it was very useful). If I never calibrated, I would get way too many false low alarms overnight (that alone makes them practically not worthwhile), or I would take insulin when I didn’t need it, or eat carbs when I shouldn’t. I ended up having to check my numbers with the meter anyway, just in order to know whether I should treat or not, which is what I would do without a CGM. So, for me, not worth it!
Thanks Joe! That’s great to know.
Anyway, thanks for all the info on meters and finger sticking, and for the PDF link - I really appreciate it!
Having a lot of CGM readings is great. Really helpful. Especially in conjunction with a pump that can automatically adjust insulin dosage up or down to compensate. But I had “good enough” control with 2 fingersticks a day and a solid handle on my routine (diet, dosage, etc).
When I say 6-10 is excessive, I don’t mean that it’s bad to have that much data. I mean that it’s painful to be pricking your fingers every hour or two, and I personally would not find the benefit worth the cost. My control hasn’t been as tight as yours (A1C of ~7.3 for most of it, which comes to an average around 180, down to around 6.4 now with a closed loop pump in the last 2 years, with my 30 day Dexcom average at around 140), but I’ve had no complications from it in the last 30 years and my doctors are happy with where I am. I’d find testing that often and keeping control that tight to be stressful, restrictive, and unsustainable over the long haul. You and your doctors may feel differently. Whatever you choose, good luck!
Not a good comparison in my opinion. First off if you need reliability and relevant information for dosing, you have to be checking blood 6-7 times per day minimum. That’s not excessive if you ask me. My script says test 10x per day so I always have enough. The CGM sensor stays in ya and so 120+ “checks” is really just a polling frequency. What the CGM can give you is your post meal trajectory and your general trend, such as overnight, as long as you realize there is lag.
Any given bs meter is subject to error. It is usually 5-10% but can be 20% under certain conditions. Meaning if your finger stick reads 180 mg/dl, your actual blood sugar is “probably” between 198 and 162 and “very likely” between 216 and 144. The truth is even a finger stick sucks if you are trying to ride 80 mg/dl with accuracy and reliability. All opinions, no offense intended, your experience may be different.
I get you. Thanks for the info and for sharing your own experience - it’s great to hear you’ve done well. I’m just starting out, and may need to check less over time as I get better at knowing where I’m at based on food, activity, etc. Even 10 months in it still feels new and weird… but less so w/ each passing month…
I agree with the minimum of 6-7 times/day for relevant info, from my experience so far. My scripts are for the same.
Yes many of the CGM readings are not necessary info, which makes the comparison weak. On the other hand (assuming it’s fairly accurate), you may need those in-between readings (relative to 7 finger sticks/day) to have a better idea of what you need to do - and surprises happen, which you might not catch or realize w/ finger sticks. So in that sense, comparing it to CGM is useful, since you’re just saying, “more info maximizes relevant info (even if it also maximizes irrelevant info)”. But again, that’s assuming the numbers are fairly accurate in the first place.
Yeah meters aren’t 100% accurate either, though I guess more so than CGM. For me, that just means meters are better, and CGM not worth the hassle (e.g. of always second-guessing how accurate it is).
It does take a while to get the hang of it. My first year, we were measuring everything I ate or drank and leveling off the measuring cups. We got the hang of it as time went on. Learned to eyeball stuff and how my body reacted to it. My grandfather, who was insulin dependent before I was born, needed tighter control (both for his own peace of mind and, later, because we were balancing the needs of several conditions). You’ll find what works for you in time.
Like I said, when I started out, meters had a 20% error factor and CGMs didn’t exist. Now meters are more accurate and CGMs have a 20% error factor. Which means my CGM is as accurate as the meter I had in 1990, except I get readings every 5 minutes instead of a few times a day. (And, for me personally, my Dexcom has been considerably more accurate than 20% most of the time.)
It is pretty cool having the graph show me the arc as I digest meals and warn me of spikes and dips. Even cooler having a pump that can actively use that data. We’ve come a long way.
But, yeah, if yours isn’t dependable enough for you, that makes sense. You’ll find what does work in time.
Only 6 was a good day for us. Breakfast, snack, lunch, snack, dinner, and bedtime is 6, and that’s without a single check for feeling low, rechecking after treating a low, or having the meter reject your strip. (Not casting aspersions on anyone who manages differently, just letting you know what we did.)
We like the G6 very much, but it’s clearly not for everyone — including us for the first 4+ years after diagnosis, others on this forum a heck of a lot longer than that, and some who will never want one. You do you, Becky. Let a thousand flowers bloom.
Thanks for your feedback, it’s much appreciated! Hopefully CGM tech continues to improve, even for people who already find them helpful - icing on the cake…
I use an Accuchek SoftClix lancing device - I can adjust depth as needed. Now that I use Dexcom’s G6 fingersticks are occasional, but I do regal the days of multiple sticks! My fingertips had so many marks on them a manicurist was trying to figure out what was going on - those are long gone.
I currently use a Dexcom G6 CGM, but when I was doing finger sticks I was doing 8 - 10 sticks per day. I did them all on my finger tips for close to 30 years. I got calluses from time to time, but as others here have noted, I would poke a different spot for a week or so and the callus would go away. - - My method was to always use the side of my finger(s), but to go closer to the tip for one week and then farther down my finger for the next week. Doing this, I stopped getting calluses all together.
For the record, I don’t feel testing 6 - 10 times a day is excessive. For me, it gave me great control of my blood sugars! Some people may feel it is too much. Personally, I never found it to be so.
T1D 56+ years and counting!