From the Guidelines
To minimize bruising and pain from frequent blood sugar checks, consider using Flash Glucose Monitoring (FGM) or rotating testing sites, and employing techniques like using the sides of fingertips, adjusting lancing device depth, and applying gentle pressure. This approach is supported by recent guidelines, such as those outlined in the clinical application guidelines for blood glucose monitoring in China (2022 edition) 1, which highlight the benefits of FGM in reducing the need for frequent finger pricks and improving patient compliance with glucose monitoring.
When using traditional blood glucose monitoring, several strategies can help decrease bruising and pain:
- Rotate testing sites regularly, using different fingers and alternative sites like the forearm or thigh when the meter allows, as suggested by assessing glycemia in diabetes using self-monitoring blood glucose and hemoglobin A1c 1.
- Use the sides of fingertips rather than the center, as these areas have fewer nerve endings.
- Adjust the lancing device to the minimum depth necessary for an adequate blood sample.
- Ensure the use of fresh, sharp lancets, ideally changing them daily.
- Before testing, wash hands with warm water to improve circulation and make blood collection easier.
- Apply gentle pressure instead of squeezing the puncture site to reduce bruising.
- After testing, apply brief pressure to the site to minimize bleeding.
- Consider using newer, thinner gauge lancets (30-33 gauge) which cause less trauma.
These strategies work by minimizing tissue damage, reducing nerve stimulation, and improving blood flow, making the testing process less traumatic to the skin and nerve endings. However, for those who can access it, FGM offers a significant reduction in the pain and discomfort associated with frequent blood sugar checks, as it does not require calibration through finger pricks 1.
From the FDA Drug Label
Use temporarily relieves minor pain The most relevant strategy to decrease pain from blood sugar checks is using lidocaine (TOP), as it temporarily relieves minor pain 2. However, there is no information about decreasing bruising.
- Lidocaine (TOP) may help with pain associated with blood sugar checks.
- No strategy is mentioned for reducing bruising.
From the Research
Strategies to Decrease Bruising/Pain from Blood Sugar Checks
- To minimize bruising and pain from frequent blood sugar checks, alternative sites for blood glucose monitoring can be considered, such as the dorsal side of the finger between the nail and the distal finger joint, as shown in a study 3.
- Using a lancet device with adjustable puncture depths (0.2 mm and 0.3 mm) can substantially reduce the proportion of subjects who experience pain during blood glucose monitoring, with 89% and 94% of subjects feeling no pain, respectively 3.
- Continuous glucose monitoring (CGM) systems, such as flash CGM, can also be used to reduce the need for frequent finger-prick blood glucose checks, providing detailed information about glycemic variability and enabling more informed decision-making 4, 5, 6.
- CGM has been shown to improve clinical outcomes in type 1 diabetes and has significant benefits in patients with type 2 diabetes, including improved glycemic control and better treatment adherence 4, 5.