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Recommending Alternative Site Testing to Patients
Decisions about whether to recommend alternative site testing (AST) should take into account the motivation
and knowledge level of the patient and his or her ability to understand the considerations relative to diabetes
and AST. If you are considering recommending AST for your patients, you need to understand that there is
a potential for a signicant difference between ngertip/palm and alternative site blood sugar test results.
The difference in capillary bed concentration and blood perfusion throughout the body can lead to sample
site-to-site differences in blood sugar results. These physiological effects vary between individuals and can
vary within a single individual based upon his or her behavior and relative physical condition. Our studies
involving AST of adults with diabetes show that most persons will nd their sugar level changes more quickly
in the ngers’/palms’ blood than the alternative sites’ blood.¹ This is especially important when sugar levels
are falling or rising rapidly. If your patient is used to making treatment decisions based upon ngertip/palm
readings, he or she should consider the delay, or lag-time, affecting the results obtained from an alternative
site.
¹Data on le.
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