Glucose monitoring: New and upcoming testing devices

The most common method of testing glucose is to use a lancet to prick a finger, producing a drop of blood. To minimize discomfort or bruising, it may help to use the side of a finger, wash hands in warm water, shake the hands, or use finer-tipped lancets. Still, most people with diabetes would love to have an alternative way of testing their blood.

The following products can replace fingerstick testing with a lancet:

• The "Lasette" draws a drop of blood from the finger, but does so using a laser. The laser creates a small painless hole in the skin, producing only a mild tingling sensation. This product's main drawback is a hefty price tag.
• Several companies make devices that draw blood from areas other than the fingertips. These areas -- such as the upper arm or thigh -- tend to be less sensitive, so it may not hurt as much as using a finger tip. The devices also require a smaller drop of blood. Brand names include Accu-Chek, AtLast, Freestyle, and One Touch.
• The "Sof-Tact" uses light suction to hold skin on your arm firmly in place, while an integrated lancet draws the blood. The drop is applied automatically to a test strip with results in 20 seconds. It eliminates the need for a person to lance a fingertip.

You may also hear about the following products, which provide more continuous, detailed blood glucose information. They supplement but do not replace fingerstick testing:

• A product by MiniMed (the Guardian REAL Time Continuous Glucose Monitoring System) uses a sensor under the skin to record blood glucose every 5 minutes for 3 days. This detailed information can be used by a doctor to suggest corrections to a person's diabetes management program (like eating and exercising habits).
• The FreeStyle Navigator continuous glucose monitor received approval from the Food and Drug Administration (FDA) in 2008. The device has early warning alarms at 5, 10, and 15 minutes in advance of low and high blood sugar readings. The device can be worn for up to 5 days and has a wireless transmitter with a 10-foot range.
• Dexcom is another continuous glucose monitoring system. An updated version now also provides trend arrows to show you the direction your blood sugar is heading, and how quickly it is moving in that direction. This helps you avoid high and low readings. You can also wear the device for up to a week.

Finally, some companies are trying to develop devices that would replace fingerstick testing and lancets altogether. One such device, the Diasensor, has been in development since the mid-90s but has not yet received FDA approval. It uses an infrared beam to read blood glucose in capillaries under the skin without breaking the skin. A number of other companies are working on similar devices. As research continues and new products come to market, glucose testing may some day be essentially effortless and painfree.

References

American Diabetes Association. Standards of medical care in diabetes--2009. Diabetes Care. 2009 Jan;32 Suppl 1:S13-61.

Bui H, Perlman K, Daneman D. Self-monitoring of blood glucose in children and teens with diabetes. Pediatr Diabetes. March 2005:50-62.

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