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The Painless Revolution

By David Mendosa

Last Update: June 2, 2001

They are technically called alternative site blood glucose meters. Alternatives to fingertips, these sites are on your forearm and other places that have few nerve endings.

The term alternative sites doesn't sound too exciting. But what is exciting is that most people can now test their blood glucose painlessly most of the time.

‘Alternative sites…meters are a blessing.’

Amira Medical's AtLast meter, reviewed here in the May 2000 issue, was the first alternative sites testing meter to hit the market. It uses only 2 microliters of blood and gives the result in 15 seconds or less. Gentle pumping brings blood to the surface, which you then lance.

Now, with different technologies four new alternative meters give the same painless results. That's because each of these meters use very little blood, 2 to 3 microliters or less.

The newest and most advanced design is the MediSense Sof-Tact from Abbott Laboratories. Introduced to the U.S. market in April, the Sof-Tact's integrated design hides the blood glucose testing within the meter, essentially precluding user error in sampling your blood. Since you can pre-load the meter with a new strip for up to eight hours, you can use it discreetly in public places. The pre-load feature also makes middle-of-the-night testing that much easier as it also is for adults with limited dexterity.

After inserting a new strip and lancet in the meter, you use it by resting it on your arm. When you press the start button, a built-in vacuum pump creates a seal over the area to be lanced. The lancet goes through the test strip and lances the skin. Then the vacuum draws 2-3 microliters of blood to the surface and onto the test strip. Results are ready in 20 seconds.

You can also use the Sof-Tact for traditional fingerstick testing. To do that you use the external port, which is otherwise used for the control solution, calibration, and downloading test results to software. But this requires a lancing device, which is not supplied.

Compared to other meters the Sof-Tact is large. It is 5½ inches long and weighs 10.6 ounces.

At $199.95 list the Sof-Tact is also considerably more expensive that other meters. A box of 50 strips sells for $49.99. MediSense has no plans to offer rebates or trade-ins like those regularly available for other meters, a company spokesperson says.

Like the Sof-Tact, the TheraSense FreeStyle is offered primarily as an alternative site meter. The FreeStyle is unique because it uses only 0.3 microliters of blood, which is about the size of a pinhead and just a fraction of that used by any other meter.

The FreeStyle comes with a special lancing device that has a clear cap where you can see your blood sample. You can also use it for fingertip testing.

The FreeStyle is 3¾ inches long. It weighs only 2.3 ounces.

Listing for $75, the FreeStyle includes a $40 rebate coupon, making the effective list price just $35. A box of 50 strips sells for $38.95.

FastTake and Ultra
Inverness Medical makes the other two meters that use a small enough blood sample for alternative site testing. But they are offered by LifeScan, which sells them as the One Touch FastTake and the One Touch Ultra.

These cute little meters are the smallest and lightest of these meters. Each is 3 inches long and weights only 1.5 ounces.

Until recently LifeScan promoted the One Touch FastTake exclusively for fingertip testing. But its new test strips require only 1.5 microliters of blood, making alternative site testing possible. You get the result in 15 seconds.

Even newer, faster, and requiring less blood than the One Touch FastTake is the One Touch Ultra. Available since February, the Ultra takes only 1.0 microliter of blood. It's the fastest of all meters, giving a result in only 5 seconds.

LifeScan claims the broadest operating temperature range for the One Touch Ultra. It works from 43° to 111°F.

LifeScan says it doesn't have a list price for its meters. But the FastTake typically sells in drugstores for less than $70, and LifeScan offers a $20 rebate and $45 trade-in. A box of 50 strips sells for $35 to $40.

The Ultra also sells for less than $70, and here LifeScan offers a $40 rebate and $25 trade in. A box of 50 Ultra test strips goes for about $40.

Sharon Brown of Sacramento, California, speaks for users of all of these new meters. "I currently use the TheraSense FreeStyle monitor and I love it," she says. "It really is painless. I'm finally getting back in control of my blood glucose levels, which have been out of whack for a long time. I used two other meters, but I couldn't get myself to do the fingersticks on a regular basis. After a few times, my fingers would be very sore and it became increasingly difficult to milk any blood from them."

Not everyone will notice that big a difference. "Many people with diabetes who have been testing for years have fingers so callused that they hardly notice the lancet's sting any more," says William Biggs, M.D., an endocrinologist practicing in Amarillo, Texas. "But for those newly diagnosed there's hardly anything in the day-to-day management of their diabetes that's worse. For them the new alternative sites testing meters are a blessing."

Some people do report occasional bruising and others report red pinholes on their arm with alternative site meters. A MediSense representative says that you can minimize bruising by testing on the upper surface of your arm, rather than the lower surface where veins are close. You can also minimize any marks by wiping the small amount of blood from your arm right after testing.

Even if you have your heart set on the Cygnus GlucoWatch Biographer, which the Food and Drug Administration approved in March, these meters warrant your careful consideration. While the GlucoWatch tests non-invasively through the skin and automatically provides readings every 20 minutes, it will not be available until the end of the year and then probably only in limited quantities. You will also need to calibrate the GlucoWatch against a blood glucose meter every day and to double-check high or low readings. 

This article originally appeared in Diabetes Wellness Letter, June 2001, pp. 5, 8.

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