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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
significant difference between fingertip/palm and alternative site blood glucose test results.
The difference in capillary bed concentration and blood perfusion throughout the body can
lead to sample site-to-site differences in glucose 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 alternative site testing of adults with
diabetes show that most persons will find their glucose level changes more quickly in the
fingers'/palms' blood than the alternative sites' blood.* This is especially important when
glucose levels are falling or rising rapidly. If your patient is used to making treatment
decisions based upon fingertip/palm readings, he or she should consider the delay, or lag-
time, affecting the reading obtained from an alternative site.
* Data on file
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