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Self-Monitoring of Blood Glucose: The Use of the First or the Second Drop of Blood
Open accessAbstract
OBJECTIVE: There is no general agreement regarding the use of the first or second drop of blood for glucose monitoring. This study investigated whether capillary glucose concentrations, as measured in the first and second drops of blood, differed ≥10% compared with a control glucose concentration in different situations. RESEARCH DESIGN AND METHODS: Capillary glucose concentrations were measured in two consecutive drops of blood in the following circumstances in 123 patients with diabetes: without washing hands, after exposing the hands to fruit, after washing the fruit-exposed hands, and during application of different amounts of external pressure around the finger. The results were compared with control measurements. RESULTS: Not washing hands led to a difference in glucose concentration of ≥10% in the first and in the second drops of blood in 11% and 4% of the participants, respectively. In fruit-exposed fingers, these differences were found in 88% and 11% of the participants, respectively. Different external pressures led to ≥10% differences in glucose concentrations in 5–13% of the participants. CONCLUSIONS: We recommend washing the hands with soap and water, drying them, and using the first drop of blood for self-monitoring of blood glucose. If washing hands is not possible, and they are not visibly soiled or exposed to a sugar-containing product, it is acceptable to use the second drop of blood after wiping away the first drop. External pressure may lead to unreliable readings.
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The first blood drop is generally considered the best biological matrix to be used.
“The first blood drop is generally considered the best biological matrix to be used 99.”
From Glucose biosensors in clinical practice: principles, limits and perspectives of currently used devices (2022) · cites this paper as [99]
The Conclusions recommend the first drop for self-monitoring of blood glucose after washing and drying the hands. They also say there is no general agreement about which drop to use and permit the second drop under specified conditions. The paper therefore supports a conditional preference, not the unqualified claim that the first drop is generally considered the best biological matrix. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe diffusion of glucose from the capillary to the ISF occurs with a short delay of 5-10 min, thus limiting the reliability of results in hypoglycemic emergencies.
“The diffusion of glucose from the capillary to the ISF occurs, however, with a short delay of 5-10 min, thus limiting the reliability of results in hypoglycemic emergencies 99.”
From Glucose biosensors in clinical practice: principles, limits and perspectives of currently used devices (2022) · cites this paper as [99]
The Methods section ('Time interval during measurements'; page unavailable) describes a maximum 90-second interval between consecutive capillary blood measurements, not diffusion from capillary blood to interstitial fluid. Searches for the claimed 5–10-minute interstitial-fluid delay and its effect in hypoglycemic emergencies found no passage addressing either point. (LLM, conf=0.76)
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Metadata
- Authors
- Hortensius, J., Slingerland, R. J., Kleefstra, N., Logtenberg, S. J. J., Groenier, K. H., Houweling, S. T., & Bilo, H. J. G.
- Affiliations
- Isala (NL)
- University Medical Center Groningen (NL)
- University of Groningen (NL)
- Medical Research Group, Langerhans, the Netherlands
- Corresponding author
- Hortensius, Johanna
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2011-02-17
- Volume
- 34
- Issue
- 3
- Pages
- 556-560
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3041180
- OpenAlex
- W2132891417
- Cited by
- 76
- References
- 13
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 3 · 2023: 5 · 2022: 2 · 2021: 5 · 2020: 3 · 2019: 6 · 2018: 2 · 2017: 5 · 2016: 6 · 2015: 8 · 2014: 6 · 2013: 9 · 2012: 8
- FWCI
- 6.30
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Funders
- Sanofi
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- self-monitoring of blood glucose, capillary blood glucose, hand washing, diabetes mellitus
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Humans, Blood Glucose Self-Monitoring
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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