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Cited by 114Diabetes Management and ResearchClinical Laboratory Practices and Quality ControlHyperglycemia and glycemic control in critically ill and hospitalized patients

Glucose Monitoring at the Arm

Open access
Jungheim, Karsten, Koschinsky, Theodor·2002·Diabetes Care
DOI 10.2337/diacare.25.6.956
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Abstract

OBJECTIVE—We have examined whether rapid changes in blood glucose (BG) result in clinically relevant differences between capillary BG values measured at the forearm and the fingertip and whether local rubbing of the skin before blood sampling can diminish such differences. RESEARCH DESIGN AND METHODS—Capillary BG samples were collected every 15 min for 3–5 h from the fingertip and the forearm of 17 insulin-treated diabetic patients and analyzed with different glucose monitors (FreeStyle, One Touch Ultra, and Soft-Sense). In a subgroup of patients (n = 8), local rubbing of the forearm skin was performed before blood sampling. A rapid increase in BG was induced by oral administration of glucose, and subsequently, a rapid decrease in glucose was induced by intravenous administration of insulin. RESULTS—In the fasting state, the BG values at the fingertip and at the forearm were similar (7.8 ± 2.4 vs. 7.2 ± 2.3 mmol/l, P = 0.06). However, during rapid increase in glucose, BG values at the fingertip were consistently higher than at the forearm (maximal difference 4.6 ± 1.2 mmol/l, P < 0.001). During rapid decrease in glucose, lower BG values were recorded at the fingertip (maximal difference to forearm 5.0 ± 1.0 mmol/l, P < 0.001). At the forearm, BG was delayed by a median of 35 min (P < 0.01) in relation to the fingertip. Rubbing of forearm skin decreased the observed differences but with a large intraindividual and interindividual variability. There were no obvious device-specific differences. CONCLUSIONS—To avoid risky delays of hyperglycemia and hypoglycemia detection, BG monitoring at the arm should be limited to situations in which ongoing rapid changes in BG can be excluded.

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  • When glucose is rising or has just risen sharply, fingertip capillary glucose is greater than at forearm, thigh, and abdomen, with variable differences in repeated tests.

    “When glucose concentrations are rising or have just risen sharply, fingertip capillary glucose concentrations are greater than those in capillary blood from other sites including forearm, thigh and abdomen (Ellison et al. 2002;Jungheim & Koschinsky, 2002;van der Valk et al. 2002), with variable differences in repeated tests on the same subject (Ellison et al. 2002);”

    From Glycaemic index methodology (2005) · cites this paper as Jungheim & Koschinsky, 2002

    The Abstract and Data analysis report that fingertip glucose was consistently higher than forearm glucose during a rapid rise. The Procedures describe sampling only at the fingertip and forearm, so this paper does not establish the comparison with thigh or abdomen. The repeated-test variability clause is cited to Ellison et al., not to this source. Page numbers are unavailable for these passages in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • When blood glucose falls, fingertip capillary glucose is lower than forearm.

    “conversely, when blood glucose concentrations fall, fingertip capillary glucose concentrations are lower than those on the forearm (Jungheim & Koschinsky, 2002).”

    From Glycaemic index methodology (2005) · cites this paper as Jungheim & Koschinsky, 2002

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Authors
Jungheim, K., & Koschinsky, T.
Affiliations
Deutsches Diabetes-Zentrum e.V. (DE)
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2002-06-01
Volume
25
Issue
6
Pages
956-960
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.25.6.956
OpenAlex
W2082028634
Cited by
114
References
22
Citations by year
2026: 1 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 3 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 4 · 2014: 2 · 2013: 9 · 2012: 3
FWCI
6.93
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
Keywords
capillary blood glucose, hyperglycemia detection, hypoglycemia detection, insulin-treated diabetes
MeSH terms
Awareness, Capillaries, Fingers, Forearm, Humans, Hyperglycemia, Hypoglycemia, Insulin, Blood Glucose Self-Monitoring, Reproducibility of Results

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