多部位血糖测试 AST.ppt

* * Rubbing is important to increase the blood flow to the area to be punctured. It provides for easier sampling and less physiological influences * * * * Keep in mind the way we have found and characterized these physiological differences is through rigorous, round the clock monitoring. In the graphs we just reviewed patients were testing 4 times an hour. This has the effect of exaggerating or dilating differences. [and that was our intention.] [It is important to note that] the blood glucose differences we have reviewed We have observed that hyperglycemic excursions can have this lag, but are not clinically significant. It is when testing for hypoglycemia that the physiological differences can be an issue. … and The vendors who have received FDA clearance for alternate site testing have labeled accordingly I can say that in my practice, patients are not testing 4 times an hour…… My recommendation is to test using very common monitoring guidelines… pre-meal, bedtime and occasional post-prandial 2-3 hours post meal testing. At each of these points, glucose is very likely to be stable. * * * Presented at ADA Post Grad Sessions in San Francisco in February 2002 Published in referenced journals * The blue line indicates the unrubbed arm – the red line represents the finger Arm lags in response to glucose changes versus the finger. This physiological is attributed to circulation/diffusion differences. Circulation in the fingers and palms is between 3-5 times faster than in the arms, legs and trunk. * * When glucose is relatively stable, there is not enough difference to raise any objective concern. Let me now draw your attention to the left-hand corner of the screen…. * * Needs updating * I have touched on some of the clinical advantages we has observed with the innovation in alternate site or “multisite” testing. * Rubbing increases circulation – this is the same person that exhibited lag in the previous slide, but with rubbing the lag was eliminated.