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护理学报 ›› 2023, Vol. 30 ›› Issue (6): 52-56.doi: 10.16460/j.issn1008-9969.2023.06.052

• 临床护理※内科护理 • 上一篇    下一篇

替代部位血糖监测的可行性与准确性研究

何首谊1,2, 余慧琴1,2, 张迪1,2, 李敏1   

  1. 1.中国医科大学附属第一医院 内分泌与代谢病科室,辽宁 沈阳 110000;
    2.中国医科大学 护理学院,辽宁 沈阳 110121
  • 收稿日期:2022-09-29 出版日期:2023-03-25 发布日期:2023-04-12
  • 通讯作者: 李敏（1978-）,女,辽宁沈阳人,硕士,副主任护师,护士长。Email：nancy_li_822@163.com
  • 作者简介:何首谊（1998-）,女,四川广元人,本科学历,硕士研究生在读。
  • 基金资助:
    2021年度辽宁省自然科学基金项目（2021-MS-178）

Feasibility and accuracy of blood glucose monitoring in alternative sites

HE Shou-yi1,2, YU Hui-qin1,2, ZHANG Di1,2, LI Min1   

  1. 1. Dept. of Endocrinology and Metabolic Diseases, the First Affiliated Hospital of China Medical University, Shenyang 110000, China;
    2. School of Nursing, China Medical University, Shenyang 110121, China
  • Received:2022-09-29 Online:2023-03-25 Published:2023-04-12

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摘要： 目的 探讨其他身体部位作为血糖监测替代部位的可行性、实用性及准确性。方法 采用自身对照方法,于2021年12月—2022年6月在沈阳市某三级甲等医院纳入志愿者100例为研究对象,同时（间隔<5 min）穿刺不同部位（包括耳垂、指尖、大鱼际、小鱼际、手臂、脚趾）获得随机血糖值,并抽取静脉生化血糖。比较6个部位的取样情况、准确性、疼痛得分等指标。结果 6个部位的穿刺取样差异有统计学意义（P<0.05）;耳垂、大鱼际、小鱼际、手臂、脚趾5个替代部位的血糖值均与指尖血糖值呈高相关性和一致性,具有统计学意义（P<0.05）;耳垂、指尖、手臂、脚趾的血糖值和静脉生化血糖的差异无统计学意义（P>0.05）;6个部位疼痛评分比较差异具有统计学意义（P<0.05）。结论 耳垂的血糖值呈现较高的准确性和一致性,且穿刺操作方便、疼痛感低,可能是最佳的血糖监测替代部位。

关键词: 毛细血管血糖监测, 替代部位血糖监测, 疼痛, 护理

Abstract: Objective To explore the feasibility, practicability and accuracy of other body parts as alternative parts for blood glucose monitoring. Methods With self-control method, 100 volunteers were enrolled in a tertiary grade-A hospital in Shenyang from December 2021 to June 2022. Random blood glucose values were obtained by puncture (interval <5 min) in different parts (including earlobe, fingertip, maisar, minnoir, arm and toe), and venous biochemical blood glucose was collected. The sampling, accuracy and pain scores of the six sites were compared. Results The difference in puncture sampling at six sites was statistically significant (P<0.05). Blood glucose value of other 5 sites was highly correlated and consistent with that of the fingertip, showing statistical significance (P<0.05). There was no significant difference in blood glucose and venous biochemical blood glucose in earlobe, fingertip, arm and toe (P>0.05). NRS pain score of the 6 sites was statistically significant (P<0.05). Conclusion The blood glucose value of the earlobe shows high accuracy and consistency, and the puncture is convenient and with less pain, so it may be the best alternative site for blood glucose monitoring.

Key words: capillary blood glucose monitoring, blood glucose monitoring in alternative sites, pain, nursing

中图分类号: 

  • R473.5
[1] Zhang L, Gu C, Ma H, et al.Portable glucose meter: trends in techniques and its potential application in analysis[J].Anal Bioanal Chem,2019,411(1):21-36.DOI:10.1007/s00216-018-1361-7 (2019).
[2] Draznin B, Aroda VR, Bakris G, et al.16. Diabetes care in the hospital: standards of medical care in diabetes-2022[J].Diabetes Care, 2022, 45(Suppl 1):S244-s253. DOI:10.2337/dc22-S016 (2022).
[3] Tang L, Chang SJ, Chen CJ, et al.Non-invasive blood glucose monitoring technology: a review[J]. Sensors (Basel),2020,20(23). DOI:10.3390/s20236925 (2020).
[4] Le Floch JP, Bauduceau B, Lévy M, et al.Self-monitoring of blood glucose, cutaneous finger injury, and sensory loss in diabetic patients[J].Diabetes Care,2008,31(10):e73. DOI:10.2337/dc08-1174 (2008).
[5] Bruen D, Delaney C, Florea L, et al.Glucose sensing for diabetes monitoring: recent developments[J].Sensors (Basel),2017,17(8):1866. DOI:10.3390/s17081866 (2017).
[6] Jeon SY, Shi Y, Lee AK, et al.Fingerstick glucose monitoring in veterans affairs nursing home residents with diabetes mellitus[J]. J Am Geriatr Soc,2021, 69(2):424-431. DOI:10.1111/jgs.16880 (2021)
[7] Lee KT, Abadir PM.Failure of glucose monitoring in an individual with pseudohypoglycemia[J]. J Am Geriatr Soc,2015,63(8):1706-1708. DOI:10.1111/jgs.13572 (2015).
[8] Fedele D, Corsi A, Noacco C, et al.Alternative site blood glucose testing: a multicenter study[J]. Diabetes Technol Ther,2003,5(6):983-989.DOI:10.1089/152091503322641033 (2003).
[9] Knapp PE, Showers KM, Phipps JC, et al.Self-monitoring of blood glucose with finger tip versus alternative site sampling: effect on glycemic control in insulin-using patients with type 2 diabetes[J]. Diabetes Technol Ther,2009,11(4):219-225. DOI:10.1089/dia.2008.0060 (2009).
[10] 黄燕,李卉,高金平,等.合肥地区健康成年人群皮肤微循环的观察[J].安徽医科大学学报,2017,52(10):1572-1574.DOI: 10.19405/j.cnki.issn1000-1492.2017.10.035.
[11] Peled N, Wong D, Gwalani SL. Comparison of glucose levels in capillary blood samples obtained from a variety of body sites[J]. Diabetes Technol Ther, 2002, 4(1):35-44; discussion 5-7.DOI: 10.1089/15209150252924067.
[12] Greenhalgh S, Bradshaw S, Hall CM, et al.Forearm blood glucose testing in diabetes mellitus[J]. Arch Dis Child,2004,89(6):516-518.DOI:10.1136/adc.2002.019307 (2004).
[13] Harris DL, Weston PJ, Gamble GD, et al.Glucose profiles in healthy term infants in the first 5 days: the glucose in well babies (GLOW) study[J].J Pediatr,2020,223:34-41.e4. DOI:10.1016/j.jpeds.2020.02.079 (2020).
[14] Everett E, Mathioudakis N.Update on management of diabetic foot ulcers[J]. Ann N Y Acad Sci, 2018, 1411(1): 153-165.DOI: 10.1111/nyas.13569.
[15] Association AD.11. Microvascular complications and foot care: standards of medical care in diabetes-2021[J].Diabetes Care,2021, 44(Suppl 1):S151-s167.DOI:10.2337/dc21-S011 (2021).
[16] Chan HY, Lau TS, Ho SY, et al.The accuracy and acceptability of performing capillary blood glucose measurements at the earlobe[J].J Adv Nurs,2016,72(8):1766-1773. DOI:10.1111/jan.12944 (2016).
[17] Fedele D, Corsi A, Noacco C, et al.Alternative site blood glucose testing: a multicenter study[J]. Diabetes Technol Ther, 2003,5(6):983-989.DOI:10.1089/152091503322641033.
[18] Wei CH, Peng TC, Wang PY, et al.Clinical evaluation and alternative site blood glucose testing of the EasyPlus mini R2N blood glucose monitoring system[J]. Clin Chim Acta,2009, 403(1-2):167-172. DOI:10.1016/j.cca.2009.02.011 (2009).
[19] Kempe KC, Budd D, Stern M, et al.Palm glucose readings compared with fingertip readings under steady and dynamic glycemic conditions, using the OneTouch Ultra Blood Glucose Monitoring System[J]. Diabetes Technol Ther, 2005, 7(6):916-926. DOI:10.1089/dia.2005.7.916.
[20] Ellison JM, Stegmann JM, Colner SL, et al.Rapid changes in postprandial blood glucose produce concentration differences at finger, forearm, and thigh sampling sites[J].Diabetes Care,2002, 25(6):961-964. DOI:10.2337/diacare.25.6.961 (2002).
[21] Bina DM, Anderson RL, Johnson ML, et al.Clinical impact of prandial state, exercise, and site preparation on the equivalence of alternative-site blood glucose testing[J].Diabetes Care,2003,26(4):981-985. DOI:10.2337/diacare.26.4.981 (2003).
[22] 谢琪林,康芳.疼痛敏感性的评估及相关影响因素研究进展[J].国际麻醉学与复苏杂志,2021,42(6):659-663. DOI:10.3760/cma.j.cn321761-20200514-00315.
[23] Porro CA, Baraldi P, Pagnoni G, et al.Does anticipation of pain affect cortical nociceptive systems?[J]. J Neurosci, 2002, 22(8):3206-3214.DOI:10.1523/JNEUROSCI.22-08-03206.2002.
[24] Kempe KC, Budd D, Stern M, et al.Palm glucose readings compared with fingertip readings under steady and dynamic glycemic conditions, using the One Touch Ultra Blood Glucose Monitoring System[J].Diabetes Technol Ther,2005,7(6):916-926. DOI:10.1089/dia.2005.7.916 (2005).
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