Influence of Repetitive Finger Puncturing on Skin Perfusion and Capillary Blood Analysis in Patients with Diabetes Mellitus

Frequent puncturing of fingers to check blood glucose in patients with type 1 diabetes might alter skin perfusion and, hence, influence the representativeness of the blood sample. We investigated the influence of repetitive puncturing on skin microcirculatory perfusion using laser Doppler fluxmetry...

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Bibliographic Details
Published in:Clinical chemistry (Baltimore, Md.) Md.), 1999-12, Vol.45 (12), p.2200-2206
Main Authors: de Graaff, Jurgen C, Hemmes, Geesje J, Bruin, Taco, Ubbink, Dirk T, Michels, Robert P.J, Jacobs, Michael J.H.M, Sanders, Gerard T.B
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Blood Glucose - analysis
Blood Specimen Collection
Cholesterol - blood
Diabetes Mellitus - blood
Diabetes Mellitus - physiopathology
Endocrinology
Female
Fingers
Humans
Investigative techniques, diagnostic techniques (general aspects)
Laser-Doppler Flowmetry
Male
Medical sciences
Microcirculation - physiopathology
Middle Aged
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Punctures
Skin - blood supply
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Summary:Frequent puncturing of fingers to check blood glucose in patients with type 1 diabetes might alter skin perfusion and, hence, influence the representativeness of the blood sample. We investigated the influence of repetitive puncturing on skin microcirculatory perfusion using laser Doppler fluxmetry and on the preanalytical phase of capillary blood analysis for small molecules (glucose) and large particles (cholesterol). In 49 patients with long-standing (mean, 21 years) type 1 diabetes, with a mean puncture frequency of three times daily for a mean duration of 13 years, laser Doppler skin perfusion was measured in a finger at a frequently punctured site and compared with a similar site of another finger of the same hand, which was never punctured. In the supine position with the hand level with the heart, resting flux (RF), peak flux (PF), and the microcirculatory reserve capacity (MRC; PF - RF) were assessed. Subsequently, blood samples for capillary whole blood glucose and cholesterol analyses were taken from the same sites. No significant differences were found between the puncture and control sites in mean RF (2.3 vs 2.0 V; P = 0.14, paired-samples t-test), PF (3.3 vs 3.1 V; P = 0.24), MRC (1.0 vs 1.0 V; P = 0.65), glucose (10.2 vs 10.2 mmol/L; P = 0.69), or cholesterol (5.1 vs 5.2 mmol/L; P = 0.26). Power calculation for a RF of 2.0 V and the SD and n of this study indicate a power (beta) of 80% to detect a 25% change in RF at P
ISSN:0009-9147
1530-8561