Two years ago, our four-year-old daughter was diagnosed with type 1 in Las Vegas. They told us we could check her blood glucose using her toes as well as her fingers, but not for many years. We still use her toes for blood glucose checks, at least four times a day. Here in Israel, the doctors haven’t heard about using the toes and disagree with that. It is extremely important for us to know if we can continue doing that (the results at fingers and toes are the same) and, if so, until what age? Can it cause any damage to her feet/toes/nerves later on in life?

Using the toes in a young person with type 1 diabetes can be done with very little risk. I bet the doctors in Israel are concerned that people that have longstanding poorly controlled diabetes have issues with infection and nerve damage in their feet. I suspect your daughter will be testing occasionally on her toes for just a few short years – and not for the long term. It makes sense to me that using toes in someone who has had diabetes for a long time is likely not in their best interest – but is acceptable in a child for a few years. There should be no significant difference in the measured blood sugar done on a finger or toe.

MSB