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June 15, 2000

Blood Tests and Insulin Injections

Question from Uniontown, Ohio, USA:

I would like to use an instant hand sanitizer to clean my child's fingers before doing a finger prick (when we are on the go, etc.) My doctor said this would be bad to continually use on my child's fingers (scarring, decrease in blood flow, etc.) I spoke with the manufacturer of one of these products and they assured me my doctor was providing me with inaccurate information. Who should I believe?

Answer:

Most of the instant hand sanitizers are alcohol based. Infrequently using an instant hand sanitizer prior to finger pokes should not be a problem — just discard the first drop of blood.

Quoting from Understanding Insulin-Dependent Diabetes (which you can download without charge at www.uchsc.edu/misc/diabetes/UIDDM.html): “The hands should be washed with warm water (to increase blood flow and to make sure they are clean). Any trace of sugar on the finger may give a false elevated reading. We do not recommend routinely wiping with alcohol, as any trace of alcohol left on the skin will interfere with the chemical reaction for the blood sugar test (Table 3). Occasionally, when away from home (e.g., camping, picnics), it is necessary to use alcohol to cleanse the finger. In that situation, dry the finger and, when possible, discard the first drop of blood.”

In reality, most kids don’t wash their hands every time they poke their finger.

MSB
Additional comments from Dr. Kenneth Robertson:

All that is required before checking a blood sugar is that the finger is clean and free from sugar from food. Soap and water is all that is necessary. If you are not near soap and water then a hand-wipe is adequate. Anything more elaborate is overkill.

KJR
Additional comments from Dr. Stuart Brink:

We usually recommend simple water to keep hands clean. Soap if they’re obviously dirty. Usually no alcohol and never anything else seems to be needed. I don’t know exactly what an instant hand sanitizer is but suspect that it is not necessary. I would believe your doctor rather than the manufacturer who has a sale at stake, however.

SB