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June 19, 2000

Blood Tests and Insulin Injections

Question from a physician in Bulgaria:

My child is quite negative about blood glucose monitoring. Is there any way of controlling the blood sugar without sticking fingers to get a blood drop?

Answer:

In order to properly control blood glucose levels it is necessary to do at least three blood sugars a day. If a child is having sufficient trouble over this that proper control is impaired then it is important to try and find out why. In small children at the very start of the diabetes, there is sometimes a frank needle phobia which can usually be diagnosed and quickly treated by an experienced clinical psychologist. In older children the same problem may be a plea for more family help in managing his/her diabetes, so that a first step may be to have one parent do the actual finger sticking until confidence is restored.

On a more practical basis there are a variety of adjustable lancing devices that make sampling a much more comfortable affair. One of these is the ‘ultraTLC’ made by MediSense U.S.A., telephone 1-800-527-3339 or MediSense Inc, 4A Crosby Drive, Bedford, MA 01730, USA. More recently a number of glucose monitors have been developed that use a very small drop of blood taken from the forearm, where there are fewer nerve endings than the finger tips. One such instrument is the Laser Lancet from Venisect, Inc. at Suite 1100, 323 Center Street, Little Rock, AR 72201, e-mail [email protected], Fax 1-502-376-3969, Tel 1-888-711-2345.

In the last few months two devices have been approved that measure blood glucose on very small blood samples that can again be taken from the forearm. One of these is the AtLast made by Amira Medical in California which uses 2 ul of blood and the other from TheraSense also in California uses only 2ul. You would need to check the web sites for availability of the instrument and supplies in Bulgaria.

There is also the GlucoWatch which will hopefully be available later this year; but the present model would be rather cumbersome for children. The manufacturers hope soon to develop a smaller version for children; but there is no indication as to how long this might take.

Finally and in case I have misinterpreted your question: there is no way, at the moment, in which Type 1A or autoimmune Diabetes can be controlled without insulin by injection.

DOB