My 13-year-old daughter has had type 1 diabetes since December 2006. Her father and I are divorced. Recently, she mentioned that while she stays with her father for visitation weekends, he often uses the same alcohol wipe for several blood sugar checks during the night, and that he often uses the same alcohol wipe for her blood sugar check AND Humalog/Lantus injections. I always use a new wipe for each check and injection. I thought we were told that a new one needed to be used each time to make sure her fingertip is clean for the blood sugar check, and most importantly, to be sure the area for insulin injections is clean. Am I correct or being too cautious? I wanted to make sure before I approach her dad about this. To me, it seems wrong to use the same alcohol wipe to clean her finger, then use it to clean the injection area. She has asked her father not to do this, especially with her nighttime checks (which are often many), but her dad tells her that the germs on the wipe are killed by the alcohol, thus making it safe to use again and again. What do you recommend?

Many clinicians do not feel it is necessary to use alcohol on the skin prior to an insulin injection. Some circumstances may be different, so it is important to check with your daughter’s health care provider about this.

For blood glucose monitoring, the important thing is to clean the skin of substances that may lead to a false glucose reading. If alcohol wipes are used, it is important to let the alcohol dry completely before lancing the finger. Some people find that alcohol is very drying to the skin and causes problems with frequent use, so, once again, check with your daughter’s health care provider. Others just clean off the finger and make sure it is dry before lancing.

For your daughter’s sake, it would be important to find an approach that works for all and does not lead to disagreement within the family. Diabetes care can be extra difficult when families are separated. The important things would be adequate supervision of your daughter’s overall diabetes care, and making sure that things don’t “fall through the cracks” in the transition from home to home. The 13-year-old needs a balance of independence and supervision that is oh so tricky.

LM