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Dear Diabetes: 'Best' Finger?

Is there a ‘best’ finger for blood sugar testing?

Dear Diabetes: Is there a ‘best’ finger for blood sugar testing?

This question has stuck with me since shortly after I was diagnosed with type 1 diabetes when I was a senior in college. Some friends and I were playing a trivia game, and my team drew a card that asked which finger had the most nerve endings. We stared at each other in clueless silence and then I had an idea: I pulled out my lancet and pricked each of my fingertips. My completely unscientific conclusion? The index finger. My teammates winced, but according to the game, I was right.

Since that night, I’ve been surprised to see so many diabetes-related advertisements show people testing their blood glucose on those sensitive index fingers. I understand not wanting to run magazine ads that prominently feature middle fingers, but my two favorite testing options – ring finger and pinky – are nowhere to be seen. Was the trivia game wrong? Was I unusual?  I set out to see if there really is a best – or worst – finger on which to test blood sugar.

After speaking and emailing with doctors, neurologists, and pain experts, I have reached two conclusions: First, there is not a lot of research being devoted to this question! Second, while no one could conclusively tell me which fingertip is the least painful, I was correct that it’s probably not the index finger. James N. Campbell, MD, president and CEO of Arcion Therapeutics, a company that works to advance the treatment of chronic pain, hypothesized that, since “from an evolutionary perspective, we’ve searched and explored the world most notably with our index finger, it would make great sense for pain sensitivity to be greatest there.”

Okay, so if the index finger isn’t likely to be the least painful, is there another reason it’s so frequently featured in imagery? Does that finger somehow offer a better blood sample? In a word, no. According to Campbell and his colleagues, “Blood flow is roughly the same to each finger, which means you should be able to get a satisfactory drop for testing whichever one you use.”

By the end of my research, I came away with several personal “Finger Tips,” which I follow when I test:

●      Whichever finger you choose, don’t test blood glucose on the center of your fingertip’s pad – that’s the most sensitive part of your finger (therefore it will hurt more).

●      Wash your hands with soap and water (don’t use an alcohol wipe, which can interfere with test results), and aim for the side of the top part of your finger, roughly in the middle. This area has fewer nerve endings than your finger pad, and is therefore less painful to prick.

●      If you don’t want to use any of your fingers, try a glucometer that can accept samples from alternate testing sites, such as your forearm.

And if you do your own finger-prick experiment and decide that they’re all equally painful, consider Campbell’s conclusion on how he’d choose a digit to prick: “I’d rather have a sore little finger than a sore index finger.”

For more stories in the Dear Diabetes series, visit The DX archive.

Catherine Price is a freelance journalist and type 1 diabetic who has written for The New York Times, Slate, Popular Science, and O Magazine, among others. She blogs about diabetes at asweetlife.org. Price is currently working on a book about the history and science of vitamins, to be published by the Penguin Press. Price is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.

© 2012 The DX: The Diabetes Experience

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