Self-monitoring of blood glucose empowers diabetes patients to effectively control their blood glucose (BG) levels. A potential barrier to frequent BG controls is lancing pain, intrinsically linked to pricking the finger several times a day. In this study, we compared different state-of-the-art lancing devices from leading manufacturers regarding lancing pain, and we intended to identify lancing devices that are less painful.
First, 165 subjects compared 6 different BG monitoring systems—consisting of a lancing device and a BG meter—at home for 36 days and at least 3 BG tests per day. Second, the subjects directly compared 6 different lancing devices—independent from a BG meter—in a laboratory setting. The test results were collected in questionnaires, and lancing pain was rated on a numerical rating scale.
One hundred fifty-seven subjects were included in the analysis. Accu-Chek BG monitoring systems were significantly (p ≤ .006) preferred to competitor BG monitoring systems and were rated by >50% of the subjects as “less painful” than competitor BG monitoring systems. Accu-Chek lancing devices were significantly (p < .001) preferred to competitor lancing devices and were rated by >60% of the subjects as “less painful” than competitor lancing devices.
We found significant differences in lancing pain between lancing devices. Diabetes patients clearly preferred lancing devices that cause less lancing pain. In order to improve patient compliance with respect to an adequate glycemic control, the medical staff should preferentially prescribe lancing devices that cause less lancing pain.
Comparison of Blood Glucose Monitoring Systems and Lancing Devices
|BG monitoring systems||Accu-Chek Aviva||versus||OneTouch Ultra2|
|Accu-Chek Compact Plus||FreeStyle Freedom|
|Lancing devices||Accu-Chek Softclix||versus||OneTouch UltraSoft|
|Accu-Chek Softclix Plus||TheraSense FreeStyle|
|Accu-Chek Multiclix||Ascensia Microlet / Vaculance|
Several studies have demonstrated the importance of tight blood glucose (BG) control for diabetes patients, e.g., the Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study.Self-monitoring of blood glucose (SMBG) enables diabetes patients to effectively control their BG levels. The clinical benefits of SMBG in type 1 diabetes patients are widely accepted.In type 2 diabetes patients, clinical, epidemio-logical, and economical evidence supporting SMBG is accumulating steadily.
Diabetes patients and health professionals can choose from a wide range of dedicated medical devices for SMBG. The first concrete step in SMBG is the collection of a few microliters of capillary blood. For diabetes patients, this means pricking the finger—or an alternative site—with a lancing device. Current BG meters require only very small amounts of blood, and the extraction of blood from the skin capillary bed is generally accepted by diabetes patients. However, the lancing pain associated with lancing into the skin is one of the obstacles to ensure good patient compliance. Burge showed that lancing pain and finger soreness are leading reasons for self-reported patient noncompliance with physician recommendations for SMBG.
In our observational field study, we evaluated differences in lancing pain associated with using Accu Chek BG monitoring systems and lancing devices compared to three competitor brands. The choice of competitor brands was based on market shares. Our aim was (1) to detect differences in lancing pain between lancing devices and (2) to identify lancing devices that are less painful for diabetes patients.