If you’ve recently been diagnosed with diabetes, you may find yourself overwhelmed by your first meeting with a Diabetes Specialist. People with diabetes may need a lot of different diabetes care supplies to manage their condition, and many people feel anxiety at the idea of pricking their fingers with lancets each day to check their blood sugar.
So, what are lancets and what can you do to minimize the pain associated with testing your blood sugar each day?
What are lancets?
Lancets are small needles encapsulated in plastic that are used in conjunction with a lancing device to prick a small hole in the skin in order to draw a blood sample. This sample is read by a glucometer to check that person’s blood sugar level to ensure that they are in a safe range or give the information needed to get it there.
A traditional lancet consists of a molded piece of plastic with a round cap, under which there is a needle. The needle is exposed by removing the plastic cap. The needle underneath the cap is sterile and is intended for one-time use. The needle contained in a lancet is intentionally tiny and thin to make a hole in the skin that is as small as possible, but large enough for a drop of blood to be drawn.
There are hundreds of different brands of lancets, some of which require the use of a specific lancing device. Others are universally compatible with a standard lancing device.
Why do people with diabetes use lancets?
Lancets are one of the most important supplies in a diabetes organizer because some people with diabetes need them to regularly check their blood sugar levels.
Checking your blood sugar is an important part of diabetes self care. The checks, which may be done several times per day, offer useful insight about your diabetes, including the following:
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How effective your diabetes medication is at lowering your blood sugar levels
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Whether your blood sugar is currently high, low, or normal
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How you are progressing in your overall diabetes treatment plan
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How certain foods affects your blood sugar level
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How exercise impacts your blood sugar level
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How factors such as illness or stress impact your blood sugar level
What should you look for in a lancet?
Although it might seem like there is not much difference between different types of lancets, not all lancets are created equal.
When considering which lancets to purchase, you’ll generally want to pay attention to needle gauge size as well as find ones that are self-contained, allowing for easy disposal. It may seem counterintuitive, but the thinnest needles have the largest numbers associated with their gauge size. For example, a lancet with a gauge of 23 or 25 contains a larger and thicker needle than a lancet with a gauge size of 28 or 30. The higher the gauge number, the smaller and thinner the needle contained in your lancet will be.
Keep in mind that using a thinner needle is not always better. Although thin needles cause less pain, they may not be strong enough to penetrate thick or rough skin, which means you may have to poke yourself repeatedly to get the amount of blood you need for your glucose test. On the other hand, this can be remedied by using a lancing device that allows you to adjust the depth of the prick.
While the original lancets were usually gauge size 23 or 25, today, the most common gauge sizes are 28 and higher, with about 30g being ideal for most users.
How many lancets should people with diabetes expect to use in one day?
No matter whether you have type 1 or type 2 diabetes, you may need to check your blood sugar regularly to make sure that you stay in a safe range.
You should use a new lancet each time you check your blood sugar in order to minimize the risk of infection and avoid deep scarring from dull needles. If you reuse the same lancet over and over, it quickly loses its sharp point and more closely starts to resemble a fish hook, ultimately meaning you’re actually tearing your skin open with each draw instead of pricking it.
For less painful pricking and much faster healing, use a new lancet each time and keep a steady supply on hand. Thankfully, lancets (among the rest of your supplies) are inexpensive with Diathrive, costing just a few pennies each for a box of 100, or free for subscribers.
There are several factors that influence the number of lancets a person can expect to use per day.
People with type 1 diabetes may need to check their blood sugar anywhere from four to ten times per day, depending on what factors affect their blood sugar levels specifically and how their treatment plan is set up.
Most people with type 2 diabetes generally check their blood sugar at least once per day. The frequency of the testing depends on a number of factors as well. People who have recently been diagnosed with type 2 diabetes will often be asked by their doctor to check their blood sugar more often, as doctors need a sufficient amount of data in order to recommend an appropriate treatment plan.
People who use insulin to treat their type 2 diabetes will need to test their blood sugar more often, particularly those who take several doses of insulin per day or who use an insulin pump -- these people may need to check their blood sugar three or more times per day. People with type 2 diabetes who exercise regularly or play sports will also need to check blood sugar more often, as exercise can impact blood sugar levels.
In general, people with diabetes who need to do blood sugar checks can expect to use anywhere from one to ten lancets per day when checking their blood sugar.
When should people with type 2 diabetes check their blood sugar?
Each person’s treatment plan will be slightly different, and not all people with type 2 diabetes will need to do regular blood sugar checks, but there are some specific daily events that can serve as check-markers for those who do.
In general, checking before meals is recommended, especially if you need to calculate how much insulin you need to take to help manage the coming spike in blood glucose.
If you check your blood sugar after a meal (postprandial check), make sure that you wait at least one to two hours after you finish eating before checking.
It’s also recommended to check your blood sugar after you work out or play sports, as exercise can influence your blood sugar level. If you are preparing to engage in more physical activity than you normally would, such as going on a long hike or taking a long bike ride, it’s also recommended to check your blood sugar before exercising, as well as throughout if it’s a longer activity.
The morning glucose check is arguably one of the most important for type 2 diabetes because it is the “fasting” check, and can give you a lot of information about how your diabetes management is going. People with type 2 diabetes who wake up with high blood sugar every day often need to start or adjust medications, or make adjustments to their nightly routine. The raw glucose data from morning checks is least likely to be influenced by any current factors, such as food and exercise, and is crucial.
Checking your blood sugar at bedtime is also recommended so you can make sure you are at a safe level before sleeping and use a morning check to see how the previous night’s activities or medications may have affected blood sugar.
If you are feeling ill, you should also increase the frequency of your checks until you start feeling better, as sickness can impact your blood sugar.
However, some people may not need to check as often if they are a bit more familiar with what may raise or lower their blood sugar.
Do people who use a continuous glucose monitor (CGM) need to use lancets?
Some people with diabetes, especially those with type 1 diabetes, may choose to use a continuous glucose monitor (CGM) to measure their blood sugar levels instead of regularly using lancets and test strips. CGMs work by using a sensor inserted under the skin to measure your blood sugar level every few minutes throughout the day. The sensors can usually be used for between one to two weeks before being changed. There are some CGMs that use an implanted sensor that can be used for up to three months and wirelessly transmit information about your blood sugar to an app on your smartphone.
However, even people who use CGMs will need to use test strips and lancets from time to time. Some CGMs require calibration by finger stick tests in order to ensure that they are operating correctly, and some CGMs may not work properly when people take medications like acetaminophen, albuterol, and lisinopril. People who take medications that can interfere with the results of their CGM will need to double check the results of their CGM occasionally by using a standard glucose meter and lancets.
CGM readings can also be affected by pregnancy, kidney dialysis, and serious illness, so people with any of these conditions may need to use lancets and standard blood glucose meters to verify the readings.
It’s also recommended that people with diabetes have ready access to a standard glucose meter, lancets, and test strips as part of their diabetes organizer in the event that their CGM stops working or doesn’t seem to be providing accurate results.
Sources:
https://www.everydayhealth.com/diabetes/type2/managing/when-to-check.aspx
https://diatribe.org/taking-sting-out-fingersticks-lancets-life-hacks-and-more
https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/blood-sugar/art-20046628