Accu-Check Active User Guide
Accu-Check Active User Guide
Owner’s Booklet
Dear ACCU-CHEK System Owner,
Thank you for choosing the ACCU-CHEK Active system.
Congratulations on your decision to take control of your diabetes. We’ve designed your new
ACCU-CHEK Active system with comfort, convenience, and control in mind – to help make living
with diabetes a little easier.
This booklet will help you get the most from your ACCU-CHEK Active system. We also invite you
to visit www.accu-chek.com to find out about services, tools, and information that can help you
manage your diabetes.
To start testing quickly, you can also refer to the First Time Guide or the Quick Reference Guide.
If you have questions, we’re here to help. Just call the ACCU-CHEK Customer Care Service Center
toll-free at 1-800-858-8072. We offer assistance 24 hours a day, 365 days a year, in Spanish
and many other languages.
*Items may be sold separately. You may purchase control solutions separately at your pharmacy, or by calling
the ACCU-CHEK Customer Care Service Center, 1-800-858-8072.
Need Help?
Just call the ACCU-CHEK Customer Care Service Center, 24 hours a day, 365 days a year, at
1-800-858-8072. You can also visit www.accu-chek.com for diabetes management tools and product
demonstrations. To make sure you receive the best customer service possible and news about product
updates, please complete and mail your Warranty Card.
Arrowheads Protective
Cover
Lancet Device Plunger
1. Use your thumb to slide the battery 2. Remove the plastic strip and
tray up and out of the meter. throw it away.
Chapter 1: Understanding Your New System 12 ACCU-CHEK Customer Care Service Center 1-800-858-8072
3. Slide the battery tray back into the meter • The battery symbol on the screen means
until it locks into place. the battery is low and should be
To change the battery, remove the old changed soon.
battery and place the new one in the • If the meter shuts off after 3 seconds, no
tray with the + side facing down. more tests can be run.
Notes:
• The meter uses one lithium battery. Always keep an
extra battery on hand.
• After you change the battery, you will have to reset the
time and date, but all test results stay in memory with
their time and date.
• The meter turns off automatically after two minutes of
nonuse. When this happens, test results are still saved
in memory.
Chapter 1: Understanding Your New System 13 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Setting the Beeper, Year, Time, and Date
Setting the time and date is important if you use the meter’s memory or connect to a computer.
Chapter 1: Understanding Your New System 14 ACCU-CHEK Customer Care Service Center 1-800-858-8072
3. Press . The 5. Repeat Steps 3 and 4 6. Press twice to
hour will flash. to change the finish set-up and
minutes, year, month, turn off the meter.
4. Press to
a
day, and beeper
change the hour.
setting (on or off).
You may hold the button Leaving the beeper
down to scroll forward quickly. on is recommended.
Chapter 1: Understanding Your New System 15 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Coding the Meter
1. With the meter off, slide the orange code key into the code key slot.
It should easily snap into place.
2. When you insert a test strip (see Chapter 3, “Running a Blood Sugar
Test”), make sure the code on the meter matches the code on the
Code Key test strip container.
(included with
test strips) 3. Throw away the old code key.
Notes:
• If “code---” appears on the display, remove the test strip to
turn off the meter, make sure the code key is all the way in,
then turn on the meter again.
• Don’t force the code key into the meter; it only goes in one
way.
• If the code number on the display does not match the code
number on the test strip container, call the ACCU-CHEK
Customer Care Service Center at 1-800-858-8072.
▲
!
Change the code key every time you open a new box of test strips.
Be sure the code key matches the code on the test strip container. If they don’t match, you could get inaccurate results.
16
Chapter 1: Understanding Your New System ACCU-CHEK Customer Care Service Center 1-800-858-8072
Chapter 2: Control Testing
Why Run Control Tests
Control tests ensure that both the meter and the test strips are working properly and giving reliable results.
You should run a control test when:
• The meter is new • You drop the meter
• You open a new box of test strips • Your test results don’t agree with how you feel
• You leave the cap off of the test strip container • You want to make sure you’re performing tests
• You want to check the performance of the meter correctly
and test strips
About the Control Solution
• Make sure you use only ACCU-CHEK Active • Never use control solution that has expired.
control solution. • Always close the control solution bottle tightly.
• When you first open the bottle, write the date on • Store at room temperature, between 36-86°F
the label – the control solution is good for three (2-30°C).
months from that date or until the expiration
date on the bottle, whichever comes first.
17
Running a Control Test
For control testing, you’ll need your meter, a test strip, a
Arrowheads bottle of ACCU-CHEK Active control solution, and a
napkin or paper towel.
1. Take a new test strip from the container. Make sure the
yellow color in the round window on the back of the strip
matches the yellow color above “0 mg/dL” on the
Orange container. If it looks green, don’t use it.
Pad 2. Insert the test strip, with the orange pad facing up, until it
will go no further into the meter. Do not bend the test
strip. (The arrowheads are almost no longer visible when
the test strip is inserted correctly.)
After the flashing blood drop appears, you have 2
minutes to apply solution to the strip.
4. Briefly roll the bottle of control solution, open it, squeeze one drop onto a paper
towel, and wipe the tip of the bottle clean.
5. Touch one drop of low level (blue cap) control solution to the center of the
orange pad. Do not bend the test strip. When the test is done, the meter will
display the test result.
6. Check that the result with the low control solution is within the low range on
the test strip container.
If the result is not in the acceptable range, see Chapter 2,
High Level Testing “Understanding Control Test Results.”
Low level testing is all you need to do most of the time. If you think your meter or test strips might not be working correctly, you may
also want to do a high level test. Simply repeat Steps 3 through 6, using high level control solution (red cap).
If you do not have high level control solution, you may purchase control solutions separately at your pharmacy, or by calling the
ACCU-CHEK Customer Care Service Center, 1-800-858-8072.
The low level solution has a blue cap. The high level solution has a red cap.
Example
1. Pull off the cap. 2. Insert a lancet until it clicks. 3. Twist off the lancet’s
protective cover.
Note: You can refer to the First Time Guide or the Quick Reference Guide for a simple testing summary.
22
4. Snap the cap back on after 5. Twist the cap to set the lancet 6. Press the plunger (like a pen) until
lining up the notches. The depth. Start at 2 or 3. For tougher it clicks. The release button turns
cap easily snaps into place. skin, dial to a higher number. yellow when the device is ready.
Set aside until later in the test.
Release Button
Notes:
• The best depth setting is the lowest number that lets you get enough blood
for a test. Try different settings to find the one that’s right for you.
• To maximize testing comfort, always use a new lancet for every test.
• To reduce the risk of infection, never share your lancet device with anyone.
Chapter 3: Testing Your Blood Sugar 23 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Running a Blood Sugar Test
Before running your first test, make sure you set up your meter properly and run a control test.
See Chapters 1 and 2 for details.
Do not operate the meter without the test strip guide attached. For more information, see Chapter 5,
“Maintenance and Troubleshooting.”
Applying Blood with Test Strip Inside the Meter
1. Using warm water, wash and then dry your
Arrowheads
hands. Dirty hands could affect results.
2. Take one test strip from the container. Close the
container cap tightly. Make sure the yellow color
in the round window on the back of the test
Orange strip matches the yellow color above “0 mg/dL”
Pad on the container. If it looks green, do not use it.
3. Insert the test strip, with the orange pad facing
up, until it will go no further into the meter. Do
not bend the test strip. (The arrowheads are
almost no longer visible when the test strip is
inserted correctly.)
4. Make sure the code on the meter matches the
Do not bend the test strip. code on the test strip container.
Chapter 3: Testing Your Blood Sugar 24 ACCU-CHEK Customer Care Service Center 1-800-858-8072
5. When you see the flashing blood drop, hold the lancet device
against the side of your fingertip and press the release
button.
Notes:
• Once the blood drop appears on the screen, you have 2
minutes to apply the drop of blood.
• If the test has begun and you still need to add more blood
throw the test strip away and start over.
Chapter 3: Testing Your Blood Sugar 25 ACCU-CHEK Customer Care Service Center 1-800-858-8072
7. Touch the blood drop to the center of the square orange
pad. Do not bend the test strip.
8. An hourglass symbol appears on the screen, then the test
result appears.
9. To remove the lancet, take off the lancet device cap and
point the lancet end away from yourself.
10. Slide out the ejector to discharge the lancet into an
appropriate container for sharp objects.
For more information about your test results, see Chapter
3,” Understanding Your Test Results.”
▲ Example
Chapter 3: Testing Your Blood Sugar 26 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Applying Blood with Test Strip Outside of the Meter
Do not operate the meter without the test strip guide attached. For more information, see Chapter 5,
“Maintenance and Troubleshooting.”
Follow Steps 1 through 6 of “Running a Blood Sugar Test,”
Chapter 3, then:
1. Take the test strip out of the meter.
2. Touch the center of the square orange pad to the drop of blood.
Do not bend the test strip.
3. Within 20 seconds, insert the test strip, with the orange pad
facing up, until it will go no further into the meter. Do not bend
the test strip. (The arrowheads are almost no longer visible
when the test strip is inserted correctly.)
4. An hourglass symbol appears on the screen, then the
test result appears.
5. To remove the lancet, take off the lancet device cap and point
the lancet end away from yourself.
6. Slide out the ejector to discharge the lancet into an appropriate
container for sharp objects.
For more information about your test results, see Chapter 3,
“Understanding Your Test Results.”
Do not bend the test strip.
Chapter 3: Testing Your Blood Sugar 27 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Testing with Blood from Alternative Sites
With the ACCU-CHEK Active system, you have the option to use blood from
an alternative site (palm, forearm, upper arm, thigh, or calf) in addition to
blood taken from your fingertip. Although blood from your fingertip may be
tested at any time, there are times when testing from alternative sites is
not ideal. Before you begin testing areas other than your fingertip, please
read this section to understand which option is right for you.
Notes:
• Because your fingertip has more blood vessels, your fingertip and
alternative site test results may be different.
• NEVER ignore symptoms that may be due to low or high blood sugar.
• If your blood sugar result does not match how you feel, do a fingertip
test to confirm your result. If the fingertip result still does not match
how you feel, call your doctor.
• Do not change your treatment based on just one result.
Chapter 3: Testing Your Blood Sugar 28 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Alternative site testing may be done: Alternative site testing is NOT recommended:
• Immediately before a meal • After a meal (two hours or less)
• When you are in a fasting state • After exercise
• During sickness
• When you think your blood sugar is very low
(hypoglycemic)
• If you often don’t notice when you are
hypoglycemic
• During peak action time of short-acting or
rapid-acting insulin analogues.
• Up to two hours after injecting a short-acting
or a rapid-acting insulin analogue.
Chapter 3: Testing Your Blood Sugar 29 ACCU-CHEK Customer Care Service Center 1-800-858-8072
1. Wash the alternative site with warm water and
dry, then follow Steps 2-4 from Chapter 3,
“Running a Blood Sugar Test.”
2. Make sure you are using the clear cap specially
designed for alternative site testing with the
ACCU-CHEK Softclix lancet device.
3. Adjust the clear cap to the highest setting.
4. Press and hold the lancet device against a
fleshy area on the alternative site. Press the
release button and continue to apply steady
pressure to the site.
Don’t be afraid to apply a lot of pressure to
the area with the lancet device to get a good
blood drop.
Chapter 3: Testing Your Blood Sugar 30 ACCU-CHEK Customer Care Service Center 1-800-858-8072
5. Take the test strip out of the meter.
You have 20 seconds to apply the blood to the
test strip and put it back in the meter.
6. Turn the test strip down on top of the blood
drop, aiming for the center of the orange pad.
7. Put the test strip back into the meter with the
orange pad facing up.
8. An hourglass symbol appears on the screen,
then the test result appears.
9. To remove the lancet, take off the lancet device
cap and point the lancet end away from
yourself.
10. Slide out the ejector to discharge the lancet
into an appropriate container for sharp objects.
For more information about your test
results, see Chapter 3, “Understanding Your
Test Results.”
Chapter 3: Testing Your Blood Sugar 31 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Recording Your Results
Always record your blood sugar results after testing. This helps you and your healthcare professional find
patterns in your blood sugar results. This information helps you better manage your diabetes, reducing your
chances for complications. Record your results in the self-test diary included in your kit, the meter’s memory,
or on your computer.
▲ !
Never store test strips in areas of high heat and/or moisture, such as the kitchen,
bathroom or laundry room—heat and moisture can damage them.
Chapter 3: Testing Your Blood Sugar 32 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Using Your Test Strips
• For accurate results, use only approved test • Close the container cap tightly immediately after
strips. removing a test strip.
• Do not bend the test strip • Note the expiration (“Use By”) date on the test
• Replace the code key and run a control test strip container. Throw test strips away after that
every time you get a new box of test strips. date.
• Store test strips in their original container. • Store your test strips and meter in a cool, dry
place. Refer to the Test Strip Package Insert for
more information.
Chapter 3: Testing Your Blood Sugar 33 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Symptoms of High or Low Blood Sugar
Being aware of the symptoms of high or low blood sugar can help you understand your test results and decide
what to do if they seem unusual. Here are the most common symptoms.
High blood sugar (hyperglycemia): fatigue, increased appetite or thirst, frequent urination, blurred vision,
headache, or general aching.
Low blood sugar (hypoglycemia): sweating, trembling, blurred vision, rapid heartbeat, tingling or numbness
around mouth or fingertips.
If you are experiencing any of these symptoms, test your blood sugar. If your blood sugar result is
displayed as LO or HI, and you have symptoms of low or high blood sugar, follow your doctor’s
instructions, or contact your doctor immediately. If your blood sugar result does not match how you
feel, follow the steps under “Unusual Test Results.”
Unusual Test Results
If your blood sugar result doesn’t match the way you feel, follow these steps:
1. Run a control test (see Chapter 2, “Control Testing”).
2. Repeat a blood sugar test (see Chapter 3, “Testing Your Blood Sugar”).
3. If your blood sugar results still don’t reflect the way you feel, follow your doctor’s instructions or call your
doctor immediately.
Note: Always follow your doctor’s instructions. For example, if your doctor has advised you to immediately
treat a low blood sugar result (such as by eating something), then do that first.
Chapter 3: Testing Your Blood Sugar 34 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Chapter 4: Using Your Meter’s Memory
Storing Test Results
Your meter automatically stores up to 200 test results, and you can review them at any time.
If you’ve set the time and date on the meter (see Chapter 1, “Setting the Beeper, Year, Time, and Date”), this
information is stored and displayed with your test results. If you haven’t set the time and date, test results are
simply stored in order, from the newest to the oldest.
35
Viewing Trend Information
The ACCU-CHEK Active meter displays 7- and 14-day blood sugar averages. The time and date must be
set to use this feature.
▲
Example 3. Press and again at the same time to
display the 14-day average. By repeating this
step, you can switch back and forth between
▲ the 7-day and 14-day averages.
Example
4. Press to return to memory.
5. Press to turn off the meter.
Chapter 4: Using Your Meter’s Memory 36 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Notes:
Do not change your therapy based on one individual result recorded in memory.
Talk to your doctor before changing therapy based on results in memory.
• Results stored in memory will not be lost when you replace the battery,
but you will need to reset the time and date.
• Once 200 results are in memory, adding a new test result causes the
oldest one to be deleted.
Chapter 4: Using Your Meter’s Memory 37 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Transferring Data
Infrared
(IR) Window
1. Install the software according to the instructions.
2. Run the software program and follow the instructions about how to
download information.
Make sure the software is ready to accept data from the meter.
3. Locate the infrared (IR) window on the top of the meter.
4. Locate the IR window on the infrared cable or PDA.
5. Point the two IR windows toward each other. They should be no
more than 4 inches (10 cm) apart.
6. Press until “PC” flashes and release to turn on the meter.
Chapter 4: Using Your Meter’s Memory 38 ACCU-CHEK Customer Care Service Center 1-800-858-8072
When “PC” flashes on the display, you have 2 minutes to start transferring data before
the meter shuts off.
7. After the information has been transferred to your computer, “End” will
appear and you can turn off the meter by pressing .
The software program may turn off your meter automatically when the
transfer is complete.
Notes:
• If the data did not transfer successfully, call the ACCU-CHEK Customer
Care Service Center.
• To make the most of the download feature, you must set the year, date,
and time in your meter.
Chapter 4: Using Your Meter’s Memory 39 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Chapter 5: Maintenance and Troubleshooting
Cleaning Your Meter
Caring for your ACCU-CHEK Active meter is easy. If the display or the outside of the meter is
dirty, wipe it off with a slightly damp cloth. Only use water to dampen the cloth.
If there is any blood in the test strip opening or if your meter displays the E-4 or E-5
message, follow these steps to clean it:
1. Take the strip guide off by pressing down with your thumb as you slide it off.
2. Clean the guide with a soft cloth dampened slightly with cleaning solution (dishwashing
detergent and water or 1:10 bleach solution)* or by letting it soak for one hour in the solution.
3. Gently wipe the measuring window with a dry lint-free cloth.
4. When the guide is dry, gently slide it back onto the front of the meter until it clicks into place.
Do not operate the meter without the test strip guide attached.
5. Run a control test (see Chapter 2, “Running a Control Test”) to make sure the meter is
working properly.
*Blood disinfection is only achieved using 10% bleach solution made fresh the day of use.
Notes:
Some cleaning methods can damage your meter. To protect it, DO NOT:
• Use vinegar or scouring agents to clean the meter because they can harm the display
and measurement window.
• Spray any cleaning solution directly onto the meter.
• Put the meter under water (or any liquid).
• Pour liquid into the meter.
40
Maintenance and Testing
Your meter needs little or no maintenance with normal use. It automatically tests its own
systems every time you turn it on and lets you know if something is wrong. (See Chapter
5, “Screen Messages and Troubleshooting”).
If you drop the meter or think it’s not giving accurate readings, make sure that your test
strips and control solution haven’t expired, then run a control test.
Periodically test your display to make sure it is working properly. To test the display, turn
off the meter, then press and hold and for at least five seconds. The entire
display will appear. All the sections should be clear and look exactly like the picture at
the left. If not, call the ACCU-CHEK Customer Care Service Center at 1-800-858-8072.
Press or to turn off the meter.
Chapter 5: Maintenance and Troubleshooting 41 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Screen Messages and Troubleshooting
▲
!
Never make treatment decisions based on an error message. If you have any concerns, please call
the ACCU-CHEK Customer Care Service Center at 1-800-858-8072, 24 hours a day, 365 days a year.
Blood sugar may be lower than the measuring range of the system or the test strip has
been bent. See Chapter 6, “Specifications.” We recommend retesting your blood sugar
according to Chapter 3, “Testing Your Blood Sugar.” Verify results by running a control test.
See Chapter 2, “Running a Control Test.”
Chapter 5: Maintenance and Troubleshooting 42 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Blood sugar is higher than the Your surroundings are too bright.
measuring range of the system. Repeat the test in a darker environment
See Chapter 3, “Understanding Your (shaded from direct sunlight), using a
Test Results.” new strip.
The temperature is above or below The code key is missing or not working
the proper range for the meter properly. Replace the code key.
(50°F to 104°F). Move to an area
between 50°F and 104°F, allow the
meter to warm up or cool down
slowly to room temperature. Do not
artificially heat or cool the meter. The test strip is not inserted correctly.
Refer to “Proper Testing Conditions,” Make sure the arrows are pointing
Chapter 3. toward the meter and the orange square
is facing up and is positioned over the
Battery power is low. measuring window.
Change the battery soon.
The wrong code key is in the meter.
Put in the orange code key that came
with the container of test strips you are
using.
Chapter 5: Maintenance and Troubleshooting 43 ACCU-CHEK Customer Care Service Center 1-800-858-8072
The meter is having trouble reading A test error has occurred, or there is
the code key. Take the orange code electromagnetic interference.
key out and put it back in again. Repeat the test. If you get the same
For help, see Chapter 1, “Coding message, move away from sources of
the Meter.” interference and repeat the test.
Chapter 5: Maintenance and Troubleshooting 44 ACCU-CHEK Customer Care Service Center 1-800-858-8072
The test strip was not inserted There was not enough blood on the test
correctly, it was removed during strip to start the test. Repeat the test
testing, or blood was applied too with a larger drop of blood.
soon. Repeat the test with a new
test strip. Make sure you insert the
test strip until the arrowheads are
no longer visible, with the orange The temperature is above or below the
square facing up (see Chapter 3, proper range for the meter. Move to an
“Running a Blood Sugar Test”). area between 50°F and 104°F, allow the
meter to warm up or cool down slowly to
The meter is defective. Call the room temperature and repeat the test. If
ACCU-CHEK Customer Care Service you get a result with a temperature icon,
Center at 1-800-858-8072. it could be inaccurate. Do not artificially
heat or cool the meter.
Chapter 5: Maintenance and Troubleshooting 45 ACCU-CHEK Customer Care Service Center 1-800-858-8072
Chapter 6: Technical Information
Product Limitations
Please read the literature packaged with your test strips to find the latest information on product specifications and
limitations.
Specifications
Display 96-segment LCD
Automatic power-off After 2 minutes
Power supply One 2032 or equivalent lithium battery
Meter type ACCU-CHEK Active Meter
Measuring range 10-600 mg/dL
Sample size 1µL
Measuring time Approximately 5 seconds
System operating conditions Refer to the test strip package insert
46
Meter storage conditions -40°F to 158°F (-40°C to 70°C)
Test strip storage conditions Refer to the test strip package insert
Relative humidity operating range Less than 85%
Altitude <10,150 ft.
Memory capacity 200 blood glucose results with time and date
Dimensions 4.6 x 1.7 x 0.9 inches (118 x 44 x 23 mm)
Weight 57 g (without battery)
Construction Hand-held
Lancet device depths 0.80, 0.95, 1.10, 1.25, 1.40, 1.55,
1.70, 1.85, 2.00, 2.15, 2.30 mm
CAUTION One 2032 or equivalent The ACCU-CHEK Active meter This product fulfills the This product fulfills the
Please refer to safety-related lithium battery. has been listed by requirements of requirements of
notes in the manual Underwriter’s Laboratories, Directive 98/79/ EC on Directive 98/79/ EC on
accompanying this Inc., in accordance with UL in vitro diagnostic in vitro diagnostic
instrument. 3101-1 and CAN/CSA C22.2 medical devices. medical devices.
No. 1010-1.
1
Directive 2002/96/EC (Directive on waste electrical and electronic equipment (WEEE).
2
29 CFR 1910.1030 – Bloodborne pathogens.
▲
! CAUTION – A RESTRICTED LICENSE LIMITS USE OF THE ACCU-CHEK ACTIVE SYSTEM – READ
CAREFULLY THE LIMITATIONS LISTED BELOW.
The ACCU-CHEK Softclix lancet device and use are protected by U.S. Patent Nos. 4,924,879; 6,419,661;
7,077,828; and Re. 35,803. A license to use the ACCU-CHEK Softclix lancet device is only granted when
ACCU-CHEK Softclix lancets are used as a part of the ACCU-CHEK Softclix lancet device.
The ACCU-CHEK Active system (meter, including the code key, and test strips) and its use are protected by U.S.
Patent Nos. 5,424,035; 6,055,060; 5,463,467; 5,366,609; 6,906,802; and 5,206,147. A license to use the
ACCU-CHEK Active system is only granted when the ACCU-CHEK Active meter is used with the ACCU-CHEK
Active test strips and ACCU-CHEK Active code keys. ACCU-CHEK Active test strips are provided with a
specifically matched ACCU-CHEK Active code key. These test strips and code keys are specifically manufactured
for operation with the ACCU-CHEK Active meter. Use of other test strips with an unmatched code key or even
Control Solution
ACCU-CHEK Active Control Solutions Cat. No. 3146324
Lancets
ACCU-CHEK Softclix Lancet Device Cat. No. 957
ACCU-CHEK Softclix Lancets Cat. No. 971 (100/box)
ACCU-CHEK Softclix Lancets Cat. No. 988 (200/box)
References
1. Stedman, TL Stedman’s Medical Dictionary, 27th Edition, 1999, p. 2082.
2. American Diabetes Association, “Clinical Practice Recommendation Guidelines 2003.” Diabetes Care,
Vol. 26, Supplement 1, pg. S22.
Decisions about whether to recommend alternative site testing (AST) should take into account the motivation and
knowledge level of the patient and his or her ability to understand the considerations relative to diabetes and AST.
If you are considering recommending AST for your patients, you need to understand that there is a potential for a
significant difference between fingertip and alternative site blood glucose results. The difference in capillary bed
concentration and blood perfusion throughout the body can lead to blood sample site-to-site differences in glucose results.
These physiological effects vary between individuals and can vary within a single individual based upon his or her behavior
and relative physical condition. Our studies involving AST of adults with diabetes show that most persons will find their
glucose level changes more quickly in the fingers’ blood than the alternative sites’ blood. This is especially important when
glucose levels are falling or rising rapidly. If your patient is used to making treatment decisions based upon fingerstick
readings, he or she should consider the delay, or lag-time, affecting the reading obtained from an alternative site.