This study determines if there are significant differences in blood glucose sampled at the earlobe relative to fingertip sites. A 50-participant cross-sectional comparative design was conducted at a 480-bed community hospital. Four trained data collectors obtained demographic information and blood glucose samples from both the fingertip and earlobe sites. Data analysis included descriptive statistics, paired t test, and the Bland Altman technique, assessing agreement between two methods of clinical measurements. Results indicate that the mean finger stick glucose result was statistically significantly greater than the mean earlobe glucose result. The Bland Altman plot did not demonstrate clinical significance. Results suggest that the earlobe may be a viable alternative to exclusive fingertip site when frequent sampling is necessary in acutely ill patients and demonstrate the importance of the role of the clinical bedside nurse in implementing evidence-based nursing practice related to diabetes treatment and management.
American Diabetes Association. (1996). Self-monitoring of blood glucose (consensus statement). Diabetes Care, 19(Suppl. 1), S62-S66.
2.
Bina, D.M., Anderson, R.L., Johnson, M.S., Bergenstal, R.M., & Kendall, D.M. (2003). Clinical impact of prandial state exercise and site preparation on the equivalence of alternative-site blood glucose testing . Diabetes Care, 26(4), 981-985.
3.
Brunner, G.A., Ellmerer, M., Sendlhofer, G., Wutte, A., Trajanoski, Z., Schaupp, L., et al. (1998). Validation of home blood glucose meters with respect to clinical and analytical approaches. Diabetes Care, 21(4), 585-590.
4.
Carley, S.D., Libetta, C., Flavin, B., Butler, J., Tong, N., & Sammy, I. (2000). An open prospective randomised trial to reduce the pain of blood glucose testing: Ear versus thumb. British Medical Journal, 321, 20.
5.
Ellison, J.M., Stegmann, J.M., Colner, S.L., Michael, R.H., Sharma, M.K., Ervin, K.R., et al. (2002). Rapid changes in postprandial blood glucose produce concentration differences at finger, forearm, and thigh sampling sites . Diabetes Care, 25(6), 961-964.
6.
Estrada, C.A., Young, J.A., Nifon, L.W., & Chitwood, W.R. (2003). Outcomes and perioperative hyperglycemia in patients with or without diabetes mellitus undergoing coronary artery bypass grafting. Annals of Thoracic Surgery, 75(5), 1392-1399.
7.
Kagansky, N., Levy, S., & Knobler, H. (2001). The role of hyperglycemia in acute stroke. Archives of Neurology, 58(8), 1109-1112.
8.
Khan, A.I., Vasquez, Y., Gray, J., Wians, F.H., Jr., & Kroll, M.H. (2006). The variability of results between point-of-care testing glucose meters and the central laboratory analyzer. Archives of Pathology & Laboratory Medicine, 130(10), 1527-1532.
9.
Krinsley, J.S. (2004). Effect of an intensive glucose management protocol on the mortality of critically ill adult patients. Mayo Clinic Proceedings, 130, 1527-1532.
10.
Lee, D.M., Weinert, S.E., & Miller, E.E. (2002). Study of forearm versus finger stick glucose monitoring . Diabetes Technology & Therapeutics, 4(1), 13-23.
11.
Lock, J.P., Szuts, E.Z., Malomo, K.J., & Anagonostopoulos, A. (2002). Whole-blood glucose testing at alternate sites: Glucose values and hematocrit of capillary blood drawn from fingertip and forearm. Diabetes Care, 25(2), 337-341.
12.
Malmberg, K. (1997). Prospective randomized study of intensive insulin treatment on long-term survival after acute myocardial infarction in patients with diabetes mellitus. British Medical Journal, 314, 1512-1515.
13.
McGarraugh, G., Price, D., Schwartz, S., & Weinstein, R. (2001). Physiological influences on off-finger glucose testing. Diabetes Technology & Therapeutics, 3(3), 367-376.
14.
Peled, N., Wong, D., & Gwalani, S.L. (2002). Comparison of glucose levels in capillary blood samples obtained from a variety of body sites. Diabetes Technology & Therapeutics, 4(1), 35-44.
15.
Petruzzi, E., Marsilii, A., Monami, M., Mannucci, E., Pieri, M., Arrighetti, G., et al. (2003, August). Glucose monitoring self-testing: evaluation of five last generation different devices performance. Paper presented at the 18th International Diabetes Federation Congress, Paris.
16.
Polit, D.F., & Beck, C.T. (2004). Table 20.6: Approximate samples sizes necessary to achieve selected levels of power as a function of estimated effect size for test of difference of two means. In Nursing research: Principles and methods (7th ed., p. 497). Philadelphia: Lippincott Williams & Wilkins.
17.
Sala, J., Masia, R., Gonzalez de Molina, F.J., Fernández-Real, J.M., Gil, M., Bosch, D., et al. (2002). Short-term mortality of myocardial infarction patients with diabetes or hyperglycaemia during admission. Journal of Epidemiology & Community Health, 56, 707-712.
18.
Shibata, S.K., Nurashige, N., & Kami, M. (2004). The lower pole of the earlobe is an alternative site for painless blood sampling in the self-assessment of blood glucose concentrations . Internal Medicine, 43(9), 787-791.
19.
TheraSense, Inc. (2002). Recent developments in alternative site testing [Brochure]. Alameda, CA: Author.
20.
Toledo, F.G., & Taylor, A. (2004). Alternative site testing at the earlobe tip. Diabetes Care, 27, 616-617.
21.
Williams, L.S., Rotich, J., Qi, R., Fineberg, N., Espay, A., Bruno, A., et al. (2002). Effects of admission hyperglycemia on mortality and costs in acute ischemic stroke. Neurology, 59, 67-71.
22.
Yendamuri, S., Fulda, G.J., & Tinkoff, G.H. (2003). Admission hyperglycemia as a prognostic indicator in trauma. Journal of Trauma, 55, 33-38.
