Intended for healthcare professionals


Earlobes are less convenient than fingerpricks for blood glucose testing

BMJ 2000; 321 doi: (Published 04 November 2000) Cite this as: BMJ 2000;321:1161
  1. Matthew Cohen, director of medical services (matcohen{at}
  1. International Diabetes Institute, Caulfield 3162, Australia

    EDITOR—Probably billions of fingerpricks have been performed by people with diabetes since self monitoring of blood glucose concentrations was introduced in 1979. The site usually recommended is the side of the fingers rather than the thumb or earlobe.

    Carley et al showed a small reduction in pain in the earlobe compared with the thumb.1 Their conclusion that “tests should be obtained by lancet puncture of the skin on the earlobe rather than … the thumb” is not, however, warranted, as it does not take into account other factors that are important to patients.

    The earlobe cannot be seen by the patient without a mirror. This makes both pricking and subsequent pressure for haemostasis more difficult. My patients' experience is that this results in blood dripping on to their clothes. Earlobes may be slightly less painful, but using them is less convenient than using one's fingers.

    Techniques for finger pricking that reduce pain include using variable depth finger pricking devices and ultrafine lancets and pricking the back of the nail bed with a 29 or 30 gauge insulin needle (as described by Raab).2


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