Korean J Lab Med.  2010 Jun;30(3):264-275. 10.3343/kjlm.2010.30.3.264.

Comparison of Blood Glucose Measurements Using Samples Obtained from the Forearm, Finger Skin Puncture, and Venous Serum

• Park KS
• Park MS
• Cha YJ
• Kim WJ
• Choi SS
• Kim KO
• Cha EJ
• Kim KA

• KMID: 1781626
• DOI: http://doi.org/10.3343/kjlm.2010.30.3.264

Abstract

BACKGROUND
Blood glucose testing (BGT) at the forearm minimizes the pain experienced during sampling of capillary blood. We compared the BGT results for forearm sampling with those for standard finger skin puncture and venous serum to evaluate the clinical validity of forearm BGT.
METHODS
BGT was performed on the finger (G(F)) and forearm (G(A)) with a portable glucometer in 555 subjects, including 61 diabetic patients, under fasting conditions. BGT with venous serum (G(V)) was followed within an hour in 514 subjects. Simple linear regression, intraclass correlation, and Passing-Bablok regression analyses were performed using the G(A)-G(F) and G(A)-G(V) data.
RESULTS
G(A) showed an excellent linear relationship with both G(F) and G(V) with a Pearson correlation coefficient (r) of 0.97 (P<0.0001) in the patient group, which was similar to the findings in the normal group except for the lower r values. The mean bias between G(A) and G(F) and between G(A) and G(V) were within +/- 10 mg/dL in both groups. The intraclass correlation coefficients were slightly smaller than the corresponding r values, but they showed the same tendency in both groups. In the Passing-Bablok analyses, the 95% confidence intervals of the slope and intercept parameters were <+/-20% of unity and <+/-20 mg/dL, respectively, which were within the acceptable ranges. All 3 statistical analyses supported the satisfactory agreement of G(A) with G(F) or G(V).
CONCLUSIONS
BGT at the forearm was highly consistent with the standard BGT, thereby confirming its applicability in clinical practice for self-testing under steady fasting conditions.

Keyword

Blood glucose test; Alternative blood sampling site; Regression analysis

MeSH Terms

Adult
Aged
Blood Glucose/*analysis
Blood Specimen Collection
Female
Fingers/*blood supply
Forearm/*blood supply
Humans
Male
Middle Aged
Regression Analysis

Figure

• 

  Fig. 1. Simple linear regression results between the forearm (GA) and the finger (GF) glucose measurements in the normal (A) and the patient (B) groups. The solid and dotted lines represent the regression and the identity lines, respectively.

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  Fig. 2. Simple linear regression results between the forearm (GA) and the vein (GV) glucose measurements in the normal (A) and the patient (B) groups. The solid and dotted lines represent the regression and the identity lines, respectively.

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  Fig. 3. Results of the Passing-Bablok regression analysis between the forearm (GA) and the finger (GF) (A) and between the forearm and the vein (GV) (B) presented with the 95% confidence limit lines (dotted lines) and acceptable limit lines (solid lines with the slopes of 0.8 and 1.2).

• 

  Fig. 4. Individual blood glucose data points obtained from the forearm (GA) and finger (GF) plotted in the GA-GF plane superimposed on the error grid. In addition, the figure shows clinically accepted zones (denoted by AU,L and BU,L) in which 98% of the data are included (refer to text).

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