By: Jan Chait
It’s the instrument we all love to hate: the lancing device.
With today’s blood-glucose testing, diabetes control is a lot easier than it was in the days of "chemistry sets" and urine strips. The downside is that you have to draw some blood.
When we asked readers to tell us about their favorite lancing devices, nearly 200 responses poured in, with some clear favorites—and some not-so-favorites.
While three out of four people who responded use the device that came with the meter they’re using, the remainder have their favorites regardless of meter brand—and some don’t bother with a lancing device at all. Some were unaware that different brands of lancing devices existed other than the ones that came with the meters. (Yes, you can buy them separately.)
And, in an interesting development, our questions garnered responses from a few diabetes educators as well, telling us what they—and their clients—look for in a lancing device.
Ups and Downs
"When I was first diagnosed 14 years ago and using only pills/diet/exercise for control, the lancing device was a big hurdle to jump," writes Mike Walter of Long Grove, Illinois. "I remember chasing my finger around the bathroom, not wanting to press the trigger on the end of the device because it always penetrated deeply. Now lancing is a nonissue. I still have excellent sensitivity in my fingers, but cannot recall the last time lancing felt even uncomfortable."
Because many lancing devices today have dial-a-depth features, one could use different depths for different fingers, as Rabbi Hirsch Meisels of Spring Valley, New York, does. With his Roche Softclix, he reports, "my pinkies need only the 1/2 setting, my thumb needs a 3, and the rest of my fingers need a 2."
Cheryl Lloyd of Wiltshire, England, also found the Softclix to be "quieter, easier to adjust depth settings and sturdily made," not to mention user-friendly—on her cat. Any lancing device she uses has to be "cat-friendly," since she tests blood "from a marginal ear vein prick."
It’s Not the Poker, Silly!
Interestingly, although the highest percentage of respondents use the lancing device that comes with LifeScan meters—especially the Ultra—not many indicated that they particularly liked the device.
Sara Falconer of Tucson, Arizona, liked the "original Penlet that came with my Profile. LifeScan has replaced it, and the meter, several times, but the last time they sent this horrid thing—the Penlet Plus—maybe because it hurts extra good. I hate it."
For some, however, the problem isn’t the lancing device itself. For instance, David Flagg of Winter Park, Florida, writes: "For me, it’s not the lancet device; it’s all in the lancet. I use the Penlet Plus, [but] I use the BD UltraFine II lancets. They hurt less."
On the other hand, the Penlet Plus—and its lancets—are just fine with Amy Weiderer’s clinic patients. Weiderer, an LPN in the Internal Medicine Clinic at the Veterans Administration Hospital in Tampa, Florida, says both she and the patients "are very pleased" with the Penlet Plus. "The dial-a-depth feature is wonderful, and the devices seem to have a long life."
Paul Cross of Carmel, California, also uses BD UltraFine II lancets in the UltraSoft device that came with his OneTouch meter, on the advice of his nurse educator. "It is much more comfortable to use," he reports, "apparently because it is a 30-gauge lancet."
What Lancing Device?
Several people who responded to our reader survey don’t use a lancing device at all. They prick their fingers with a lancet, an insulin syringe or an insulin pen needle.
"I hate the spring-loaded poker," writes Dawn Poetter of Vernonia, Oregon. "The anticipation kills me. I poke myself without it and do much better."
Lancing device? It’s "yet another thing crowding up my purse," claims Miriam E. Tucker of Bethesda, Maryland.
Erin Oliver once forgot her lancing device while on an outing and had to prick her finger using only the lancet. She has been doing it that way ever since.
"I like to be able to control how deep the lancet goes in (no deeper than necessary, of course)."
While Michael Solomon of Marietta, Georgia, doesn’t use a lancing device, he does employ a system of sorts. "I use one-time-only Accu-Chek Safe-T-Pro lancets. I can carry several in my pocket."
Clinicians Weigh In With Their Advice
Elizabeth P. Howard, RN, BS, CDE, of Buffalo, New York, also looks to the lancet itself when it comes to alleviating the pain that can occur with fingersticks.
"The size of the lancet is the big thing for less pain," she observes. "I usually recommend any lancet device that has a penetration guide. I believe most lancet devices are adequate."
Debbi Tally of Bath, New York, is a diabetes educator, certified pump trainer and the founder and president of "Diabetes on Target," an education and support group. She swears by the Ascensia Microlet, manufactured by Bayer.
"Most of my older people with diabetes hate to test due to the pain, so I make a deal with them. I tell them that if they hurt after I’ve used a Microlet on them, I won’t bug them to test. I’ve had several laugh after I pushed the button, saying that it didn’t get them—but then I squeeze their finger a little and there’s the blood. "Boy, are they shocked!"
As both a clinician and someone who has diabetes, Sally McCarthy of Frederick, Maryland, generally uses the lancing device supplied with her meter. However, she offers several opinions about ease of use. The device that comes with the Ascensia meters, she says, is simple to use and easy to teach people. The cap that "allows the user to choose a depth is a plus," but she cautions that "removing the used lancet is difficult for most people and [is] a puncture risk."
TheraSense’s device got the same review from McCarthy, although she notes that it is easier to remove the used lancet.
Lancing devices that come with Roche meters are relatively painless, but it’s more difficult to instruct patients about how to use them, she says. The cap is difficult to remove and replace, but the lancet can be changed without risk of sticking yourself.
"The MediSense/Abbott lancing device is OK," she writes, but you can stick yourself while changing the lancet.
It’s Up to You
While somebody else’s favorite may not be the one for you, there should be a lancing device out there for everybody. Look around, try some out—or try yours with a different lancet if you can—and you’re sure to find one that works for you.