Alternate site testing for blood sugar levels

As you prick your fingers every day to test your blood glucose levels, you will likely start to experience pain in your fingertips.^(1,2)  After a while, you might wonder, "Where can I test my blood sugar besides my fingers?" and whether alternate site testing (AST) is a viable option to stop the pain and still accurately test your blood glucose. Because these alternate testing sites contain fewer nerves than your fingertips, you may find testing elsewhere more comfortable. 

Some blood glucose meters allow you to use a blood sample from other places on your body for testing. Knowing the most appropriate times when you could use these alternate sites is essential for accurate blood glucose monitoring.⁽³⁾

Here's how you can safely make use of alternative sites for blood sugar testing. 

Before testing, make sure that your blood glucose meter can be used on alternate sites.

Alternative locations for blood glucose testing include: ⁽⁴⁾

• Palm
• Forearm
• Upper arm

You might save yourself a finger prick by testing at these locations, but be mindful and consider when it’s okay and not okay to test your blood at these alternative testing sites. Consult your healthcare provider to ensure that testing on alternate sites is safe for you.

You should only consider alternate site testing when your blood glucose is stable, such as: ⁽³⁾ 

• Right before a meal
• While you’re fasting
• Towards your bedtime

If your blood sugar levels are changing, always monitor your glucose levels with a fingertip blood test. ⁽⁴⁾ This includes:

• Following a meal - when your blood glucose is rising quickly
• After an exercise session
• Whenever you think your blood glucose might be low or dropping

If you're wondering whether you can test your blood glucose levels on your arm or use other blood sugar testing sites, it’s important to remember the following: ⁽³⁾

• Check with your healthcare professional before deciding to use sites other than your fingertips for testing blood glucose
• Never ignore the symptoms of low or high blood glucose
• If the blood glucose test results don't match how you feel, confirm by following up with a finger stick. If those results still don’t reflect what’s happening with your body, get in touch with your healthcare professional.

Always consult your healthcare professional to find out if you can use alternate testing sites for blood tests. To ease any discomfort from finger pricks, opt for alternate site testing during stable glucose periods, pay attention to low or high blood glucose symptoms, and again, always consult and keep your healthcare professional informed.

Whether checking your glucose levels via alternate site blood sugar testing or using a finger prick, the Accu-Chek® FastClix lancing device— the only 1-click lancing device with a drum— can help.

¹ Helen Thomson. Fingertips and forehead are most sensitive to pain. New Scientist. Accessed January 25, 2024. https://www.newscientist.com/article/dn25688-fingertips-and-forehead-are-most-sensitive-to-pain/

² Anitha Pavithran A, Ramamoorthy L, Bs S, Murugesan R, Mj K. Comparison of Fingertip vs Palm Site Sampling on Pain Perception, and Variation in Capillary Blood Glucose Level among Patients with Diabetes Mellitus. J Caring Sci. 2020;9(4):182-187. doi:10.34172/jcs.2020.028

³ Bina DM, Anderson RL, Johnson ML, Bergenstal RM, Kendall DM. Clinical Impact of Prandial State, Exercise, and Site Preparation on the Equivalence of Alternative-Site Blood Glucose Testing. Diabetes Care. 2003;26(4):981-985. doi:10.2337/diacare.26.4.981

⁴ Jungheim K, Koschinsky T. Glucose Monitoring at the Arm: Risky delays of hypoglycemia and hyperglycemia detection. Diabetes Care. 2002;25(6):956-960. doi:10.2337/diacare.25.6.956