Evaluation of Three Lancing Devices: What Do Blood Volume and Lancing Pain Depend On?

Abstract

Background: Globally millions of people with diabetes still prick their fingers to measure blood glucose. The aim of this study was to comprehensively evaluate and to compare three lancing devices set at the minimum ("1") and at the maximum ("5") lancing depth with respect to blood volume (BV) and pain related to lancing.

Methods: Lancing devices tested were A-Glucoject Dual PLUS, B-droplet (both: HTL-Strefa S.A., Poland), and C-Microlet Next (Ascensia Diabetes Care, Switzerland), all used with personal lancets of three sizes 28G, 30G, and 33G. BVs were measured with calibrated capillaries. Pain related to lancing was expressed as a derivative of pain rating with visual analog scale.

Results: In 90 participants with diabetes, 360 lancing procedures were performed. Overall, BV and pain were higher for "maximum" compared to "minimum" lancing depth (for both P < .001). Pain differed between devices (P ≤ .001), overall was higher for device A compared to B or C; in paired comparisons differences were significant for the following settings: A > B for 28G/1 and 33G/1, B > C for 30G/1, and A > C for 28G/1, 30G/1, and 33G/1. In aggregated comparison we did not prove a significant effect of lancet size on either BV nor pain (P = .1109, P = .4966, respectively).

Conclusions: BV depended mainly on lancing depth. Pain depended on lancing depth and to some degree on device type. The results may serve as a source of comparative data of lancing devices performance for studies in which other lancing devices and/or lancets would be tested.The study was registered at ClinicalTrials.gov: NCT03479619.

Keywords: SMBG; blood sampling; glucose monitoring; lancets; lancing device; pain.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: BM, WM, IS, and AS received remuneration from the Medical University of Lodz for preparing the protocol and carrying out this study. None of the authors declared another conflict of interest related to this study.

Figures

Figure 1.

BV according to lancing device type /lancet size /lancing depth setting (eg, C/28/1 means lancing device C/lancet size 28G/lancing depth “1”). In this figure BV is presented according to (i) lancing depth setting (values for “1”—minimum are on the left, values for “5”—maximum are on the right), (ii) lancing device type (according to the average of lancing depth calculated for “1” and “5” in millimeters, ie, A [2 mm]—C [2 mm]—B [1.45 mm]), and (iii) descending lancet diameter (ie, ascending gauge No.). In the table values are presented in ascending order. There were n = 20 lancing events for each of the 18 possible configurations except for C/33/5, n = 21 and C/28/5 n = 19. BV, blood volume.

Figure 2.

Intensity of pain related to lancing (nVAS) according to lancing device type/lancet size/lancing depth setting (eg, C/33/1 means lancing device C/lancet size 33G/lancing depth “1”). In this figure nVAS values are presented according to (i) lancing depth setting (values for “1”—minimum are on the left, values for “5”—maximum are on the right), (ii) lancing device type (according to the average of lancing depth calculated for “1” and “5” in millimeters, ie, A [2 mm]—C [2 mm]—B [1.45 mm]), and (iii) descending lancet diameter (ie, ascending gauge No). In the table values are presented in ascending order. There were n = 20 lancing events for each of the 18 possible configurations except for C/33/5, n = 21 and C/28/5 n = 19. nVAS (normalized-VAS), standardized pain rating, where nVAS = VAS/everyday-VAS (everyday-VAS, patient’s rating of pain perceived during everyday finger pricking; VAS, the rating of pain [performed with visual analog scale] related to lancing patient’s particular finger during the study).