Bad Habits in Diabetes Care

We have developed some less than optimal habits in diabetes management.  I'm going to publicly confess, tell you why we do what we do, and then beseech Dr. Cogen to put these habits in perspective for us.-  How bad are they? - Which ones should we work to correct? - Do we need to make some diabetes care New Year's Resolutions?

Blood Sugar Testing

Our early training gave a very clear procedure for doing a finger stick. It went something like this: wash hands, insert new lancet, swab finger with alcohol, test, wipe blood from finger, dispose of test strip and used lancet in a sharps container. In actuality blood sugar testing goes something like this: pick least dirty finger, test with lancet that may have been changed in the last few days, lick blood from finger. (The latter is a disgusting habit my son brought home from diabetes camp; however, it's better than the blood stains he used to leave in his pump case.) For the record, and knock on wood, we have had no infections at the site of finger pricks. I wrote about the problem of residual sugar on a finger, so if we get an unexpected out of bounds number, we wash hands and retest. While I know clean fingers and sterile procedures may be optimal, getting a fast test done on the sidelines of a soccer game or before retaking the field in a baseball game takes priority over the testing procedure. How bad is our lack of sterile procedure?

Dr C's response: It is more important to test than not to test, even if the chosen site is not pristine. However, I would make a few suggestions. I love diabetes camp, but it is true that some less than ideal behaviors are acquired. It isn't always practical to have an alcohol swab on one's person at all times, so yes, pick a clean finger and test. It would be even better to rinse the finger in water and dry it off before testing to prevent dilution and sticky residue from sweets (if at all possible). MRSA (Methicillin Resistant Staph Aureus) is on the rise so you should at least try to keep sites as clean as possible. Licking the blood from the finger after testing is even done by some professionals. I do not think it is the greatest idea as the mouth is a huge reservoir for gross bacteria. On a scale of 1-10 (1=not an issue and 10=big issue) I would say (in my opinion) it is a 4, for lack of sterile procedure.

Injections

I know we're supposed to wipe the top of the insulin bottle with alcohol before inserting the syringe. I admit to skipping this step most of the time. We stopped wiping the injection site with alcohol years ago because the alcohol was really drying out Josh's skin. How dirty can his upper arm or covered thigh really be?

Dr. C's response: Not really dirty. This skipped step would be a "3".

PS: A question was posted on the Diabeteens site about reusing syringes and needles. I do not recommend reuse of disposable medical equipment if at all possible: especially needles. Use of needles through clothing is also not a good idea to avoid the potential for infection.