Mari Abe-Doi1,2, Makoto Oe2, Ryoko Murayama1,2, Mami Takahashi2, Yasunobu Zushi3, Hidenori Tanabe1,3, Iseki Takamoto4, Ryo Suzuki4, Toshimasa Yamauchi4, Takashi Kadowaki4, Chieko Komiyama5, Hiromi Sanada2,6. 1. 1 Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo , Tokyo, Japan . 2. 2 Global Nursing Research Center, The University of Tokyo , Tokyo, Japan . 3. 3 Terumo R&D Center , Kanagawa, Japan . 4. 4 Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo , Tokyo, Japan . 5. 5 Department of Nursing, The University of Tokyo Hospital , Tokyo, Japan . 6. 6 Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo , Tokyo, Japan .
Abstract
BACKGROUND: Performing self-monitoring of blood glucose (SMBG) is a clinical challenge for elderly people with low dexterity. An all-in-one-type SMBG device that can simply and easily puncture and monitor would be useful for them. We developed an automatic skin-puncturing and blood-sampling (APS) system for introducing of an all-in-one-type SMBG device. The aims of this study were to determine if the developed APS system, which has automatic puncturing, squeezing, and application functions, could provide sufficient blood sample volumes for SMBG and to determine the factors associated with failure in the use of the system by adult volunteers. METHODS: We investigated the success rate of obtaining a 0.8-μL sample volume using the APS system and determined the factors associated with failure in 140 adult volunteers. The participant characteristics, induration of puncturing sites, and states of finger grip conditions were evaluated as factors of a puncturing failure. The participant characteristics, skin hydration, states of finger grip, skin elasticity of the finger pad, and blood flow were evaluated as factors of a squeezing failure. RESULTS: The success rate was 61.9%. Puncturing failure was 21.6%, and squeezing failure was 16.5%. Automatic puncturing factors associated with failure were male sex, larger finger diameter, and thicker finger pad. The only squeezing failure factor was lower peripheral skin temperature. CONCLUSIONS: Improvement of the finger station groove shape to prevent ischemia and the squeezing angle would be useful developments of the all-in-one-type SMBG device for elderly people with decreased dexterity.
BACKGROUND: Performing self-monitoring of blood glucose (SMBG) is a clinical challenge for elderly people with low dexterity. An all-in-one-type SMBG device that can simply and easily puncture and monitor would be useful for them. We developed an automatic skin-puncturing and blood-sampling (APS) system for introducing of an all-in-one-type SMBG device. The aims of this study were to determine if the developed APS system, which has automatic puncturing, squeezing, and application functions, could provide sufficient blood sample volumes for SMBG and to determine the factors associated with failure in the use of the system by adult volunteers. METHODS: We investigated the success rate of obtaining a 0.8-μL sample volume using the APS system and determined the factors associated with failure in 140 adult volunteers. The participant characteristics, induration of puncturing sites, and states of finger grip conditions were evaluated as factors of a puncturing failure. The participant characteristics, skin hydration, states of finger grip, skin elasticity of the finger pad, and blood flow were evaluated as factors of a squeezing failure. RESULTS: The success rate was 61.9%. Puncturing failure was 21.6%, and squeezing failure was 16.5%. Automatic puncturing factors associated with failure were male sex, larger finger diameter, and thicker finger pad. The only squeezing failure factor was lower peripheral skin temperature. CONCLUSIONS: Improvement of the finger station groove shape to prevent ischemia and the squeezing angle would be useful developments of the all-in-one-type SMBG device for elderly people with decreased dexterity.