Alternate-site testing is reliable in children and adolescents with type 1 diabetes, except at the forearm for hypoglycemia detection.

Self-monitoring of blood glucose (SMBG) is crucial to the management of type 1 diabetes (1,2). Until recently, SMBG relied only on capillary blood sampling by fingerstick (a source of pain) and other forms of patient discomfort likely to diminish adherence to SMBG. After approval of alternate-site testing (AST), clinical studies found differences across measurement sites (3) in diabetic adults experiencing rapid blood glucose variations (4). Although pediatric patients with type 1 diabetes may be particularly likely to benefit from new methods that decrease pain and other burdens associated with frequent SMBG, alternate-site SMBG in this age-group has not been fully validated. The objectives of this study were to determine whether blood glucose measured at alternate testing sites (thenar and forearm) in diabetic children showed clinically significant differences compared with fingertip values and to evaluate patient satisfaction with AST. We included 29 children (aged 5–17 years) who had type 1 diabetes of at least 1 year’s duration and performed SMBG three or more times a day. The ethics committee of …