In Part 1 of this series I discussed good diabetes management. In this post, Kim Ladd, RN, BS, CPHQ, CDE, who works for the Virginia Department for the Blind and Vision Impaired as a diabetes educator, shares the “thumb-guide technique” she developed and states, “Many people with low vision or no vision are successful in getting a blood sample onto their blood glucose test strip with this technique.”
Thumb Guide Technique Steps
1. Gather your needed diabetes testing supplies.
2. Wash your hands in warm soapy water.
3. Prepare your lancing device.
4. Insert the test strip into your glucometer.
5. Place your thumb on the finger pad of the chosen finger (both the finger and thumb are from the same hand) and apply slight pressure.
6. Place this hand on a hard surface to help stabilize, and do not move your thumb until after the blood sample has been obtained.
7. Using your free hand, pick up your lancing device and place it on your thumbnail. Then slide it down until it touches the finger pad you are pricking.
8. Prick the finger and remove the lancing device, but do not move your thumb.
9. Using your free hand, pick up your glucometer and hold it like a pen with the strip facing down. Place the end of the strip on your thumbnail and slide it down until it touches the pad of the finger you just pricked, and hold it in place for about 3 seconds.
10. If a blood sample is not obtained, move the end of the strip to another spot on the finger pad using the thumb’s edge as a landmark and hold it in place for about 3 seconds. Be sure not to slide the strip on your finger; instead, pick it up and move it to another position on your finger pad along the thumb’s edge.
11. Continue steps 9 and 10 until the blood sample is obtained.
According to Kim, “This technique helps to ‘milk’ your fingertip by applying slight pressure to the finger pad, giving you a greater chance of having a large blood sample to test. It also provides a landmark and smaller surface area to explore with your test strip, increasing your chances of locating the blood sample.”
Using Insulin With Vision Loss
Insulin can be used safely and independently by people with vision loss. There are several options for insulin administration and adaptive devices to make giving yourself an injection successful. Below are Kim Ladd’s favorites:
Loaders
• Safe Shot Loader – costs about $15.00 each; The Safe Shot Syringe Loader allows blind or vision-impaired persons with diabetes to fill syringes for fixed-dose insulin administration independently.
• Count-a-Dose Syringe Loader – costs about $70.00 each; This device is useful for both fixed-dose and sliding-scale insulin doses. The Prodigy Count-A-Dose allows you to fill an insulin 1/2cc syringe without assistance. The Count-A-Dose lets you safely fill insulin syringes with one or two bottles of insulin. The bottle holder is marked to identify bottles for easy mixing—one raised dot for the first bottle, two raised dots for the second. With the click dial starting all the way down toward the raised minus (-) sign, the user moves the click dial the number of times, or clicks, per unit of insulin needed. Each click of the dial toward the plus sign (+) will draw one unit of insulin into the syringe. Manual and audio instructions are available on how to use this device.
Insulin Pens
• Insulin Pens – cost per pen is determined by your insurance company; The insulin is in the pen. Each click equals 1 unit of insulin. Count the clicks to equal the ordered dose, attach a disposable needle to the end of the pen and administer insulin. The doctor must order insulin pens (call the insurance company to determine if they are covered and what your co-payment amount will be). Some insurance plans may require Pre-Authorization by the prescribing doctor to justify their need due to vision impairment. If denied, the doctor can also submit an appeal by sending in the “medical necessity” form to the insurance company. NOTE: Not all types of insulin are available in pen form.
Magnifiers
• Syringe Magnifiers – cost about $15.00 each; A syringe magnifier provides 1.7 times magnification to read the syringe markings more easily. The Magni-Guide works with B-D 1CC, 1/2 cc, and 3/10 cc insulin syringes. It also helps guide the syringe needle into the vial. It is easy to use: Nest the vial in the semi-circle guide at the end of the magnifying bar, and from the other end, slide the syringe along the channel guide and into the vial. You can see and measure the correct doses more easily and accurately than ever.