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Evaluation of Blood Volume and Perceived Pain During Fingerstick Monitoring of Blood Glucose

Evaluation of Blood Volume and Perceived Pain During Fingerstick Monitoring of Blood Glucose When Using Different Currently Marketed Lancing Devices and Lancets

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00741390
Enrollment
250
Registered
2008-08-26
Start date
2008-08-31
Completion date
2008-09-30
Last updated
2010-03-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2

Keywords

Diabetes, Lancets, Pain

Brief summary

The procurement of blood for SMBG, usually via a finger stick, is considered by many patients to be the most painful portion of diabetes therapy. This has led to the marketing of smaller gauge lancets, lancing devices with variable depth settings and blood glucose sensors that require less blood for measurement. In this study, two main outcomes were evaluated: The first, which was assessed at Visit 1, was whether specific combinations of lancets and lancing devices would yield sufficient blood volume to allow valid assessment of diabetic subjects' glucose levels. The other outcome, assessed at Visit 2, was the level of pain perceived by subjects during lancing with specific combinations of lancets and lancing devices. During Visit 2, pain assessment was done using a Visual Analog Scale and such that for each lancet/lancing device, the lowest lancing device setting that yielded a valid BG reading for each subject during Visit 1 was used. A third outcome measure, overall comfort with lancing, was also assessed at Visit 2. A total of 5 combinations of lancets and lancing devices were evaluated. These were as follows: * BD/33G = BD Lancet device/BD 33G lancets (BGM measured with the OneTouch® UltraMini™ (BGM) and OneTouch® Ultra® test strips) * OTM/33G =OneTouch® Mini Lancet device / BD 33G lancet (BGM measured with the OneTouch® UltraMini™ (BGM) and OneTouch® Ultra® test strips) * OTM/28G =OneTouch® Mini Lancet device / OneTouch® UltraSoft® 28G Lancet (BGM measured with the OneTouch® UltraMini™ (BGM) and OneTouch® Ultra® test strips) * OTU/28G = OneTouch® UltraSoft® Lancet device/OneTouch® UltraSoft® 28G Lancet (BGM measured with the OneTouch® UltraMini™ (BGM) and OneTouch® Ultra® test strips) * ACC/28G= Accu-Chek® Softclix Lancet device/Accu-Chek® Softclix 28G Lancet (BGM measured with Accu-Chek® Advantage BGM and Accu-Chek® Comfort Curve test strip) After enrollment and qualification, subjects were assigned to one of 4 intervention arms. The arm assignment determined which 3 of the 5 combinations of lancets and lancing devices the subjects would evaluate in Visit 1 (for volume adequacy) and of these 3, which 2 they would evaluate in Visit 2 (pain during lancing). The lancet/lancing device combinations assigned to each arm are shown in the Assigned Interventions Table below.

Interventions

DEVICEBD/33G

BD Lancet device/BD 33G lancets (BGM measured with the OneTouch® UltraMini™ (BGM) and OneTouch® Ultra® test strips)

DEVICEOTM / 33G

OneTouch® Mini Lancet device / BD 33G lancet (BGM measured with the OneTouch® UltraMini™ (BGM) and OneTouch® Ultra® test strips)

DEVICEOTU/28G

OneTouch® UltraSoft® Lancet device/OneTouch® UltraSoft® 28G Lancet (BGM measured with the OneTouch® UltraMini™ BGM) and OneTouch® Ultra® test strips)

DEVICEACC/28G

Accu-Chek® Softclix Lancet device/Accu-Chek® Softclix 28G Lancet (BGM measured with Accu-Chek® Advantage BGM and Accu-Chek® Comfort Curve test strip)

DEVICEOTM/28G

OneTouch® Mini Lancet device / OneTouch® UltraSoft® 28G Lancet (BGM measured with the OneTouch® UltraMini™ (BGM) and OneTouch® Ultra® test strips)

Sponsors

Becton, Dickinson and Company
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
SINGLE (Subject)

Eligibility

Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No

Inclusion criteria

* Must currently be diagnosed with either Type I or Type II diabetes mellitus. * Must currently be performing self monitoring of blood glucose * Must be between 18-70 years of age (inclusive). * Must be able to read and follow study instructions in English.

Exclusion criteria

* Pregnant (self reported) * History of poor blood circulation. * Any skin condition on his or her fingers that prevents blood sampling. * History of a bleeding disorder. * Neuropathy or other condition affecting sensation in the hands. * Self-reported blood borne infection (e.g., HIV, hepatitis B or C \[non A, non B\], syphilis, malaria, babesiosis, brucellosis, leptospirosis, arboviral infections, relapsing fever, T lymphotropic virus Type 1, Creutzfeldt-Jakob disease). * Currently participating in another study * Employed by BD, J&J, Roche or the Clinical Site.

Design outcomes

Primary

MeasureTime frameDescription
Blood Sample of Sufficient Volume to Yield a Valid Meter ReadingStudy Day 1 (Visit 1)Number of subjects in whom valid meter reading was obtained with each device configuration. The primary outcome of a successful lancing is defined as whether or not a technician is able to use the lancing system to yield a blood sample of sufficient volume to yield a valid meter reading.
Difference in Lancing Pain for Device Pair at Visit 2. (For Subjects Assigned to Arms A, B, C Only)Approximately Day 3 (Visit 2)In Visit 2 subjects kept the same group assignment they had in Visit 1. Each subject tested 2 of the 3 systems from Visit 1. Up to 6 pairs of lancings were performed in order to obtain 4 evaluable pairs. After each pair of lancing, the subject was asked to record the pain from the 2nd lancing as compared to the first using a 150mm visual analog scale(0mm = same pain, -75mm = max score for less painful than first lancing,+75mm = max score for more painful). A positive value on the scale (and in table below) indicates that the first device in the pair was more painful than the second.

Secondary

MeasureTime frameDescription
Difference in Lancing Pain for Devices in Visit 2 Only. (For Subjects Assigned to Arm D Only)Approximately Day 3 (Visit 2)The subjects who participated in Study Visit 2 kept the same group assignment they had in Study Visit 1. Each subject tested 2 of the 3 systems they experienced during Visit 1. Up to 6 pairs of lancings were performed in order to obtain 4 evaluable pairs. After each pair of lancing, the subject was asked to record the difference in the pain they perceive between two lancing systems using the 150 mm visual analog scale. A positive value on the scale (and in the table below) indicates that the first device in the pair was more painful than the second.
Reported Device Preference Within Lancing Pair at Visit 2Approximately Day 3 (Visit 2)After each pair of 4 lancings, the subject was asked: Which of the two devices did you find more comfortable, overall? The choices were: first lancing, second lancing or equivalent. The Stated Preference row indicates # of lancing pairs in which one device was preferred over the other device while the 2 rows below indicate the # of pairs in which each device was preferred. First and second device refers to the 1st and 2nd devices identified in column headers, not the device order during testing. The No Preference row includes lancing pairs with preference of equivalent or no answer.

Countries

United States

Participant flow

Recruitment details

A total of 250 subjects were enrolled in this study between 8/4/2008 (first subject visit) and 9/5/2008 (last subject visit) at two study centers.

Pre-assignment details

After enrollment, baseline characteristics such as demography, diabetes history, and current lancets were recorded for each subject. No additional baseline measures were taken. Thereafter, subjects were assigned to one of the 4 intervention arms. Subjects were able to complete the enrollment visit and Study Visit 1 activities on the first day.

Participants by arm

ArmCount
Entire Study Population250
Total250

Baseline characteristics

CharacteristicEntire Study Population
Age Continuous52.1 years
STANDARD_DEVIATION 12.3
Blood Glucose Meter Brand
Abbott
45 participants
Blood Glucose Meter Brand
Agamatrix
1 participants
Blood Glucose Meter Brand
Bayer
20 participants
Blood Glucose Meter Brand
BD/Novamax
17 participants
Blood Glucose Meter Brand
Lifescan
106 participants
Blood Glucose Meter Brand
Other
16 participants
Blood Glucose Meter Brand
Private Label Walgreens
2 participants
Blood Glucose Meter Brand
Reli-on
2 participants
Blood Glucose Meter Brand
Roche
41 participants
Diabetes Type
Type 1
95 participants
Diabetes Type
Type 2
155 participants
Region of Enrollment
United States
250 participants
Sex: Female, Male
Female
151 Participants
Sex: Female, Male
Male
99 Participants
Years Since Diagnosis
<1
12 participants
Years Since Diagnosis
>10
146 participants
Years Since Diagnosis
1-5
46 participants
Years Since Diagnosis
6-10
46 participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —
other
Total, other adverse events
5 / 626 / 6311 / 626 / 63
serious
Total, serious adverse events
0 / 620 / 630 / 620 / 63

Outcome results

Primary

Blood Sample of Sufficient Volume to Yield a Valid Meter Reading

Number of subjects in whom valid meter reading was obtained with each device configuration. The primary outcome of a successful lancing is defined as whether or not a technician is able to use the lancing system to yield a blood sample of sufficient volume to yield a valid meter reading.

Time frame: Study Day 1 (Visit 1)

Population: BD/BD33g and Mini/BD33g were included in 4 arms,the Mini/OT28g in 2 arms,and Ultra/OT28g and AC/AC28g in 1 arm. Thus the # of subj evaluated for each device was 246, 246, 124, 63, and 60, resp. Subj were analyzed for blood volume adequacy if they completed the depth setting/volume testing for at least 1 device w/o significant protocol deviation.

ArmMeasureGroupValue (NUMBER)
BD/33GBlood Sample of Sufficient Volume to Yield a Valid Meter ReadingSufficient Volume - Success245 Participants
BD/33GBlood Sample of Sufficient Volume to Yield a Valid Meter ReadingSufficient Volume - Unsuccessful1 Participants
OTM/33GBlood Sample of Sufficient Volume to Yield a Valid Meter ReadingSufficient Volume - Success246 Participants
OTM/33GBlood Sample of Sufficient Volume to Yield a Valid Meter ReadingSufficient Volume - Unsuccessful0 Participants
OTM/28GBlood Sample of Sufficient Volume to Yield a Valid Meter ReadingSufficient Volume - Success124 Participants
OTM/28GBlood Sample of Sufficient Volume to Yield a Valid Meter ReadingSufficient Volume - Unsuccessful0 Participants
OTU/28GBlood Sample of Sufficient Volume to Yield a Valid Meter ReadingSufficient Volume - Unsuccessful0 Participants
OTU/28GBlood Sample of Sufficient Volume to Yield a Valid Meter ReadingSufficient Volume - Success63 Participants
ACC/28GBlood Sample of Sufficient Volume to Yield a Valid Meter ReadingSufficient Volume - Success60 Participants
ACC/28GBlood Sample of Sufficient Volume to Yield a Valid Meter ReadingSufficient Volume - Unsuccessful0 Participants
95% CI: [98.09, 99.59]
95% CI: [98.79, 100]
95% CI: [97.61, 100]
95% CI: [95.36, 100]
95% CI: [95.13, 100]
Primary

Difference in Lancing Pain for Device Pair at Visit 2. (For Subjects Assigned to Arms A, B, C Only)

In Visit 2 subjects kept the same group assignment they had in Visit 1. Each subject tested 2 of the 3 systems from Visit 1. Up to 6 pairs of lancings were performed in order to obtain 4 evaluable pairs. After each pair of lancing, the subject was asked to record the pain from the 2nd lancing as compared to the first using a 150mm visual analog scale(0mm = same pain, -75mm = max score for less painful than first lancing,+75mm = max score for more painful). A positive value on the scale (and in table below) indicates that the first device in the pair was more painful than the second.

Time frame: Approximately Day 3 (Visit 2)

Population: Of the 234 subjects that completed Visit 2, 229 had evaluable pairs and were included in the analysis for Visit 2. Some of the lancing pairs from several subjects were excluded due to protocol deviations, subject discontinuation or adverse events. Of these 175 subjects were analyzed for this primary outcome.

ArmMeasureValue (MEAN)Dispersion
BD/33GDifference in Lancing Pain for Device Pair at Visit 2. (For Subjects Assigned to Arms A, B, C Only)10.86 mmStandard Deviation 34.07
OTM/33GDifference in Lancing Pain for Device Pair at Visit 2. (For Subjects Assigned to Arms A, B, C Only)8.71 mmStandard Deviation 36.69
OTM/28GDifference in Lancing Pain for Device Pair at Visit 2. (For Subjects Assigned to Arms A, B, C Only)-0.03 mmStandard Deviation 31.83
p-value: <0.00195% CI: [6.8, 10.84]ANOVA
p-value: 0.00395% CI: [3.63, 8.55]ANOVA
p-value: 0.4695% CI: [-3.57, 0.23]ANOVA
Secondary

Difference in Lancing Pain for Devices in Visit 2 Only. (For Subjects Assigned to Arm D Only)

The subjects who participated in Study Visit 2 kept the same group assignment they had in Study Visit 1. Each subject tested 2 of the 3 systems they experienced during Visit 1. Up to 6 pairs of lancings were performed in order to obtain 4 evaluable pairs. After each pair of lancing, the subject was asked to record the difference in the pain they perceive between two lancing systems using the 150 mm visual analog scale. A positive value on the scale (and in the table below) indicates that the first device in the pair was more painful than the second.

Time frame: Approximately Day 3 (Visit 2)

Population: 61 subjects in this arm completed visit 1 and evaluable data for lancing pain. See further description above.

ArmMeasureValue (MEAN)Dispersion
BD/33GDifference in Lancing Pain for Devices in Visit 2 Only. (For Subjects Assigned to Arm D Only)4.86 mmStandard Deviation 33.75
p-value: 0.01795% CI: [1.14, 4.9]ANOVA
Secondary

Reported Device Preference Within Lancing Pair at Visit 2

After each pair of 4 lancings, the subject was asked: Which of the two devices did you find more comfortable, overall? The choices were: first lancing, second lancing or equivalent. The Stated Preference row indicates # of lancing pairs in which one device was preferred over the other device while the 2 rows below indicate the # of pairs in which each device was preferred. First and second device refers to the 1st and 2nd devices identified in column headers, not the device order during testing. The No Preference row includes lancing pairs with preference of equivalent or no answer.

Time frame: Approximately Day 3 (Visit 2)

Population: Comfort was analyzed per lancing pairs. 236 subjects performed up to 4 lancing pairs. 869 pairs were evaluated across the 4 arms. Pairs were excluded if they did not result in a valid meter reading or associated with protocol deviations or had missing comfort data.

ArmMeasureGroupValue (NUMBER)
BD/33GReported Device Preference Within Lancing Pair at Visit 2# of pairs in which participants stated preference180 lancing pairs
BD/33GReported Device Preference Within Lancing Pair at Visit 2First device in pair preferred67 lancing pairs
BD/33GReported Device Preference Within Lancing Pair at Visit 2Second device in pair preferred113 lancing pairs
BD/33GReported Device Preference Within Lancing Pair at Visit 2# of pairs in which no preference was stated43 lancing pairs
OTM/33GReported Device Preference Within Lancing Pair at Visit 2First device in pair preferred70 lancing pairs
OTM/33GReported Device Preference Within Lancing Pair at Visit 2Second device in pair preferred113 lancing pairs
OTM/33GReported Device Preference Within Lancing Pair at Visit 2# of pairs in which no preference was stated26 lancing pairs
OTM/33GReported Device Preference Within Lancing Pair at Visit 2# of pairs in which participants stated preference183 lancing pairs
OTM/28GReported Device Preference Within Lancing Pair at Visit 2Second device in pair preferred89 lancing pairs
OTM/28GReported Device Preference Within Lancing Pair at Visit 2First device in pair preferred84 lancing pairs
OTM/28GReported Device Preference Within Lancing Pair at Visit 2# of pairs in which no preference was stated32 lancing pairs
OTM/28GReported Device Preference Within Lancing Pair at Visit 2# of pairs in which participants stated preference173 lancing pairs
OTU/28GReported Device Preference Within Lancing Pair at Visit 2# of pairs in which no preference was stated46 lancing pairs
OTU/28GReported Device Preference Within Lancing Pair at Visit 2First device in pair preferred73 lancing pairs
OTU/28GReported Device Preference Within Lancing Pair at Visit 2# of pairs in which participants stated preference186 lancing pairs
OTU/28GReported Device Preference Within Lancing Pair at Visit 2Second device in pair preferred113 lancing pairs
Comparison: Analysis consisted of a one proportion test for the 1st device in the lancing pair being preferred, out of the total number of times that a preference was stated. Note: lancing pairs in which no preference was stated or where data were missing were excluded from analysis. The null hypothesis for the one proportion test was that the 1st device in the lancing pair was preferred 50% of the times.p-value: 0.001Fisher Exact
Comparison: Analysis consisted of a one proportion test for the 1st device in the lancing pair being preferred, out of the total number of times that a preference was stated. Note: lancing pairs in which no preference was stated or where data were missing were excluded from analysis. The null hypothesis for the one proportion test was that the 1st device in the lancing pair was preferred 50% of the times.p-value: 0.002Fisher Exact
Comparison: Analysis consisted of a one proportion test for the 1st device in the lancing pair being preferred, out of the total number of times that a preference was stated. Note: lancing pairs in which no preference was stated or where data were missing were excluded from analysis. The null hypothesis for the one proportion test was that the 1st device in the lancing pair was preferred 50% of the times.p-value: 0.761Fisher Exact
Comparison: Analysis consisted of a one proportion test for the 1st device in the lancing pair being preferred, out of the total number of times that a preference was stated. Note: lancing pairs in which no preference was stated or where data were missing were excluded from analysis. The null hypothesis for the one proportion test was that the 1st device in the lancing pair was preferred 50% of the times.p-value: 0.004Fisher Exact

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026