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Settings Help Reduce Finger Pain
In our last issue, we reviewed injection aids. Here we present a review of lancing devices with a few comments from our readers. Like our last review, this is an unscientific and informal review, not an exhaustive consumer survey. The comments of readers are solely the opinions of the respondents and do not necessarily reflect the views of Diabetes Health.
Because so many companies manufacture and market lancing devices, deciding which device best suits one's needs can be a confusing, but worthwhile, process. Approximately 10 companies produce lancing devices. These products are, in turn, marketed by an even greater number of companies. Information on some of these companies' products was unavailable at press time, while other companies chose not to be included in this review.
The manufacturers of lancing devices have taken the question "Will it hurt?" to heart and have added some comforting features to their devices. Some devices have different sized tips that control how deep a lancet is delivered into the skin. Other devices make use of an adjustable tip that provides the user even greater control over the depth of lancet penetration with the turn of a dial. Still others use color-coded platforms to control the depth of penetration. By allowing deep penetration for callused skin or shallow penetration for sensitive skin, manufacturers are adapting the devices to users' needs.
Palco Labs is the leader in lancing device production with three other companies marketing its devices.
Palco's auto-Lancet¨ has recently received a face-lift. It now has an adjustable tip with five settings: 1 to 2 are for soft or thin skin, 2 to 3 for average skin and 4 to 5 for thick or callused skin. For finer adjustment, the tip can be positioned between any two numbers. This replaces their older system of distributing the device with two caps, one for thick skin and one for regular skin. Palco devices can be used with almost all lancet designs.
It takes four steps to activate the device. First, the tip is unscrewed and the lancet is inserted into the holder. The lancet's protective cap is then removed and the device's tip is screwed back on. The device is cocked by pulling on a sliding barrel. When the trigger is pushed, the lancet is automatically delivered into the skin.
For those of you using the older device, you can upgrade to the new adjustable tip for $3.75. To find a retailer near you call Palco at (800) 346-4488.
Becton Dickinson (B-Dª Lancet Device) and MediSense (MediSense¨ Lancing Device) still market the older Palco device with two depth control caps, but they will be switching to the new adjustable tips in the near future.
Cheryl Fitzgerald, of Bellefonte, Pa., has been using the B-D Lancet Device for three years and is quite happy with the product. "The B-D device is excellent! It is quick and easy to load."
Boehringer Mannheim Corp. is another company that markets a Palco device under their own name. Boehringer recently abandoned their Soft Touch¨ II device, which they had produced themselves, in favor of the Soft Touch¨, the name they gave to Palco's device with the adjustable dial.
The prices for these Palco produced products range from $10 to $16.
For more information call Palco at (800) 346-4488, B-D at (800) 237-4554, MediSense at (800) 527-3339 and Boehringer at (800) 428-5076.
Ulster Medical Products
The Gentle-let-PC¨, by Ulster Medical Products, is the new name for a lancet device that has been called the Feather-let-PC¨ in the past. The device is very similar to Palco's auto-Lancet and the suggested retail price is $8.25.
For more information, call (800) 631-0076.
Of all the producers of lancing devices, Owen Mumford has the most diverse selection.
The smallest lancing device on the market is the new Autolet¨ Mini from Owen Mumford. Barely larger than the lancet it holds, the Autolet Mini fits in the palm of your hand for discreet sampling. The easy-open blister pack includes two devices, one to pack with your meter kit and one to keep at home. Autolet Mini also comes with ten ultra-thin Unilet¨ Universal ComforTouchª lancets for comfortable daily sampling. However, this device is compatible with nearly all brands of lancets.
Mrs. Gibbs from Gainesville, Georgia, writes, "My 10-year-old daughter saw the Autolet Mini in an ad and asked me to buy it. When she used the new device, she found the Mini very quiet and, with the ComforTouch lancets, found it was the most comfortable device that she has used. Plus, she likes the small size for easy handling."
Owen Mumford quotes the suggested retail price for the Autolet Mini as $6.95 for two devices.
Owen Mumford also markets the Autolet¨Lite lancing device. It differs from most other lancing devices in that it does not require the user to cock the device. The device is automatically cocked and ready to fire when the hinged top is closed. The lancet is delivered into the skin automatically when a firing button on the base of the device is triggered. The AutoletLite is made of tan plastic and is the size of a cigarette lighter.
Owen Mumford refers to the AutoletLite package as their "starter's pack" because it comes supplied with lancets, depth adjustment platforms and a handy diabetes ID card to be carried in the user's wallet. While some devices require the user to remove the used lancet by hand, the AutoletLite has a push-button for removing the lancet. This eliminates the possibility of unintentional sticks and possible infection.
Three color-coded platforms are provided with the AutoletLite that allow the user to choose between three penetration depths. The orange platform is used for thick skin, the yellow platform for normal skin and the white platform for thin skin. Also supplied with the AutoletLite are the new Unilet Universal ComforTouch lancets. These 0.45 mm lancets are Owen Mumford's thinnest.
The suggested retail price for the AutoletLite is $15.95.
The Autolet¨ II, the original lancing device from Owen Mumford, is designed for personal and clinical use. When the device is used with the platform and lancets provided, it comprises a unique blood letting system, "which meets the particular requirements of multi-patient/hospital situations in addition to the needs of individual home blood monitoring patients," according to Owen Mumford.
Both the Unilet lancets and the Autolet platforms can be ejected semi-automatically after use, preventing injury and possible infection from contaminated lancets and platforms. To use, the lancet is placed into a cocked loading arm. With the press of a button, the loading arm is released and automatically delivers the lancet.
The Autolet II comes in a navy blue vinyl wallet, and the suggested retail price is $20.00.
For more information about Owen Mumford products, call (800) 421-6936.
In addition to the Soft Touch device made by Palco, Boehringer Mannheim Corp. also produces their own lancing device, the Softclix¨. Boehringer claims their Softclix lancing device is "a virtually pain-free lancet device." It comes equipped with a Comfort Dialª on the tip that allows the user to adjust the lancet's penetration depth. The Softclix has six depths to choose from. The smallest depth penetration is 0.7 mm and the greatest is 2.2 mm.
In addition to adjustable depths, Boehringer claims that their device, unlike spring loaded devices, reduces damage to the skin by utilizing a "precise linear sliding motion." According to Boehringer, this feature eliminates side-to-side movements of the lancet that can cause painful dilation and tearing of skin tissue. This system utilizes a specially designed lancet that only fits in the Softclix device.
To cock the device, the user twists the tip until two clicks are heard. On the base of the device is an eject button which actually shoots the lancet out of the lancet holder to be deposited in a sharps container. The Softclix requires the use of the Softclix lancets and is not interchangeable with other lancets on the market.
Sheldon W. Hoenig, a weekly e-news reader, writes, "In the past I have used Boehringer Mannheim's Soft Touch device and lancets. In December I changed to their Softclix device and lancets. As a result, pain dropped tremendously."
Dr. Jack J. Gerber adds, "By far the best one I have used is the Softclix which allows you to adjust the depth of penetration."
Softclix comes with a one-year warranty. Although Boehringer Mannheim does not have a suggested retail price, they have taken a survey and determined the going rate of the Softclix is $31 to $32.
For more information on Boehringer Mannheim products, call (800) 428-5076.
Stat Medical Devices
Qwik-Letª was added to the list of finger-sticking supplies in 1996 after the company spent years evaluating the lancing device market. The device is multi-colored, making it attractive for kids and adults. Unlike many devices, it is not cylindrical but ergonomically shaped, so it is easy to handle and will not roll.
Stat Medical Devices has patented the internal mechanism that automatically cocks the device while it is being loaded with a lancet. This assures the user that a fresh lancet is used each time the device is used. The suggested retail price of the Qwik-Let is $9.95.
Stat Medical Devices will be introducing the Qwik-Let cap at the June 1997 ADA conference in Boston. This cap will be a separate component that attaches to the Qwik-Let lancing device. Once a lancet has been used, the cap will eject the lancet so it can be safely deposited into a sharps container without the user having to touch it.
For more information about Stat Medical Devices, call (800) 767-7828.
The lancing device offered by LifeScan, a Johnson & Johnson company, is the Penletª II. It is an automatic blood sampler in the shape of a stubby, short cigar. The four-and-a-half-inch device is made of gray plastic and is light weight and easy to use. Two caps come with the device that allow for variable depth penetration. The cap with a single line on the side is recommended for children and most adults. The cap with a double line on the side works well for people with thick or callused skin.
To use, the cap is pulled off and a lancet is inserted into the holder. The lancet's protective disk is then removed and the cap is replaced. The Penlet is then cocked by pulling out a sliding barrel until a click is heard. The lancet is automatically injected by pressing a small dark gray button on the side of the device. After obtaining a drop of blood, the lancet can be safely removed by gripping two T-shaped prongs.
"I use the Penlet II device that came with my One Touch¨ meter. I have used every lancet that will fit in it, and lots do. My first choice is the B-D Ultra Fine¨ Lancet. The extra-fine needle provides the least pain and most comfort while allowing for a more than adequate drop of blood," writes David of Key West, Fla.
Especially for Small Fingers
Parents with young children should know about a disposable lancing device on the market made specifically for small fingers. Disposable lancets are single use, self-contained plastic devices that are generally used in hospitals and clinical settings. Although there are other companies who make disposable devices, International Technidyne Corporation (ITC) has developed a line of disposable devices made especially for infants. These devices are available for consumer purchase.
For heel incisions, ITC has the tenderfoot¨, tenderfoot¨ preemie and tenderfoot¨ toddler. The tenderfoot¨ is recommended for full-term to 6-month-old babies. The tenderfoot¨ preemie is for babies under three-and-a-quarter pounds. And the tenderfoot¨ toddler is for 6-months-old to 2-years-old.
For a box of 50 tenderfoot heel devices, the cost is $147.
The finger devices made by ITC come in three sizes. The Tenderlett¨ Toddler is for older infants and toddler use. The device has a pink trigger and a white case with a 0.85 penetration depth. The Tenderlett¨ Jr., for pediatric use, has a blue trigger and white case with a 1.25 mm penetration depth. The Tenderlett¨ with a red trigger is for adult use. It has a 1.75 mm penetration depth. "The contoured device minimizes skin indentation because it matches the shape of the finger," says ITC.
The suggested retail price for a box of 100 Tenderlett finger devices is $59.
Tenderlett products can be ordered through BioCare (800) 224-0001.
What does the future hold?
Laser technology could be the future of lancing devices. This alternate method to lancing recognizes the hazards involved in the collection of blood for medical testing. In place of a sharp needle, this technology would use a small laser beam to puncture the skin. This method of skin puncturing would greatly reduce the risk of accidental injuries and infection.
Venisect Inc. is one company working towards the application of this new technology. Their Laser Lancetª has not been approved, but entered its latest round of trials with the Food and Drug Administration (FDA) in early January, according to Colleen Clements, director of investors of Corporate Communications for La Barge Inc. La Barge entered into a joint venture with Venisect in 1995 and, if the product is approved by the FDA, will manufacture the Venisect Laser Lancet.
In December, GEM Edwards submitted their laser lancet, the Finger Friendª, to the FDA. The company is hoping to have an answer on approval by April 1, 1997. If it is approved, it will be used in hospitals and will be available for the professional market before the summer. Following the anticipated approval for hospital use, GEM plans to resubmit the Finger Friend and have it reviewed for public use.
Although the future looks bright for this new technology, lancets and lancet devices are still needed in the meantime.
Mar 1, 1997