Buying guide for best lancing devices

For many type 1 and type 2 diabetics, daily blood glucose testing is an important part of the day-to-day routine. Blood glucose levels determine how many units of insulin to inject before meals, for instance. They also help measure the effectiveness of other blood sugar control regimens. Unfortunately, to get those daily results, this endeavor calls for numerous sticks with sharp lancets.

When shopping for a new or replacement lancing device, it is important to remember that the end result should always be a good test sample. A multi-click lancing device may be more convenient to use, but if it doesn’t deliver a good “stick”, it is not an upgrade. Having more depth options is helpful, but not if those higher settings cause more pain or skin damage.

If you’re in the market for a new lancing device, we encourage you to consider the information and product suggestions we provide in this shopping guide.

The three most common lancet gauges are 28, 30, and 33, although there are some lancets as thin as 70 gauge on the market.

Key considerations

A basic blood glucose testing kit almost always includes a spring-loaded lancing device to deliver the “stick” of a sterile lancet. That said, many users seek a better model that addresses their specific needs.

Lancet depth selection

Some users have very thin skin, while others have thicker or callused skin. A quality lancing device allows users to adjust the power and depth of the stick to meet their specific needs. Look for a model that offers at least six degrees of depth selection, if not more. Some lancing devices actually offer over 20 levels of tension, although the difference between each level may be negligible.

The ideal lancet depth will provide enough blood to saturate a glucose strip without causing long-term damage or pain. Sometimes, changing the gauge of the lancet itself may be preferable to changing the depth gauge on the lancing device.

Barrel design

One noticeable difference among lancing devices is the length of the barrel. Some are small enough to be concealed in the palm of a hand; others are much larger. One end of the barrel is used to load the spring mechanism, while the other end is pressed against the user’s fingertip or other sampling site. Basic lancing devices are not always ergonomically designed, but many mid-range and high-end models can fit comfortably in one hand.

Changing out a single lancet or installing a new multi-click barrel should be a straightforward process. Some basic models can expose users to the sharp tip of a lancet if not handled with extreme care.

Lancet compatibility

Some lancets cause less pain than others. A thinner lancet is generally less painful on the fingertips. Some lancets have a special coating that reduces friction, too.

The problem is, a number of lancing devices are not designed to accommodate a wide assortment of lancets. Users may be limited to a specific brand or design. Ultra-thin lancets can also be very expensive, and some lancing devices may not be able to handle them.

“Universal” is a key term to look for when shopping. A universal lancing device should accept lancets from different manufacturers that meet a certain industry standard. This adaptability is more convenient, and it may also prove to be less expensive and/or more comfortable for the consumer over time.

Capacity

Most of the lancing devices that come with a starter glucose test kit can accommodate one sterile lancet at a time. The user must insert a new lancet into the barrel and remove the safety cap, which exposes the needle.

Some users may not be comfortable with handling or viewing a sharp lancet. A special cartridge containing multiple lancets can be installed in certain lancing devices. This eliminates the need to manually replace lancets between every use. Notably, a cartridge system like this may be more expensive.

When shopping for a new or replacement lancing device, consider your personal comfort level with the lancet replacement process. A single lancet delivery system offers sizing options not always available in multi-click cartridges. However, a multi-click system does not require as much handling of exposed needles. Many multi-click lancing devices are auto-loading, meaning they are pre-set to deliver a good stick without cocking a spring mechanism.

Lancing device features

Alternative blood sampling

Although the fingertips are the preferred site for blood glucose sample collection, a number of users find that this process grows more painful over time. Alternating hands and fingers sometimes addresses the issue, but not always. For some users, the best solution is finding an alternative collection site, such as the palm, forearm, upper arm, or thigh.

Not all lancing devices offer the option of alternative site blood sample collection. If offered, this feature should be mentioned in the product description or packaging. A lancing device designed for alternate sites should include a special transparent cap that fits over the end of the barrel. When using an alternate site, the cap provides additional pressure and a slight vacuum. It also allows the user to see when an adequate sample has been obtained.

Vacuum-powered extraction

A common problem encountered by testers is an insufficient blood sample. Sometimes, the lancet simply does not penetrate the skin deeply enough. A handful of high-end lancing devices have a powered vacuum cap to address this. This vacuum seal encourages blood to flow without the need for painful squeezing or a second lancing. It can also be used to collect blood from an alternate site on the body.

Ergonomic design

The basic lancing devices included in testing starter kits are not praised for their ergonomic design or ease of use. They can be slippery in the hand and difficult to control. However, there are mid-range and high-end lancing devices that are specifically designed for maximum comfort in the hand. The barrels are curved to match the contours of the hand, and the tips are angled to provide a more solid stick (and less skin tearing) when the trigger is pressed.

Lancing device prices

Most blood glucose testing kits include a standard lancing device and a supply of sterile lancets. As we’ve mentioned, however, it is not unusual for users to seek a better lancing device for ease of use, personal comfort, or economic reasons. Here’s what to expect at different price points.

Inexpensive (under $10): Many blood glucose testing kits include a basic lancing device that would be in this price range if sold separately. The lancing device may offer a limited number of tension settings or no adjustability at all. These models generally accommodate one lancet at a time, and this may not include the ultra-thin lancets many users prefer.

Mid-range ($10 to $35): At this price range, lancing devices with multiple click capability start to appear. Instead of loading one lancet at a time, users can install a special cartridge that contains at least six lancets. The design will be more ergonomic, making it less painful to use on alternative sites. One-handed operation is common in this price range.

Expensive (over $35): High-end lancing devices are often universal, meaning they accept a wide variety of lancets from different manufacturers. Many are designed to keep the lancets out of sight, which can help reduce anxiety. The most advanced lancing devices have a vacuum that encourages blood flow without the need for squeezing. There are also medical-grade lancing devices that use concentrated laser light instead of metal to penetrate the skin and open capillaries.

Tips

• Always wash and dry the sampling site before using a lancing device. Use an alcohol pad to sanitize the area.
• Try lancing the sides of the fingertips instead of the central finger pads.
• Use the lowest possible setting necessary to obtain a good sample. Users with thin skin should start with the lowest setting. Users with thicker or calloused skin should start with a higher setting.
• Changing the gauge of a lancet can make a noticeable difference if pain is an issue.
• Never share a lancet with another user. Lancets should be treated like hypodermic needles, and users should observe the same safety protocols.
• Vigorous shaking or waving the hand can improve capillary blood flow before testing.

Other products we considered

In addition to the contenders on our shortlist, we found several other quality lancing devices on the market. The Microlet 2 Lancing Device by Bayer HealthCare features a one-handed operation system that customers describe as noticeably less painful than similar devices. It is easily carried in a shirt or pants pocket.

The TRUEdraw Lancing Device by True Decor is an exceptionally affordable model that accepts a wide variety of lancet brands and delivers a solid stick on thicker skin. We highly recommend it for users who prefer testing alternative sites, like the forearm.

In terms of overall comfort, we liked the Delica Lancing Device by Lifescan. Although it only accepts the proprietary lancets from OneTouch, the Delica can handle the company’s thinnest gauge offering. Advanced glide control and reduced vibration are also positive points worth considering.

Alternative blood sampling sites include the palm, upper arm, forearm, thigh, and calf. However, samples taken from these areas may affect the blood sugar test results.

FAQ

Q. My partner and I are both type 2 diabetics. Can we share the same lancing device?
A. You can use the same lancing device to obtain blood samples, but you shouldn't use the same lancets. Make sure the lancing device contains a fresh, sterile lancet every time you or your partner use it.

Q. My new lancing device has multiple settings. How can I tell which setting would be right for me?
A. There are several methods for determining the best setting for your fingertips. Some users automatically set a new lancing device to a medium level and adjust up or down after the first test. Others start at the lowest setting and work their way up until they find a level that punctures the skin but does not penetrate too deeply or cause undue pain.

Q. My doctor recently diagnosed me with type 2 diabetes, and I dislike the inexpensive lancing device that came with my blood testing kit. Is a high-end lancing device really worth the extra money?
A. The answer largely depends on how much daily blood sugar testing you need to perform. Some type 2 diabetics, especially those who are insulin-dependent, must test several times a day. Others may only check their blood sugar once in the morning or once at night. Frequent testers may find that a high-end lancing device is less painful and easier to adjust. Infrequent testers, however, may not notice much difference between a $10 lancing device and a $90 upgrade.