Faking high FSBS?

[military spouse]

Had an inmate today that repeatedly had a "high" FSBS. He was given 10 units reg. and still read "high" after a couple of hours. Received 6 more units and drank a bunch of water. Continued to read between 515 and "high." Was getting ready to send him to the infirmary for closer monitoring and he becames panicked and nervously said, "Okay, okay. Let me just check it one more time." MIRACULOUSLY, it was down to 102. Was using 3 different glucometers at this point and each read between 99 and 102. All of this occured between 1600 and 2330. What are ways that one can manipulate a FSBS? One of the nurses said they can put sugar on their fingers. Was hoping for more details such as dry sugar or rubbing wet sugar solution on hands and letting it dry? Not too sure. I THOUGHT I was watching him do the FSBS, but apparantly not that well. Of course, quickly became concerned that inmate's sugar would be too low since the insulin given was based on apparant false readings. Any thoughts or experiences?

[katkonk, BSN, RN]

He must have been wiping something on his hands. I suspect he was high to begin with and then started playing the game later in the evening. We have over 50 inmates doing FSBS and insulins and his was the only unusual situation. I would just love to see what was in his pocket.

For a result that was that bizarre....I would have told him of my suspicion in a calm and professional manner and asked the officer to "shake him down". Then THEY could find whatever was in his pocket! And if something was found, then he would get "a case" or "a ticket" or whatever your institution calls it. Also, agree with the EMT-I would have seen what a venous draw showed, and/or if I had any I-STAT machine (or something similar) may have run a cartridge on that to verify.

I have to say that I have learned a lot from this post. I really did not think it was possible to manipulate a FSBS this way. Obviously, we have seen people who really aren't fasting and read high, but never knew that it was possible to apply something to the hands to affect that. GREAT post!

[everthesame, LPN, LVN]

We had an offender who used to have both suspicious high and suspicious low readings. I would clean the finger myself and even ran the alcohol pad under her fingernail...very thoroughly. When we became suspicious of her blood sugar readings and started cleaning her finger ourselves, she would try to stick her finger in a spot that wasn't cleaned or would even try to stick a different finger. We all assumed she was putting something on her finger or she was eating food she wasn't supposed to be eating. We never did figure out how she was manipulating the number to read low. We watched her eat her meals and she was also watched for going into the bathroom to try to vomit immediately after meals. We all did the happy dance when that one was released.:clpty:

[celclt]

how did he not bottom out from all of the insulin?

[christi britt]

What happened to swabbing the prospective site with an alcohol swab first and then allowing it to dry? Would this not solve your problem?