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Needle size for adults

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Omg he thinks hypo's can't hurt us.😱

'fraid so ! I'm simply going to record all my appointments from now on. Its not what I want to do but I feel I need to 'prove' its not me passing blame etc etc. Honestly, it just seems i'm being mugged off
 
Yeah, it would be hilarious if it wasn't so f^ckin' serious. But my GP said that
Can you change GPs or see another one at the practice
 
Welcome to the forum Dean 🙂
I'm another 4mm needle user here. I use the BD viva 4mm. I was using the horrible, cheap GlucoRx 5mm when I started insulin 18 months ago, but found them bruising and just painful!
Are you happy on your current regime? Fixed insulin seems to be more 'old hat' now, and basal/bolus is much more common place. It makes eating far easier, and enables better control. Have you looked into it?
Also, diabetes uk has a helpline, if you want to talk to someone directly about your burnout - which almost all of us have or will suffer from at one stage or another. You're definitely not alone my lovely x
 
Hi Dean

I changed from 8mm to 6 mm and then when given the chance I swapped to 4 mm. A lot less bruising.
BUT that was with BD microfine. gP Practice tried to change me to the cheaper needles, which as you say cause bruises and break and bend. I wrote to the Practice and asked to be changed back to BD needles. Which they did straight away. Worth asking. The CCG just give guidance and the GO has the opportunity to ignore this. If you are struggling with your GP then switch to another who has more understanding of the condition ( or do what I did and run a training session for your GO Practice )
 
The reason why the short needles are recommended is simply because somebody (can't remember which Uni Med School it was now, it's been a while) actually went to the trouble of measuring all sorts of people's skin thickness, all ages, men women kids, sedentary, athletic, manual workers, librarians - people who lavish their bodies with creams frequently - people that didn't LOL - to get to the bit where the insulin needs to go - under the epidermis, in the space where the interstitial fluid flows between it and the fat and tissue below that. And the answer was around 4mm.

I found em a tad short TBH - and I've never got on with BD needles - they sting me - so I went with 6mm - Novofine ones in my case cos they don't make 5mm ones. I only had to ask and I got. They are still specified on my 'repeat' prescription.

When CCGs issue edicts like everyone must use this meter for which the strips are cheaper - and in any case can only have 100 each month - every GP in the land has a code he can enter in his computer to override the automatic choice of the computer program. Depending on what item he's actually prescribing he then gets a list of 'tick box' probably choices for his reason - or he can type his own reason freehand. I mean I'm using a pump and so they tick that as the 'excuse' - it isn't true, I still needed more on MDI anyway but I had a history of being a bit uncontrolled in the near past at the time, so they said it was cos I'd been advised by the hospital to test more. I couldn't care less if they said it was cos I was an ugly old woman and stroppy - as long as I got the ruddy things!

You do really need to get a GP with more than one brain cell - but meanwhile - you really should try to help yourself - cos it's amazing - the NHS engage far far better, with people who try and help themselves and can demonstrate that they do.

First thing you need to do is some basal testing, to make sure your dose of Tresiba is doing what it should for you. If not - then it needs adjusting up or down. So here it is - http://www.diabetes-support.org.uk/info/?page_id=120 Keep a record of what happens - and then work out either yourself or with our help on here - how you can try and overcome any glitches.

Good luck !
 
Hello and welcome to the forum. 🙂
 
The reason why the short needles are recommended is simply because somebody (can't remember which Uni Med School it was now, it's been a while) actually went to the trouble of measuring all sorts of people's skin thickness, all ages, men women kids, sedentary, athletic, manual workers, librarians - people who lavish their bodies with creams frequently - people that didn't LOL - to get to the bit where the insulin needs to go - under the epidermis, in the space where the interstitial fluid flows between it and the fat and tissue below that. And the answer was around 4mm.

I found em a tad short TBH - and I've never got on with BD needles - they sting me - so I went with 6mm - Novofine ones in my case cos they don't make 5mm ones. I only had to ask and I got. They are still specified on my 'repeat' prescription.

When CCGs issue edicts like everyone must use this meter for which the strips are cheaper - and in any case can only have 100 each month - every GP in the land has a code he can enter in his computer to override the automatic choice of the computer program. Depending on what item he's actually prescribing he then gets a list of 'tick box' probably choices for his reason - or he can type his own reason freehand. I mean I'm using a pump and so they tick that as the 'excuse' - it isn't true, I still needed more on MDI anyway but I had a history of being a bit uncontrolled in the near past at the time, so they said it was cos I'd been advised by the hospital to test more. I couldn't care less if they said it was cos I was an ugly old woman and stroppy - as long as I got the ruddy things!

You do really need to get a GP with more than one brain cell - but meanwhile - you really should try to help yourself - cos it's amazing - the NHS engage far far better, with people who try and help themselves and can demonstrate that they do.

First thing you need to do is some basal testing, to make sure your dose of Tresiba is doing what it should for you. If not - then it needs adjusting up or down. So here it is - http://www.diabetes-support.org.uk/info/?page_id=120 Keep a record of what happens - and then work out either yourself or with our help on here - how you can try and overcome any glitches.

Good luck !

Hello Jenny, many thanx for the extensive reply. Very informative and I can act on 99% of it. I'm amazed at the amount of erm...terminology that I have no idea about. I fully admit that I simply go through the motions. I've never really looked into what I have (with regards to T1) because I was never 'steered' into it by anyone such as my GP etc.

Yeah, the point you made about the NHS engaging much more does make sense but the info and advice they (HCP at hsptl and my GP's) give comes across as such basic do's and don'ts, whats your doses, eating etc. That, in my mind is all there is to it. Oh how wrong I was/am !

The article about basal insulin and control is excellent...thanx for that, a lot of info that I can understand (remember, i'm a bass player lol ) and makes a lot of sense.

My biggest, hugest, gargantuan (great word eh) problem is...EATING and mealtimes. As a kid I was never a great eater. I'd pick and miss meals and felt no worse for not eating for a day or so. I'm fussy about food, I detest cabbage, brocoli et al but fine with salad. This is my biggest problem. I was diagnosed at 24. 24 for g*ds sake, I was drinking, smoking dope, messing about with bands (still do), gigs, pubs, parying and general whoopy. I'm irresponsible to a degree and can be a bit chaotic (but fairly intelligent) so when I was diagnosed you can only imagine what that did. I never took to it and for the last 28/9 years has simply depressed me. I still can't believe that me, me Dean Holt could actually end up with Diabetes and injections for the rest of my life (Iwon't even go into the problem I have in the urology department if you know what I mean). To put it simply, it ruined me. I know how that sounds but it is how I feel and lived with it the whole time. Yeah, it started off as a bit of a novelty...you know, bit of a celeb, peoples concern etc then it became a hindrance. Within a year I was in bits......

I don't think i've ever expressed how I feel about it publicly before with regards to the above. It just feels its the time to reach out and try and get myself sorted.

Look, sorry for going on and going slightly off subject but I tend to let it all out when i'm on a roll...

Thanx again for all the great info, it all makes a lot of sense. Thank you 🙂

All the best

dean
 
Many thanx for all the info you wonderful people have given me. The support is fabulous. So replying to each and every one of you miss would take me a few hours (and then a blood test lol) i'll say ONE BIG THANK YOU to you all for everything.

Thanx again

Dean x
 
Can you change GPs or see another one at the practice

I won't change my practice simply because it'll feel like I have to build a relationship with a new GP BUT having said that its worth thinking about.

Yes, I can see someone else at the surgery and have done so recently. So maybe thats the way to go or at least give it go.
 
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And the answer was around 4mm.

Beat me to it Jenny!

Yes, there was research done and skin thickness before you get to the 'subcutaneous' bit where we want the insulin to go doesn't vary much at all. This important thing is that you get to choose - NICE recommendations for evidence-based best practice in treating T1D in adults state:

9.3.7
76. Offer needles of different lengths to adults with type 1 diabetes who are having problems such as pain, local skin reactions and injection siteleakages. [new 2015]
77.After taking clinical factors into account, choose needles with the lowest acquisition cost to use with pre-filled and reusable insulin pen injectors.[new 2015]
(my emphasis)

So basically it doesn't matter 2 fig if needle 'a' is cheaper than needle 'b', if the person using it doesn't like it or... finds it stings or... prefers a different length or whatever.

Often shorter needles are rather more expensive. And I think those of us with more years under our belts tend to feel comfortable with longer harpoons (I started on 12mm and dropped to 8mm in the end). The slight risk with longer ones is that you can hit muscle, of course, which knackers your expectation of absorption time.

Good luck with it!
 
Welcome to the forum Dean 🙂
I'm another 4mm needle user here. I use the BD viva 4mm. I was using the horrible, cheap GlucoRx 5mm when I started insulin 18 months ago, but found them bruising and just painful!
Are you happy on your current regime? Fixed insulin seems to be more 'old hat' now, and basal/bolus is much more common place. It makes eating far easier, and enables better control. Have you looked into it?
Also, diabetes uk has a helpline, if you want to talk to someone directly about your burnout - which almost all of us have or will suffer from at one stage or another. You're definitely not alone my lovely x

I was never actually aware of the basal/bolos regime of doing things. Again, this kind of stuff has never been explained to me. No Doc, GP or nurse has explained any of this so i'm pretty much in the dark. Having read the replies to my post i'm getting a far better picture of 'control' that I had a day ago. I know it sounds mad after 29 years but if I don't know, I don't know.

Anyway, many thanx for the reply. I'm looking into it as I write (type even)

All the best

dean
 
Hi Dean

I changed from 8mm to 6 mm and then when given the chance I swapped to 4 mm. A lot less bruising.
BUT that was with BD microfine. gP Practice tried to change me to the cheaper needles, which as you say cause bruises and break and bend. I wrote to the Practice and asked to be changed back to BD needles. Which they did straight away. Worth asking. The CCG just give guidance and the GO has the opportunity to ignore this. If you are struggling with your GP then switch to another who has more understanding of the condition ( or do what I did and run a training session for your GO Practice )

Thanx, good advice.

What do you mean about running a training session for the GP's. I have an inkling of what you mean but could you explain a little more.

Thanx

Dean
 
@Dean Holt - just wondering reading your recent post, if you think you might get something out of some structured education in managing T1? When you and I both got the nod (similar time I think) it was all presented as very simple (inject this, eat that, don't eat that...) but over the years they've developed a much more detailed way of looking at it that can help you live more freely and get better results.

Still a bit of a faff, but more freedom to respond to the flow of things rather than just having to stick to plonking out root notes on the crotchets/eighths and occasionally trying to throw in a lick learned by rote - diabetically speaking.

You could do worse than reading 'think like a pancreas' if you'd prefer to keep yourself to yourself, but actually many people find throwing their hat into the ring for something like a DAFNE course where you get some face-to-face time with others facing the same daily struggles alongside learning new techniques/appraches for food/alcohol/illness/exercise etc gives them a whole lot more than just the fact/training part alone.

Different parts of the country run different courses, but people who go on them are usually extremely enthusiastic about the experience.
 
Beat me to it Jenny!

Yes, there was research done and skin thickness before you get to the 'subcutaneous' bit where we want the insulin to go doesn't vary much at all. This important thing is that you get to choose - NICE recommendations for evidence-based best practice in treating T1D in adults state:

(my emphasis)

So basically it doesn't matter 2 fig if needle 'a' is cheaper than needle 'b', if the person using it doesn't like it or... finds it stings or... prefers a different length or whatever.

Often shorter needles are rather more expensive. And I think those of us with more years under our belts tend to feel comfortable with longer harpoons (I started on 12mm and dropped to 8mm in the end). The slight risk with longer ones is that you can hit muscle, of course, which knackers your expectation of absorption time.

Good luck with it!

Many thanx for the info. I'm getting a better picture of the needle sizes now 🙂

All the ebst

Dean
 
@Dean Holt - just wondering reading your recent post, if you think you might get something out of some structured education in managing T1? When you and I both got the nod (similar time I think) it was all presented as very simple (inject this, eat that, don't eat that...) but over the years they've developed a much more detailed way of looking at it that can help you live more freely and get better results.

Still a bit of a faff, but more freedom to respond to the flow of things rather than just having to stick to plonking out root notes on the crotchets/eighths and occasionally trying to throw in a lick learned by rote - diabetically speaking.

You could do worse than reading 'think like a pancreas' if you'd prefer to keep yourself to yourself, but actually many people find throwing their hat into the ring for something like a DAFNE course where you get some face-to-face time with others facing the same daily struggles alongside learning new techniques/appraches for food/alcohol/illness/exercise etc.

Different parts of the country run different courses, but people who go on them are usually extremely enthusiastic about the experience.

Arh yes DAFNE, I've heard of this but didn't do much about it but feeling like I do, it could do me a lot of good. I have no problem talking about myself and expressing my 'feelings' so YES, I think I could probably get a lot out of it.

Research time....

Many thanx

Dean
 
Thanx, good advice.

What do you mean about running a training session for the GP's. I have an inkling of what you mean but could you explain a little more.

Thanx

Dean
I found that none of the GPs was familiar with how to help me manage my diabetes with adjusting ratios and basal rates, which is no surprise as they are not specialists.
When I went onto a pump my GP Was inquisitive about what differences that had made, so he asked me to go in and do a session on diabetes management using a pump for one of their training days. Daunting but very useful.
 
Arh yes DAFNE, I've heard of this but didn't do much about it but feeling like I do, it could do me a lot of good. I have no problem talking about myself and expressing my 'feelings' so YES, I think I could probably get a lot out of it.

Research time....

Many thanx

Dean
I found the DAFNE course very helpful, for all the things that have been suggested, and especially time to talk to others about day to day management.
 
Dean, ive recently been on a DAFNE type course (it has a different name where I live) and it was very useful. I met several other T1s, and a couple were in a similar place that you are now - that is, been diagnosed for many years, but were just coasting along. It helped them no end, and we recently met up again. One has reduced his HbA1c from 97 - 65 and another from 88-52. So, a vast improvement once they had bettered their knowledge, and learned what to do, and also just coming to terms with their diagnosis helped so much.
Definitely look into one of these courses.
As an aside, I was also diagnosed at age 24, so I can empathise with how you felt. I grew up with a diabetic father, and I'm in the medical industry myself, so I guess I found diabetes a little easier to grasp. However, I still have days where I rant and rave at the unfairness of it all! This group helps loads, as did the DAFNE type course 🙂
 
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