Hi all.

[MonkeyMann]

Hello all.

I have been type 2 for 4 years and 2 years ago diagnosed t1. I take 2 metformin a day and inject novomix 70/30 twice a day to maintain steady mmol.
I struggle to inject in my stomach due to hitting nerves and veins a lot. I also shake a lot which doesn't help me. I'm tempted to inject in my thigh but can build up the confidence to do it and every time I search it up it tells a diffrent way to do it. Anyone else inject in the thigh? Wheres best? How's best to do it? I appreciate ill get a lot of diffrent answers but just some pointers will do.
Anyway nice to meet you all.

Mike

 

[rebrascora]

Hi Mike and welcome again..... I just responded to your other post about the discoloured insulin.

I think it is likely that you were never Type 2 but just a misdiagnosed Type 1 for longer than the last 2 years. Many of us were misdiagnosed as Type 2 initially. It is a common misconception in the medical world that Type 1 only occurs in children and young people, so they assume if you are a mature adult when you develop diabetes that you must be Type 2.

Were you given an option to change to a different insulin regime when you were diagnosed Type 1. Mixed insulin is quite inflexible and means you need to eat regular amounts of carbohydrates at regular times of day. It can be quite restrictive or difficult to maintain good diabetes management, particularly if your lifestyle doesn't lend itself to routine. Were you offered a change of insulin which would involve more injections but a more flexible lifestyle and diet? I can understand if you find injections difficult or painful that you might prefer to stick with a mixed insulin.

As regards injections being painful ie hitting nerves and blood vessels, I have problems with this quite a bit. Firstly, what size needles do you have? I think the minimum is 4mm and 32 gauge although I think it may be possible to get slightly finer ones. I don't think they come any shorter than 4mm but if you have longer ones like 8mm, then definitely ask about shorter ones. Getting too close to my belly button causes problems with nerves for me so minimum 2inches from there but you can go all the way out to your sides in that midrif area. I inject in my thighs on an evening and alternate one thigh one night and the other the next. I find from the midline down the length of my thigh to the outside and higher up tends to be less painful than lower down. Sometimes the needle going in doesn't hurt at all and I barely feel it and other times it hurts the moment I touch the needle to my skin. You can sometimes use this to touch different places and find a less sensitive spot to push the needle through the skin. I also inject into my buttocks but again it is hit and miss for places where it is sensitive and others where it isn't and moving just a few mm can make a difference.

As regards hitting small blood vessels, if you have shorter needles then it is less likely but still happens and I often get injection sites which bleed a little when I remove the needle or bruise so I have little black blue and yellow patches on my injection sites. The bleeding is not a huge issue unless you are very squeamish I suppose.

The best way to inject into thighs is sitting down and as I said above, gently touch the needle tip to your skin to find a spot which isn't too sensitive and then push through ensuring the the pen is at right angles to the surface of the skin. It is a good idea to hold down the button on the pen for about 10 seconds to allow the insulin to fully dissipate in the fatty layer under the skin and then withdraw the injector before releasing the button to prevent and back flow which may have cause the discolouration of the insulin on your other thread.

Hope some of that makes sense and if not ask again. I know I was really reticent to try different injection sites when I first started on insulin and I wasn't really encouraged to experiment but I am pleased I did and certainly some parts of the body are less sensitive than others so it pays to experiment. By the way, you can also inject into your upper arms if you would be more comfortable with that.... I haven't tried my arms yet but prefer not to have dubious looking bruises on visible sites, particularly arms at this time of year when I often wear sleeveless tops.

 

[everydayupsanddowns]

Welcome to the forum @MonkeyMann

Are you being treated as a T2 on insulin, or have you formally been reclassified as type 1?

Unfortunately Drs aren’t always 100% forthcoming with the details, or perhaps don’t express these changes in a very understandable way.

Sometimes additional checks of GAD antibodies, or cPeptide (which shows how much of your own insulin you are still able to produce)

Sorry to hear about the anxiety you are getting around injections. Do you feel significant pain or discomfort or is it the idea of injections? There are a number of options which may help, including shielded needles, or even just alternative brands. The injection itself should be something you are hardly able to feel (though the psychological impact will still be difficult for some people, who may benefit from some extra support)

 

[rebrascora]

The injection itself should be something you are hardly able to feel

I definitely feel a very high proportion of my injections.... I would say probably about 40%.... and most of those are enough to make me flinch, wince or so painful that I remove the needle half way in and try another spot and it is not uncommon for the next site to be painful too.
I can finger prick until the cows come home and whilst it hurts a bit a lot of the time it's not a big deal and nothing to the discomfort of a lot of my injections. I have had 2 different types of needles ( both 4mm 32gauge) and it doesn't seem to make much difference and sometimes the insulin stings as well as the needle insertion and sometimes it doesn't, so it really does just seem to depend on where I stick the needle. Different sites are much the same. Mornings I inject in my buttocks and sometimes I don't feel a thing but other mornings I have several attempts before I just give in and sink the needle and endure the pain ....it is very hit and miss. I might ask the nurse about it tomorrow when I see her. It doesn't discourage me from injecting and I can rationalize it but it certainly causes a significant amount of discomfort for 10-20 seconds nearly every other time.

 

[everydayupsanddowns]

I definitely feel a very high proportion of my injections.... I would say probably about 40%.... and most of those are enough to make me flinch, wince or so painful that I remove the needle half way in and try another spot and it is not uncommon for the next site to be painful too.

…but it certainly causes a significant amount of discomfort for 10-20 seconds nearly every other time.

Gosh that does sound unpleasant. My MDI injections were usually felt mildly for no more than 5-10s. I get more discomfort from infusion sites.

Occasionally I‘ve have a howler with either, and have to breathe deeply for a while, but that’s not common.

I was wondering whether it might be worth you trying a different needle brand, but it sounds like you’ve done that already.

 

[rebrascora]

Gosh that does sound unpleasant. My MDI injections were usually felt mildly for no more than 5-10s. I get more discomfort from infusion sites.

Occasionally I‘ve have a howler with either, and have to breathe deeply for a while, but that’s not common.

I was wondering whether it might be worth you trying a different needle brand, but it sounds like you’ve done that already.

Having had light shone on this topic and realising that I am experiencing more pain than "normal" I have set about tackling it rather than just accepting it. I have been making more of a conscious effort to think about each injection and take more time rather than just getting on with it and grinning and bearing it. I am making a point of gently touching the tip of the needle to my skin every time now before I try to insert it and if it feels uncomfortable then I move a little and try again until I find a spot which is less sensitive. I also find that some places, the skin is much tougher and more resistant to the needle than others and I am finding that gently twizzling the pen a little instead of just applying pressure to push it through helps the needle to pierce the skin with less trauma to the tissue and discomfort. Those two things do seem to be making a significant difference. Some injections are still a tad uncomfortable but not the wincing pain I was often experiencing before.
The insulin still smarts when it is injected on occasion but again, no pattern to that and both Fiasp and Levemir do it on occasion which suggest that it is site related rather than the insulin. Not sure there is anything I can do to tackle that and I had the problem when I was using NovoRapid too so changing insulin would not be the answer. Doesn't make a difference if insulin is cold or ambient temp. I do wonder if it may have to do with the pressure that the insulin is under as it comes out, so a partially blocked/restricted needle would create a stream of insulin under greater pressure....just like putting your finger over the end of a hose pipe causes the water to spray with more intensity.

Anyway, thanks @MonkeyMann for raising this issue as it has made me put more thought into my own injections and as a result I am seeing an improved situation and less pain. I hope my thoughts/experiments above may help others.