Injection Technique

[Amity Island]

They found an average of 3.5 errors of insulin injection technique among the 230 people they surveyed, with only 5% of the study participants making just one error and 2% making seven, with excessive injection force being the most common.

Insulin injection errors ubiquitous in adults with diabetes

Canadian researchers have identified at least one insulin injection technique error in all people with insulin-dependent diabetes who were surveyed for a study.

www.medwirenews.com

 

[DaveB]

I agree with all of the points except needle re-use. The risk of infection is probably zero or less as long as the needle cover is replaced and the needle removed between uses. Yes the needle does gradually become blunt but I find I can re-use up to about 4-5 times during one day with no issues at a cost saving to the NHS. People's skin types vary so you can't generalise.

 

[SweetGuy]

I am all for helping the NHS. But if you are given unequivocal instructions to use the needles only once and they are provided on that basis why would you ignore that? One of the flyers they sent me recently when GP changed the brand of needles showed a microscopic picture of the damage to a needle point after just one use.

 

[Sally71]

Well if you need a microscope to see the needle damage, then the extra damage it would do to your skin would also be microscopic, and your skin can heal itself. It's the same with lancets. We don’t use needles very often because we are pumping, but we do use lancets. In the beginning we did as we were told and changed the lancet after every finger prick, but then got that sometimes we would forget so we fell into changing it once a day, then it slipped into every 2-3 days, and now it's whenever we remember or whenever it hurts too much, which isn’t very often! It was not a conscious decision to not change them all the time, it just sort of happened, and as daughter doesn’t seem to be coming to any harm from it I’m not going to worry, there are plenty of things which are more dangerous! You do what you are comfortable with, if you'd rather change them every time then carry on.

 

[porll69]

I am all for helping the NHS. But if you are given unequivocal instructions to use the needles only once and they are provided on that basis why would you ignore that? One of the flyers they sent me recently when GP changed the brand of needles showed a microscopic picture of the damage to a needle point after just one use.

Have seen that picture as well. It has been disproved thou. I will try and find the link/source


@Sally71 I must be one of the only type 1s that change the lancet regularly. Am on the fasclix and change the drum every day

 

[Robin]

This is the bit that baffles me.

When shown a set of images depicting how the skin might appear when the person with diabetes pressed the button on the insulin pen, over 30% opted for the image where the skin was significantly indented, and 76% chose an image that showed greater than optimal force.
“Proper technique indicates the needle hub should be visible and to avoid indenting the skin when injecting to reduce the risk of intramuscular injection,” note Lori Berard (Winnipeg, Manitoba, Canada) and study co-authors.

As my eyes are on the front of my head, and not on the ends of my fingers, I've never had the view of the needle hub while injecting, so wouldn’t know which of the images it was supposed to look like.

 

[rebrascora]

I change my needles Wednesdays and Sundays. That is an increase from weekly on a Sunday which was my previous routine as a compromise to the nurse wanting me to use new needles every time. I haven't had a problem even with weekly needle changes.
I have concerns not just about cost implications to NHS but also environmental impact. I also only need half a unit air shot with not changing the needle so that means I use less insulin too which is also a saving for the NHS.

I think in this country because we have the NHS and free prescriptions for us diabetics we are unaware of how much insulin costs and I feel that it is my responsibility to minimise that cost as much as I can. There are people who need cancer drugs to survive etc, so if I can reduce my drain on resources, it may help someone else.
This mind set helps to motivate me to get out and get exercise to reduce my insulin needs as well as deter me from being tempted to eat something naughty which would need a large bolus. Don't get me wrong I am not into sack cloth and ashes but I do my best to reduce my personal impact on resources.
I am not judging anyone else in saying this, just that this is my take on my situation.

 

[rebrascora]

This is the bit that baffles me.

When shown a set of images depicting how the skin might appear when the person with diabetes pressed the button on the insulin pen, over 30% opted for the image where the skin was significantly indented, and 76% chose an image that showed greater than optimal force.
“Proper technique indicates the needle hub should be visible and to avoid indenting the skin when injecting to reduce the risk of intramuscular injection,” note Lori Berard (Winnipeg, Manitoba, Canada) and study co-authors.

As my eyes are on the front of my head, and not on the ends of my fingers, I've never had the view of the needle hub while injecting, so wouldn’t know which of the images it was supposed to look like.

I agree. 2 of my 3-5 daily injections go in my bot and I would rather press too hard and know that the insulin is all going in than not hard enough and perhaps lose some insulin by not having the needle fully inserted. I have enough flesh on my bot not to worry about it going into muscle.

 

[SweetGuy]

I was advised to go into the side of my leg as the main alternative to the tum if I needed to. But I have never dared try it so far. I have a bit of a spare tyre to play with and have only ever had minimal bruising.

 

[rebrascora]

I prefer to keep my stomach for bolus insulin because it seems to work a bit faster than anywhere else and is easy to access for discrete injecting when eating out.
I started off using my stomach for everything and like you @SweetGuy I was a bit apprehensive about injecting in my thighs, but it isn't really any different.
I decided to experiment with other sites because I thought 5 or maybe 6 (if corrections were needed) injections a day in my stomach for the rest of my life wasn't ideal. I used my thighs for basal for a while alternating left and right and also experimented with bolus in my thighs but found it was slower, even doing squats after injecting to see if it would speed things up. Now I prefer to use my buttocks for basal and stomach for bolus still and if I exercise and eat low carb I can sometimes get away with just 1 or 2 bolus injections a day in my stomach.

 

[DaveB]

I am all for helping the NHS. But if you are given unequivocal instructions to use the needles only once and they are provided on that basis why would you ignore that? One of the flyers they sent me recently when GP changed the brand of needles showed a microscopic picture of the damage to a needle point after just one use.

Don't forget the NHS is very rule bound and procedural e.g. they constantly measure your blood pressure regardless of need every time you go near a medic. The NHS also doesn't care about cost at the coal-face. Needle manufacturers are in business to make a profit from selling needles so you would expect them to recommend changing after each use. It's up to us to make a sensible judgement.

 

[everydayupsanddowns]

to reduce the risk of intramuscular injection,

How long are the needles in this study?!

 

[everydayupsanddowns]

I was advised to go into the side of my leg as the main alternative to the tum if I needed to. But I have never dared try it so far. I have a bit of a spare tyre to play with and have only ever had minimal bruising.

I just always pinched up slightly for thighs, where my flesh coverage is thinner (probably also frowned upon in the article?

A throwback to my early years with 12mm needles

 

[porll69]

I just always pinched up slightly for thighs, where my flesh coverage is thinner (probably also frowned upon in the article?

A throwback to my early years with 12mm needles

Before I was put on the pump I always used to pinch when injecting even with the 4mm needles.....it became automatic after so many years and those horrendous needles

 

[helli]

Before I was put on the pump I always used to pinch when injecting even with the 4mm needles.....it became automatic after so many years and those horrendous needles

I too was an "always pincher" before pumping. I never had the horrendous needles but having little fat, I needed the pinch.

If I was out and about, I may reuse my needles but always found I would bruise on second or third use of a needle. When I commented on the bruising to a nurse (I didn't mention I occasionally reused a needle), she told me "Oh well, some people are just more susceptible to bruising than others."

 

[everydayupsanddowns]

If I was out and about, I may reuse my needles but always found I would bruise on second or third use of a needle. When I commented on the bruising to a nurse (I didn't mention I occasionally reused a needle), she told me "Oh well, some people are just more susceptible to bruising than others."

I was a serial needle-reuser on MDI. I knew I shouldn’t, but some needles would last for days

I never had any kind of infection or built up any hard lumps because of it. I got a slight deposit of fat under the skin from lazy overuse of abdomen as it was so handy and available for boluses, but I thunk that was just the insulin. I am getting a slight build up around sides and back where infusion sites go and I change them very regularly at 2-3 days as instructed. I’m a good boy now.

 

[trophywench]

I use a Fastclix and don't use a new drum every day, but do change the lancet daily because I know 100% I have significant thickening of skin on my fingertips though mainly the sides thereof, having followed Alan Shanley's excellent advice on Painless Pricks, for a good many years now!

@Sally71 - please don't forget your little girl has another 70+ years of pricking the same ends of her same fingers ahead of her. At times in recent years I've sometimes had to use my thumbs or index fingers because despite turning the depth setting up and up I've not been able to get any blood out of the other 6 digits.