Appalling Advice from my GP!

[Hayley64]

hi I am absolutely disgusted at this we have had issues but not of that kind I would change my gp definitely ours have been great with issuing extra for my son but having difficulty getting extra monitors hospital says cost too much! good luck

 

[CollieBoy]

How many use your prescription exemption certificate to obtain medication for non diabetes related issues?

Well before losing gliclazide (and hence my exemption cert), I was on :
Gliclazide & strips for D (2 items)
and for co-morbidities,
5 tablets (5 items)

 

[tim2000s]

As we've had a nice long discussion here, I thought it was probably time to introduce some real research and evidence into the fray.

So here we have a couple of studies, with some interesting outcomes.

The first is a systematic review and meta-analysis of a number of other studies from the Journal of Nursing Studies August 2016 edition. The abstract can be found here: http://www.journalofnursingstudies.com/article/S0020-7489(16)30030-X/fulltext

The results state:
In total, 25 studies were included. All studies had a high risk of bias and data from only nine studies could be pooled.

Five studies showed no association between infection at site of injection and reuse of needles (risk difference = −0.00; 95% confidence interval = −0.12–0.11; P = 0.99); heterogeneity between these studies was substantial (I2 = 66%; P = 0.02).

Five cross-sectional studies showed an association between lipohypertrophy and needle reuse (risk difference = 0.16, 95% confidence interval = 0.05–0.28, P = 0.006); there was strong evidence of heterogeneity between these studies (I2 = 87%; P < 0.001).

Pooled data of two studies with no evidence of heterogeneity between them showed more perceived pain among reusers (risk difference = 0.24; 95% confidence interval = 0.06–0.43; P = 0.006).

Reusing a pen needle or disposable syringe-needle was not associated with worse glycaemic control.

They then concluded:
There is currently no clear scientific evidence to suggest for or against the reuse of needles for subcutaneous insulin injection. This practice is very common among people with diabetes; consequently, further research is necessary to establish its safety.

In 2011, the Journal of Diabetology published a study (http://www.journalofdiabetology.org/Pages/Releases/PDFFiles/FourthIssue/OA-1-JOD-10-024.pdf) which had a small data set (45 patients). What's more interesting are the references on the back page in relation to factors affecting lipohypertrophy. They concluded an increase in skin fora with needle reuse - but not specifically that it resulted in infection.

Have a read of what's available. It's really quite interesting...!

 

[donnellysdogs]

Just wish all these researchers used real people....real long term persons that could show them no damage after 30+!years of re using needles
Min fact thats my gripe full stop.. Just wish that real people were used. I get turned down forbresearch cos I got too many illnesses etc.. I never even get phoned for govt statistics for polling/voting etc...never even get selected for jury service.

I prefer to read opinions ftom here from real people than a study....although very interesting Tim!!

 

[clareb1970]

View attachment 19916

Each to their own.

Good grief! I think the diabetic that injected with the needle in the final image must have skin like tree bark! That is ridiculous. There is absolutely no way that a proper needle would be that deformed and curled up after just 6 uses.

 

[Robinredbreast]

Just wish all these researchers used real people....real long term persons that could show them no damage after 30+!years of re using needles
Min fact thats my gripe full stop.. Just wish that real people were used. I get turned down forbresearch cos I got too many illnesses etc.. I never even get phoned for govt statistics for polling/voting etc...never even get selected for jury service.

I prefer to read opinions ftom here from real people than a study....although very interesting Tim!!

I concur with most of your last sentence

 

[catapillar]

Personally, I would always try not to reuse needles, because I was told not to and because I do find reusing a needle less comfortable. That could well be a bit psychosomatic, because I was told not to reuse because reusing will make it hurt more! But even so, if I'm injecting 5 times + a day, I'll be doing that as comfortably as possible thank you - after all, if I'm injecting to keep my blood sugar in check, I'm saving the NHS the cost of dealing with my diabetic complications if I fail to inject.

How about adding some real life money to the mix too?

Each disposable single use needle costs the NHS approximately 6p - http://www.cambsphn.nhs.uk/Librarie..._effective_diabetic_needles_June_15.sflb.ashx.

So, if you are using 1 a day instead of using 5, you are saving the NHS 24p per day, or £87.60 per year.

It's doesn't sound like a massive saving. Certainly not one worth making other diabetics who make the choice to follow the official advice not to reuse the needles feel guilty about.

Wonder how much a course of antibiotics costs...? A 7 day course of erythromycin is about £11. That would be over 12% of your initial saving...

 

[ann34+]

Thanks, Tim. I managed to access the 2011 study. Although interesting, it involved only 45 hospitalised patients in Russia - not a large multi centre trial, and staff changed the needles. It would have been interesting , if the study had involved an additional groups ie - living at home - to find out if the results would have been different. I still use some syringes due to still having pump problems - maybe I will re-use them a bit less now.

 

[Robinredbreast]

Good grief! I think the diabetic that injected with the needle in the final image must have skin like tree bark! That is ridiculous. There is absolutely no way that a proper needle would be that deformed and curled up after just 6 uses.

Hi, that's why I was so pleased (and surprised too) that Garr posted the photo, as we, the users, cannot see how damaged the needle is The needles nowadays are extremely fine and made basically, for one use.
To test, I used my lunchtime needle for dinner as well last night. It went in normally, but when taking it out, I felt a scrape, a tugging in my skin, so the needle was probably already damaged.

 

[slikwipman]

It might be best practice to change every time, but in reality it makes virtually no difference. One wrong move could be our last if you are not paying attention crossing the road but not reusing your needles. It's important to take one's diabetes seriously but I also think we should all try not to be drama queens about it either. Changing or not changing your needles is a very first world problem.

A very first world problem, does this statement make any sense?

 

[Dillinger]

A very first world problem, does this statement make any sense?

I bite my tongue on commenting on your syntax but this may help as to the apparent question:

https://en.wikipedia.org/wiki/First_World_problem

 

[petepontiac]

Well, after reading everyone's responses to my post, I did a little research & even though the needle manufacturers quote "for single use only" & previous advice from my DN & other Diabetic specialists, many diabetics reuse their needles with no issues other than a little increased pain.
I stand corrected

It is not recommended to keep your needle on your pen, you must remove it after every time you use it

 

[lizdeluz]

As an aside, if, like me, you have been known to forget whether or not you have injected, removing the used needle after your injection can help you know whether you did or did not inject.

For my multiple NovoRapid injections I use an Echo pen, recommended by @noblehead for this forgetting problem: it tells me how many units and how long ago I injected. However, for some reason I couldn't obtain an Echo pen for my Lantus injection. So I remove the needle after injecting the Lantus, just as an aid to memory!

 

[Ultimaf]

I'm the same with test strips (did you know your diabetes nurse or doctor has a record of how many times you've requested a medication) mine was 120% use of test strips (not ketones). So I thought that's strange I test 5 times a day everyday for a month that is at least 150 times a month. Guess how many test strips I'm prescribed per month 100! You would think a GP or somebody of that caliber would work out its not enough?! So I'm paying for a freestyle libre which gives me the flexibility to build a little stock pile up (wrong and very expensive) lets hope it gets sorted...

 

[smc4761]

As a diabetic for over 35 years I have always reused needles, I think it is something that we just did. About 2 years ago on a routine visit to the diabetic clinic I saw a new doctor who was quite superb, spent some time with me and actually asked about my diabetes and various other things going on in my life. He was horrified when I told him that I made needles las about a week. He advised that I should be changing after every injection. Still do not do that perhaps habit but find I now change after 2/3 uses

 

[Shaggy_Dog_1]

To all those that do not change their needles after every injection (and yes, I didn't, as a type 1 since 1967). Before moving onto a pump a few weeks ago, I changed my needles after every pen injection (5 a day, like you). The advantage is twofold. Firstly, when you use a needle the end becomes barbed, and you may cause damage on the second injection, going in, coming out or under the skin. It doesn't happen often, but I noticed a distinct drop in the number of "Wow, that one hurt!" events when I stopped reusing needles. Secondly it is possible to pick up all sorts of stuff on the end of a needle, and it may be rare to get an infection, but the chances are much reduced with a sterile needle every time.

If people want to inject multiple times with the same needle, then that's fine, their choice, but in the NICE guidelines it says "Ensure that the person uses a new needle for every injection."

This about half way down this page http://cks.nice.org.uk/insulin-therapy-in-type-1-diabetes#!scenario

Tell your doctor that NICE guidelines state that you should be given a new needle for each injection, other wise talk to your diabetic nurse or hospital diabetic department (you should be going to one of these as well as your GP) and ask for them to write to your GP. If this has no effect then I would suggest changing your GP.

Good luck

Simon

 

[TJR56]

I always reused my needles one would last a week and in the good old days when we had harpoons for needles and glass syringes were expected to reuse the needles until blunt and if they became blocked we had to shove a bit of wire through the needle to clear it.

Me too. I still re-use needles and have never had a problem. I change them when they begin to lose sharpness. (Never share a needle with someone else, however!)

 

[slikwipman]

I bite my tongue on commenting on your syntax but this may help as to the apparent question:

https://en.wikipedia.org/wiki/First_World_problem

 

[slikwipman]

My syntax is off fighting with klingons as for your link why would I want to read such nonsense

 

[Dillinger]

My syntax is off fighting with klingons as for your link why would I want to read such nonsense

You asked what a common expression meant I provided you a link to it. Pleasure doing business with you.

Post edited by a Mod to remove personal remark.