How often do you change your needle?

[Juicyj]

I only change the needle with the vial, met a nurse with type 1 who told me this is what she did so that was good enough for me !

 

[picklebean]

It is DANGEROUS to use your needles more than once!!

I am shocked by the number of replies on here that say they change their needles so little... I use a new one for every injection.

Have you seen photographs of needles before and after use? .... Microscopic level images of the needle degrading... the difference is astonishing. Using an already-used needle is VERY damaging to the tissues and this can cause the build up of lumps under the skin (lipodystrophy) which in turn lead to problems with absorbing insulin and that can then affect blood sugars and overall control. that's not to mention the risk of infection!

It is SO IMPORTANT to change your needles every time - that's what they're designed for - ONE USE ONLY!!

You are putting yourself at risk if you don't change them every time! Just because a nurse thinks it's ok to use them more than once doesn't mean it's true - look at the evidence!


Please, please only use them once and discard.

EDIT: to say that this is where I got the image from

EDIT: a second time to say click on the link to see the full image - I'm not sure why it's cropped here - maybe width limits on the message board and I don't have the software to edit images on this computer. :roll:

 

[johnhnett]

Hi there,

As a rule I use 1 needle per injection unless I'm taking both insulins (i take novorapid and levemire) in which case I use the one.

Sent from the Diabetes Forum App

 

[iHs]

I think that the NHS price for a box of 100 needles is approx £12.

 

[GlazedDoughnuts]

I change mine as when I feel they're becoming blunt/painful to inject with. So sometimes a few days in, some times a couple of weeks in. I've not got any infections, no soreness/red bumps/lumps etc.
My lancet, I've been using the same one for 3 months now...

Guess I'm doing it wrong.

I can't be bothered to change needle/lancet 3-8 times a day.

 

[AMBrennan]

I follow my doctors instructions and change them every time.

 

[candi-girl]

I have a pump but if I need to inject I use disposable syringes. I use a new one for each injection. Lancets.... I change once a day, if I remember

 

[Hobs]

Draw nearer and take notice all those who do not change the needle after each injection ..this is not fiction but 100% true.

Leaving a needle connected to the injection pen is no better than trying to get something nasty into your body. That connected needle can act as a highway for any microbe able to travel up the needle's open end and then comtaminate/breed inside the insulin or whatever is being injected next time.

Do yourself a great favour from now on and change that needle every single time ..you know it makes sense!

 

[ewelina]

At the begining i was changing with every injection. now im a bit lazy :? for lantus i change every time but for novorapid with every other injection. it hurts less when the needle is new and sharp

 

[SamJB]

I'm coming round to the idea that changing it every time might be a good idea, but having done over 10,500 injections in my diabetic life, I've never had an infection. That's a probability of infection of less than 0.001%.

 

[rubecula]

This is a response to Sam's question on how to carry a day's worth of needles if you change the needle after every injection.
Sam, I have just spent two weeks on holiday and for the trip I bought a "Joe's Small-in-one" (http://www.joes-diabetes.com/diabetes-supply-cases.html). It has space for all you need - pens, needles, lancets, dextrose, test strips etc. I have the Freestyle Insulinx meter which is quite large but it fits in there as well. Great product, it worked a treat.
Best wishes,
Robin

 

[Juicyj]

Hey look I dont want to dictate to anyone on here, it's hard enough managing your diabetes without someone telling you what to do and we are all individuals responsible for our own welfare. However I have spoken to my DSN after adding my comment about changing my needle with each vial - and to be honest the convenience of doing this was my top priority as i'm in and out of the car/meetings all day so I just need to inject and go - I would recommend and will do so now (altho it will be a major pain in the butt to do so) to change it each time I inject, am not bothered about cost it's convenience for me. The flipside is having ineffective insulin, infection or just a stomach that will look like a droopy pin cushion in years to come... my car may look like a drug dealers den but best to be safe than sorry !!

-By the way my favourite joke at the moment is that insulin dependent diabetics are the only people taking drugs to stop them from getting high ! :crazy:

 

[glaves_r1991]

I carb count and have the normal 5 aday (background, morning quick , lunch quick and evening quick and background and then an injection for each snack and I only use 5 needles a day I only change at the above Times and in between meals I use the needle I used for the previous meal

Sent from the Diabetes Forum App

 

[JontyW]

I use Lantus SoloStar / Humalog Kwickpen pens and only change the needles when I change the pens. I have always done this for the past 30+ years and have never found any problems with infection or pain etc. When you quote that .. "they are designed for single use", I'm not sure where that came from since it is quite clear that they can be used multiple times with absolutely no problems providing you are careful in handling them. Obviously in surgery and hospital use it has to be "use only once" .....

One advantage of multiple usage is that, in order to clear any air bubbles, you only have to do that once when the needle is added, so this ensures good dose accuracy with no chance of bubbles reducing the dose. On average I use about 3 to 4 needles per month and the last box of 100 needles lasted me over 2 years. Same with finger pricking lancets .. I only change it about once/month (~ 200 uses) and have never had any problems what so ever But I appreciate no everyone may have the same experience.

 

[AMBrennan]

When you quote that .. "they are designed for single use", I'm not sure where that came from since it is quite clear that they can be used multiple times with absolutely no problems providing you are careful in handling them

It says so right on the pack. Which part of "Do not reuse" do you not understand?

Besides, how does your experience allow you to infer what the guy designing the needles was thinking?

Further, Solostar instructions state "Always attach a new needle before each use.". Seriously, RTFM.

so this ensures good dose accuracy

No it does not as you can get the same result by removing air bubbles with a new needle. What's more, the instructions specifically state "Always remove the needle after each injection and store Solostar without a needle attached. This helps prevent [...] entry of air into the insulin reservoir and leakage of insulin which can cause inaccurate dosing". Once again, RTFM - they don't include a square mile of instructions which each pack because they hate trees.

When in doubt consider following the instructions that came with your insulin pen or needle rather than questionable advice from some dude who evidently never read either.

 

[iHs]

Unfortunately, insulin pen needles are not manufactured free of charge to the NHS. They will cost a GP budget approx £40 per month if diabetics use a new needle every time they inject 5-6 times per day.

Although re using a pen needle will cause it to go blunt, I think most diabetics would rather get sufficient bg teststrips every month than get 300 pen needles and boxes of lancets.

 

[phoenix]

Quotes from a paper by BD who undoubtedly gain from more sales if people use once only, personally living in a health system that will pay for once only usage, I'd prefer to err on the side of caution.
http://www.bd.com/resource.aspx?IDX=9660

Electron micrographs were taken at the University of Grenoble, France, during 1997 by Dr. Jacques
Garden of pen needles and lancets that had been used by patients, according to their own normal reuse patterns in the treatment of their diabetes.The needles were then photographed under microscopic powers ranging from 370x to5000x.The observers noted the following (Look,Strauss 1998):
• Significant tip damage can occur after only one injection and was seen with all manufacturers studied
• The majority of needles and lancets showed tip damage when reused, despite the fact that pen needles only penetrate human skin witheach use, not a vial stopper.• Some needles were actually missing their tips— raising the question of whether the tips might be imbedded in the patient’s skin.
• Tip damage did not always increase proportionately with the number of times the needle was used. There were patients whose needles remained in good condition with repeated use. Therefore, skin type and injection technique may play roles in the degree of needle tip damage after use. In actual practice though, all reuse must be discouraged, as the damage occurs to such a small area of the needle tip that it cannot be detected without a high powered electron microscope — even where the needle tip has broken off.

Possible consequences of reuse

1.Tissue microtrauma:When a deformed needle is used, it lacerates tissue, causingmicrotrauma.This can result in locally
significant bruising and bleeding.Volunteers in the German studies who reused lancets were found to have more residual bleeding in sites where a more heavily reused lancet was employed for the blood letting.
2. Embedded needle tips:The studies showed that excessive reuse (>7 times/needle) was often associated with a breaking off of the microscopic end of the needle tip. The medical consequence of embedded metal tips is unknown at this time.
3. Correlation with greater incidence of lipodystrophy: According to the analysis of the German studies cited above, local growth factors may be released and join with insulin to form lumpy nodules called “lipodistrophy.” Although at this time there is not proof that reuse leads to lipodystrophy (“lipos”), there is a correlation between reuse and lipodystrophy.While “lipos” are not frequently reported, it is estimated that 20- 45% of injecting patients with Type 1 diabetes mellitus and 3.6% with Type 2 diabetes mellitus will have “lipos” (Saez-de Ibarra, Gallego 1998) once a search is conducted. These are often easier to feel
than to see and can be disfiguring. People often prefer to inject into them because it is less painful.

It is recommended that those training patients
to inject insulin do the following:
1. Include a discussion on the risks of needle reuse in their patient training sessions.
• Patients should be taught to understand that when they dispose of a syringe, pen needle or lancet after one use, they are not being wasteful, but rather, they are helping reduce their risk of tissue damage and of having needle tips embedded in their skin.
• Since as a practical matter, patients will not be able to examine their reused needles under a high-powered electron microscope,
all patients should be advised to assume that they are among the vast majority of patients in whom the needle tips become hooked or broken off with repeated use.

 

[picklebean]

I use Lantus SoloStar / Humalog Kwickpen pens and only change the needles when I change the pens. I have always done this for the past 30+ years and have never found any problems with infection or pain etc. When you quote that .. "they are designed for single use", I'm not sure where that came from since it is quite clear that they can be used multiple times with absolutely no problems providing you are careful in handling them. Obviously in surgery and hospital use it has to be "use only once" .....

One advantage of multiple usage is that, in order to clear any air bubbles, you only have to do that once when the needle is added, so this ensures good dose accuracy with no chance of bubbles reducing the dose. On average I use about 3 to 4 needles per month and the last box of 100 needles lasted me over 2 years. Same with finger pricking lancets .. I only change it about once/month (~ 200 uses) and have never had any problems what so ever But I appreciate no everyone may have the same experience.

I am NOT trying to be rude at all or personally attack you, but this is such bad practice! Have you read the instructions at all? Please take on board what AMBrennan has posted here! I would urge you to reconsider!!


Phoenix & AMBrennan are right! I totally agree! :clap:


To iHs.... The cost of needles is NOT the issue! If you use needles more than once you are damaging your body and running the HIGH risk of creating complications further down the line through lipohypertrophy and the poor control that ensues, costing the NHS far more money than the inital cost of the needles!

 

[xorsyst]

I used to change needles once per vial and lancet, well, never really.

A DSN at the local hospital managed to get me to compromise a bit to a new needle a day on Novarapid. I tend to stick to one needle a vial on lantus. I've also gone to one lancet per set of strips.

It's not about the cost, it's about the convenience. Having to carry & dispose of test strips puts me off testing at all, it wasn't until about a year ago that I started testing again after doing it only once/twice a month. I really don't want to carry spare needles and the means to dispose of them unless I need to, plus the hassle of continually requesting more supplies from the doctor - it's bad enough with test strips which they only give me 100 of at a time.

Yes, reuse of needles does cause tissue damage, but with reasonable amounts of site rotation it's not too bad, and the risk of infection is pretty low compared to most risks we face.

 

[JontyW]

I use Lantus SoloStar / Humalog Kwickpen pens and only change the needles when I change the pens. I have always done this for the past 30+ years and have never found any problems with infection or pain etc.
...... On average I use about 3 to 4 needles per month and the last box of 100 needles lasted me over 2 years. Same with finger pricking lancets .. I only change it about once/month (~ 200 uses) and have never had any problems what so ever But I appreciate no everyone may have the same experience.

I am NOT trying to be rude at all or personally attack you, but this is such bad practice! Have you read the instructions at all? Please take on board what AMBrennan has posted here! I would urge you to reconsider!!

Phoenix & AMBrennan are right! I totally agree! :clap:

To iHs.... The cost of needles is NOT the issue! If you use needles more than once you are damaging your body and running the HIGH risk of creating complications further down the line through lipohypertrophy and the poor control that ensues, costing the NHS far more money than the inital cost of the needles!

Many thanks for the many feedbacks on my posting, which was not a recommendation for needle reuse, but just my experience in answer to the original question.

So I have considered them all carefully, particularly this link http://www.bd.com/resource.aspx?IDX=9660 to the BD article entitled "A Look at the Reuse of Insulin Needles", and have decided to do a one month trial of changing the needle every injection, and monitor the obvious signs of pain (currently only very occasionally), bruising (currently get some), lipohypertrophy (don't suffer from this as far as I am aware).

But for me the main possible benefit is reduction of variable absorption which 'may' lead to better BG control.

I believe that I have never suffered any of the potential negative aspects of reuse that have been mentioned so far because of 1) good injection technique 2) soft skin 3) large insulin doses and 4) careful handling when inserting the cover.

Thank you for all your inputs on what has been a very interesting question to be asked .... and on which the jury was divided

JontyW