needle length

[ebony321]

Hi all,

Since my uncle married his wife (my auntie in law you could say) i've known she also has type 1 diabetes, they live in brighton which is a long long away from where i live so i've only met her once or twice, but recently we all met at a family wedding and we got chatting about diabetes, which was great for me as i don't know anyone else who has t1 diabetes,

anyway the point of this is...

i told her i was currently up to anywhere between 40-60 units of novorapid for EACH meal, im 5''4 and weigh around 9st so as far as i'm aware this is a very high dose... (i don't eat alot, quite healthily and i dont restrict my carbs and dont intend to)

she asked me all sorts of questions to see if there was any advice she could give me... (shes had diabetes since she was 4 so has 28 years under her belt and also works at a hospital so has a little extra knowledge )

she asked what needle size i used... 5mm i said,

she said that must be it, she said the needle may be too small and the reason im needing so much is its not being properly delivered as its small,

i've mentioned this to my nurses before but they said 5mm was fine.

i occasionally get lumps and slight leakage of insulin sometimes but i always thought it was due to a high amount on insulin?

im just asking people opinions on the needle sizes people use and reccomend i should be using,

i want to change to a larger needle to see if this helps but a bit scared of injecting too much as it could be the reaosn so the insulin would be effective, but i also dont want to see that the needle size change is in effective and i havent got enough insulin so im a bit confused on what to do,

i just dont want to inject so much insulin anymore, im willing to try anything! its quite painful to inject up to 60 units at once also, so i usually use 3 injections or more per meal so sometimes anywhere from 6-12 injections a day, and being a small person i very much feel like a pin cushion more than ever

any advice comments ANYTHING would be greatly appreciated

thanks in advance,

ebony

 

[noblehead]

ebony,

There's a couple of things to consider with needle length. One is personal preference, and the other is body fat. As you seemed to be a normal weight for your size, a 5mm needle will do just fine, if your were slightly heavier it may be necessary to use a longer needle. As insulin is injected into the fat under the skin (can't remember name for this) usually longer needles are recommended when insulin isn't delivered into this area properly.

The leakage of insulin can be overcome by leaving the needle in the skin longer after injecting, usually around 10 seconds. Everyone gets a very small dribble of insulin when withdrawing the needle, I wouldn't worry to much unless there is a lot showing.

Nigel

 

[ebony321]

Hi,

thanks for taking time to reply, i do leave the needle in for a while, maybe not always 10 seconds but i dont injected then remove it straightaway so maybe ill try leaving it in for longer, sometimes there is more insulin leakage than other times, sometimes mixed with blood :?:

i'm just worrying as 60 units seems to be alot for someone my size?

and i've only has diabetes for just over a year so i shouldnt be thinking about insulin resistance?

thankyou again noble head

 

[noblehead]

Ebony,

Just re-reading your original post, could you just clarify what you mean here:

i just dont want to inject so much insulin anymore, im willing to try anything! its quite painful to inject up to 60 units at once also, so i usually use 3 injections or more per meal so sometimes anywhere from 6-12 injections a day, and being a small person i very much feel like a pin cushion
ebony

Thanks

Nigel

 

[ebony321]

I

Ebony,

Just re-reading your original post, could you just clarify what you mean here:

i just dont want to inject so much insulin anymore, im willing to try anything! its quite painful to inject up to 60 units at once also, so i usually use 3 injections or more per meal so sometimes anywhere from 6-12 injections a day, and being a small person i very much feel like a pin cushion
ebony

Thanks

Nigel

what i mean is, if a longer needle would prove more effective in delivering insulin that it would mean i could take less insulin i would be willing to try it, or anything anybody could advise...

with having to take so much insulin, it's becoming extremely painful. which means in order to deliver this much insulin i take it in three seperate injections. so 3x3 plus long acting is ten injections a day, then there can be an odd one if i snack throughout the day.


i hope that makes more sense. i can bable so much it becomes confusing


i know alot of people would recommend i reduce my carbs to tackle this issue.

but im a firm believer in controlling my diabetes not letting it control me.

so im looking for a solution and was wondering if people would agree an increase in needle length could help this

thankyou

 

[noblehead]

with having to take so much insulin, it's becoming extremely painful. which means in order to deliver this much insulin i take it in three seperate injections. so 3x3 plus long acting is ten injections a day, then there can be an odd one if i snack

Hi again,

I could offer some more advice if I can just get something straight. So for the 3 meals each day, at each meal you inject novorapid by 3 different doses, injecting 3x instead of in 1 ? It would be helpful to know how you do your injections.

Ebony, do you inject the same amount of insulin at each meal, so you match your carbs to the insulin than opposed to matching your insulin to the carbs you eat, which would give you greater flexibility. A carb counting course such as DAFNE would be suitable here to teach you the method behind this.

I am also on novorapid and lantus, but inject only 4 x daily, so don't quite understand how you inject 10x each day. Please come back with more info.

Nigel

 

[ebony321]

Hi again ,

because its very painful to inject over 20 units at once i split the larger doses into three injections, so whs you would take one for a meal, i would take three as taking just one leaves me with a large lump which usually bruises. so i split it into lesser doses. so for three meals i take 3 injections each along with one longer lasting.

i'm currently waiting to go on the DAFNE course in july as my local diabetes centre only take 8 at a time, i've also tried carbohydrate counting with the cllins gem book, which i failed miserably at, i dont usually take the exact same amount at every meal, i do try to estimate t match the doses to what i eat and have previously seen a dietician but wasn't very succesful.

hope this is more clear for you now

 

[noblehead]

Hi again ,

because its very painful to inject over 20 units at once i split the larger doses into three injections, so whs you would take one for a meal, i would take three as taking just one leaves me with a large lump which usually bruises. so i split it into lesser doses. so for three meals i take 3 injections each along with one longer lasting.

i'm currently waiting to go on the DAFNE course in july as my local diabetes centre only take 8 at a time, i've also tried carbohydrate counting with the cllins gem book, which i failed miserably at, i dont usually take the exact same amount at every meal, i do try to estimate t match the doses to what i eat and have previously seen a dietician but wasn't very succesful.

hope this is more clear for you now

Ok Ebony, I know what you are doing now. I appreciate 20 units of insulin in one injection is a lot and may leave a lump, but could you not do this in two doses in two different locations, this way it would be one less injection for each meal. Although you say you don't take the exact amount each time I've not really had any experience of not being able to inject a large dose before, but it is important to rotate your injection sites regularly to stop lumps appearing in one place. I use both legs, arms, stomach and occasionally buttocks each time to stop this problem developing, so if you don't do this already it may be worth considering.

I don't low-carb either, but I do restrict my carbs to 100-120g a day. To inject 20 units of quick acting insulin such as novorapid, you must be eating quite a few carbs at each meal-time, although you say you don't take the exact amount , a small reduction in carbs would mean less insulin each time. I am almost certain when you get on the DAFNE course in July you will see some big improvements in your diabetes management. On the course they offer advice about insulin injection techniques and the importance of site rotation. They will also teach you to carb count correctly and match your insulin to suit, giving you greater flexibility to adjust your insulin to carb ratio when you feel the need. Also, usually day 3 or 4 of the course, there is a question and answer session with a diabetes consultant and dsn, which will be very useful with the concerns you have.

In the meantime, if these concerns are causing you great distress, ask to speak with your dsn and discuss these matters with them, after all that is what they are there for, and could offer much better advice than I have given you here.

Regards

Nigel