should you reuse pen needles

I have been told by DSNs that u can use it at least twice before u change it but I change it every time it's uncomfortable otherwise

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OK I need to get this bee out of my bonnet now.

How would we feel if someone came on to one of the Low Carb forums saying Don't eat increased protein, it will give you kidney failure? Saying You Low Carb advocates are a danger to Type 1 kids and their confused parents?

Very similar situations. The "risk of increased protein" view, like the "risk of needle reuse" view, is widely stated by medical professionals, official bodies, and vested interests (the conventional dietician industry in the case of protein, the manufacturers and the lawsuit-averse in the case of needles). In both cases the view is widely stated, and completely lacking in objective evidence. In both cases, there is a plausible "common sense" type of argument, but no data to back it up.

I would like to think that a comment of that type, inserted into a low carb thread, would be deleted by the moderator as unsubstantiated scaremongering, unless it was properly caveated ("some believe there may be a risk") and/or referenced to studies.

I'm not saying that unsubstantiated fear-promoting posts about needle reuse should be deleted by the moderator. I'm just saying people should try to be a bit more balanced in what they are saying, particularly when they don't have a shred of evidence to back it up and are just repeating what is in effect hearsay and conventional wisdom.

This following is a small scale study about needle reuse and there's further references at the bottom of the article:

http://www.journalofdiabetology.org/Pages/Releases/FullTexts/FourthIssue/OA-1-JOD-10-024.aspx

noblehead said:

This following is a small scale study about needle reuse and there's further references at the bottom of the article:

http://www.journalofdiabetology.org/Pages/Releases/FullTexts/FourthIssue/OA-1-JOD-10-024.aspx

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Thanks very much for posting that, Noblehead. I think it's the same study that was posted earlier in the thread. Some points I would make on this

1. Note that it mentions needle deformation is visible on electron micrographs. That I can believe. But the popular images on the web of deformed needles are from optical microscopes of maybe x10 - x20 power. Electron microscopes have power of up to x10,000,000. The images on the web are not electron micrographs.
2. Pain is reasonably solid finding. But the users on here who have done needle re-use are saying to discard the needle if it is painful. That wasn't an option in this study as the experimenters controlled when needles were replaced - in practice, few would continue with a needle once it started to hurt, and that alone would reduce the differences seen between the 3 groups in the needle study.
3. However the pain findings are actually a little odd, because reported pain increases even for the single use group, and the 21-use group reported much less pain after 12 uses than the 12-use group did (40% vs 60%), which is pretty much impossible to explain causally, since at that point both groups had used their needles 12 times. The likely explanation is random variation given the small sample size, only 15 patients per group.
4. While they showed a small (26.6% vs 33.3%) contamination increase between 1-use needles and 21-use needles, they didn't test the needle prior to use. Needles are not guaranteed sterile when issued.
5. The observed bacteria were all harmless. So there is no evidence of harm, only a theoretical small increased risk of harm IF harmful bacteria were to proliferate on the needle, which the study did not find.
6. They find evidence of increased hyperemia, which is noteworthy, but they don't demonstrate any link between hyperemia and lipoma or lipophypertrophy, nor do they adduce a reference for this link. Maybe some of their references establish this link - not clear?
7. One of the most interesting things about this study is that it reports how prevalent needle re-use is in the real population. That suggests that actually the whole diabetic population is a massive uncontrolled experiment in needle re-use. We can then draw some conclusions from what we don't see in the whole diabetic population. We don't see endemic skin infections or lipohypertrophy.

I couple of weeks back I was at my chemist picking up a prescription.
While I was waiting I was called in to the back room & asked to sign a document basically stating I understood the directions of my medication..
The chemist interviewed me making sure I was clear on my prescription use including the once only use of needles...

Regarding the needles & indeed lancets, I assured the chemist I was clear on the "guidelines" however in the real world regarding the bolus out & about I can't say I practice this.. But fully understand the logic behind the guide.

Incidentally it is possible to slide the cover back on a Novopen classic & a "Clickstar" without damaging or even touching the needle fitted for a consecutive use....

Jaylee said:

I couple of weeks back I was at my chemist picking up a prescription.
While I was waiting I was called in to the back room & asked to sign a document basically stating I understood the directions of my medication..
The chemist interviewed me making sure I was clear on my prescription use including the once only use of needles...

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Or what??? Or they would refuse to supply you? I would have refused. That really makes my blood boil (ok it doesn't take much).

Spiker said:

Or what??? Or they would refuse to supply you? I would have refused. That really makes my blood boil (ok it doesn't take much).

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No, I don't think that was the agenda... I seem to remember doing something like that last year too..
I think they were just "covering their own backs"..

I've signed similar things at work before now regarding health & safety and age related sales protocols...

It's just a recorded acknowledgement of training...

I have got the levimar insulin pen and use my needles just the once as we all know or if you didn't you can get new needles from ya doctor
On prescription. Also if you wasn't aware as I diabetic we get free prescriptions anyway just search for the nhs pre paid prescription. Before I became diabetic I was paying for all my meds as I'm disabled but after looking on this web page I found I no longer had to pay for it anymore.
So basically what I'm getting at is change ya needles every time because its cleaner and its free to get more also the re use of a needle gives me the chills I know some of you do but that's upto you but why do it when u don't have to after all they are free!!!

Sean, we all know they are free in the UK, we are thinking about saving the NHS money not ourselves.

Spiker said:

Sean, we all know they are free in the UK, we are thinking about saving the NHS money not ourselves.

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...with an element of wearing the same underpants a second day in a row..!

Spiker said:

Thanks very much for posting that, Noblehead. I think it's the same study that was posted earlier in the thread. Some points I would make on this

1. Note that it mentions needle deformation is visible on electron micrographs. That I can believe. But the popular images on the web of deformed needles are from optical microscopes of maybe x10 - x20 power. Electron microscopes have power of up to x10,000,000. The images on the web are not electron micrographs.
2. Pain is reasonably solid finding. But the users on here who have done needle re-use are saying to discard the needle if it is painful. That wasn't an option in this study as the experimenters controlled when needles were replaced - in practice, few would continue with a needle once it started to hurt, and that alone would reduce the differences seen between the 3 groups in the needle study.
3. However the pain findings are actually a little odd, because reported pain increases even for the single use group, and the 21-use group reported much less pain after 12 uses than the 12-use group did (40% vs 60%), which is pretty much impossible to explain causally, since at that point both groups had used their needles 12 times. The likely explanation is random variation given the small sample size, only 15 patients per group.
4. While they showed a small (26.6% vs 33.3%) contamination increase between 1-use needles and 21-use needles, they didn't test the needle prior to use. Needles are not guaranteed sterile when issued.
5. The observed bacteria were all harmless. So there is no evidence of harm, only a theoretical small increased risk of harm IF harmful bacteria were to proliferate on the needle, which the study did not find.
6. They find evidence of increased hyperemia, which is noteworthy, but they don't demonstrate any link between hyperemia and lipoma or lipophypertrophy, nor do they adduce a reference for this link. Maybe some of their references establish this link - not clear?
7. One of the most interesting things about this study is that it reports how prevalent needle re-use is in the real population. That suggests that actually the whole diabetic population is a massive uncontrolled experiment in needle re-use. We can then draw some conclusions from what we don't see in the whole diabetic population. We don't see endemic skin infections or lipohypertrophy.

Click to expand...

It was just a study I come across Spiker but you do make some valid points, but as said earlier it's entirely up to the individual if they change the needle each time they inject or reuse, however for anyone newly diagnosed its best to get into the habit of changing the needle from the onset IMHO.

Jaylee said:

I couple of weeks back I was at my chemist picking up a prescription.
While I was waiting I was called in to the back room & asked to sign a document basically stating I understood the directions of my medication..
The chemist interviewed me making sure I was clear on my prescription use including the once only use of needles...

Regarding the needles & indeed lancets, I assured the chemist I was clear on the "guidelines" however in the real world regarding the bolus out & about I can't say I practice this.. But fully understand the logic behind the guide.

Incidentally it is possible to slide the cover back on a Novopen classic & a "Clickstar" without damaging or even touching the needle fitted for a consecutive use....

Click to expand...

My pharmacy does these medicine reviews too every 12 months although I try to avoid them and say I'm too busy, it's just to check that you are taking your meds according to the manufacturers instructions or as your Dr directed.

noblehead said:

My pharmacy does these medicine reviews too every 12 months although I try to avoid them and say I'm too busy, it's just to check that you are taking your meds according to the manufacturers instructions or as your Dr directed.

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Yep, I guessed as much...

I think the crux of it is that there are these needle use guidelines that are advocated for a reason.. "Pain limitation, stable/accurate insulin delivery" ..
But let's face it. This is the real world.. I didn't come on this forum to be led on a guilt trip. I am informed as much as I am entertained..
Whatever the point given on this subject...

Jaylee said:

Yep, I guessed as much...

I think the crux of it is that there are these needle use guidelines that are advocated for a reason.. "Pain limitation, stable/accurate insulin delivery" ..
But let's face it. This is the real world.. I didn't come on this forum to be led on a guilt trip. I am informed as much as I am entertained..
Whatever the point given on this subject...

Click to expand...

No one should be judgemental on what other people do Jaylee, I suspect we all have our own ways of managing diabetes and it's no concern of others how we do just that, life is just too short to fall out each other as we are all fighting the same fight

Spiker said:

Paul, how about adducing any kind of actual evidence to back up your opinion on needle re use, before characterising us as potential baby murderers?

.

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My bold and Italics for clarity.

I NEVER said OR implied that and you know it!-you totally misconstrued my real meaning in the context of that some of the posts that suggested that changing a pen needle once a month or so was not a great idea for some people and that it could be confusing to the newly diagnosed or parents of the newly diagnosed,-be it a 2 year old,5 year old 12 year old or whatever-have you considered that a well used needle might possibly be painful for a small child? Evidence you demand? You don't have the authority to bark orders at anyone- It's an opinion of which I'm entitled to and as for saving money for the NHS?-well I'd rather pay more tax so people can have the supplies they need without discomfort! I'm not going to engage in this anymore-sorry if that disappoints you but I really AM out of this conversation now and you are now going on my 'Ignore' list on here as I no longer wish to interact with you again on this forum.

paul-1976 said:

I really AM out of this conversation now and you are now going on my 'Ignore' list on here as I no longer wish to interact with you again on this forum.

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I'm sorry I annoyed you. I did think you were being quite judgemental in your comments. It's always better to keep the discussion calm and reasonable.

Spiker said:

I'm sorry I annoyed you. I did think you were being quite judgemental in your comments. It's always better to keep the discussion calm and reasonable.

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I don't think you were barking orders, I know of two people who felt 'judged' and were told they were 'irresponsible'. I was one of those persons who was surprised at the post questioning my judgment and the other was the person who first posted her experience and then took down her post.

All one has to do is look at the beginning of this thread to see exactly what was written in response to people's experiences and some of what was said was not pretty.

I for one do not understand why for some this common practice is such a flash point? What is the big issue if you change your needle every time or once in 6-months? Why should fellow diabetics be squabbling about this practice and criticizing ones practice that has virtually NO IMPACT on ones longevity either way it is done.

IMO what would be confusing to parents with newly diagnosed diabetic children is the outdated notion espoused by most of the medical establishment that a diet high in carbohydrates is good for diabetics - which we all know is rubbish and will in most cases lead to long term complications. The other issue to me that we should ban together and change is the idea that type 2 diabetics or even pre-diabetics don't need to test their BG on a regular daily basis.

Our frustration should not be turn on one another over an innocuous issue like how many times to reuse a pen needle, but the real misinformation that continues to be presented to us an the newly diagnosed.

When I was first diagnosed, I didn't want to be labeled as a diabetic. I don't feel that way anymore. I am proud to be part of the diabetic community - even though it sucks - and I have enormous feeling of empathy and protectiveness towards all of us struggling with this disease as if we were one big family.


Sent from Runner2009 Burt

When I used the pen I couldn't tell you how often I changed the needle. Probably when I changed the cartridge or when it got painful.
And I injected through clothes. No infections, no lumps or bumps. I've probably got cotton and denim as part of my DNA now.
I'm a terrible diabetic I know. But at one stage I was told by my hospital that I had to buy the needles so this is where it started.



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Mrs Vimes said:

When I used the pen I couldn't tell you how often I changed the needle. Probably when I changed the cartridge or when it got painful.
And I injected through clothes. No infections, no lumps or bumps. I've probably got cotton and denim as part of my DNA now.
I'm a terrible diabetic I know. But at one stage I was told by my hospital that I had to buy the needles so this is where it started.



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Dr. Bernstein wrote that he injected through his cloths too.

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We should start a Terrible Diabetics' Club.

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